Intrauterine infection: consequences for the newborn. Intrauterine infection in a newborn Intrauterine infection in newborns treatment

Not much time has passed since death from infectious diseases in the first year of life was depressingly common, and in underdeveloped regions of the world the situation has not changed to this day. Fortunately, modern medicine has completely changed this picture in Western European society. Antibiotics, which became widely used in the forties of our century, revolutionized the treatment of infectious diseases in infants; There has also been a significant increase in information about how to combat infectious diseases in general.

Infant mortality, that is, the death rate for children under one year of age, is now a tenth of what it used to be, and infectious diseases, which used to be the leading cause of child mortality, now rank lower on the list.

Universal immunization, compulsory by law in the UK, has prevented terrible epidemics. With the advent of a vaccine in 1950, polio, once a terrible disease that crippled and killed thousands of children every year, became a disease of the past. Measles, which just a few years ago was practically recognizable at first sight, has become so rare that today's medical students are unable to make the diagnosis. Postpartum care, sterilization of artificial milk, infant formula, and technological advances in treatment have stopped the spread and reduced the severity of infectious diseases in newborns.

But for some groups of infants, infections pose a particular risk. Some babies' bodies cannot produce antibodies, others have chronic conditions such as cystic fibrosis, and premature babies are especially susceptible to infections in the first weeks.

Soon after birth, microorganisms, natural flora, begin to accumulate in the baby's body, which form harmless colonies of bacteria on the baby's skin, in the mouth, in the throat and in the intestines. A healthy person is able to coexist with this horde of completely ordinary bacteria, unless they begin to multiply too quickly and get into those parts of the body where they are not supposed to be. We all have natural flora. It is necessary, of course, to distinguish these bacteria from the less common and much more dangerous ones, which we classify as pathogenic, since they can cause disease, and we try to protect the child from them by strengthening his immunity.

Cystic fibrosis (cystic fibrosis) is an inherited disease whose cause is unknown; occurs in approximately one case out of two thousand. This is a general disorder in the body's glands that produce abnormal cells, resulting in excessive sweating, intestinal obstruction and respiratory complications. The pancreas, located next to the liver, is affected in 80% of cases, which makes normal digestion and absorption of fats impossible and leads to insufficient nutrition of the body.
Ma, why does the child not gain weight? Often fatal; average life expectancy is twelve to sixteen years; the risk of recurrence of the disease in a child of the same sex is 1:4.

The reserve of antibodies in a newborn baby is greater than that of the mother. The child receives relatively more antibodies that fight viral infections, and less of those that fight certain types of bacterial infections. When a particular bacterium firmly holds its position, it is usually discovered that the child has not received enough antibodies against it. If anything, nature's accounting seems to have made a mistake. Of course, if the mother herself does not have a certain type of antibody, she cannot pass it on to her child. For example, a child of a mother who has had measles or has been vaccinated against this disease is born with a supply of antibodies that will protect him in the first four to six months. A child born to a mother who has never had measles and has not been vaccinated is susceptible to this disease from birth.

The newborn's supply of antibodies gradually declines, and by the end of the fourth to sixth month, only a very small amount remains to fight infection for the next four to five months. At about three months of age, the baby begins to produce the same antibodies it received from its mother, and by the age of three to four years, antibody production will reach normal levels. Thus, if a child comes into contact with familiar or unfamiliar bacteria in the environment, his body produces its own antibodies.

Some of these infections are very mild and therefore show no symptoms even though antibodies are produced. Immunization is required against those dangerous bacteria from which the child is not protected because he received little or no antibodies from the mother. A good example is whooping cough, or spasmodic cough. Vaccination against whooping cough, diphtheria and tetanus, which a child is given at one of his first visits to the pediatrician, stimulates the production of antibodies against these microorganisms. If a child is not immunized, he will be vulnerable to infectious diseases and will not be equipped to fight them. Some antibodies, such as those against measles, remain in the body for nine to ten months and provide immunity during this period. For this reason, measles vaccination is often delayed until the amount of maternal antibodies has dropped to a certain level.

When can a child become infected?

Firstly, this can happen during the prenatal period, when the baby is still in the womb, and secondly, during or after childbirth. It has long been known about the possibility of intrauterine infection before rupture of the membranes. In these cases, the infection crosses the placenta from the mother's blood supply into the baby's bloodstream.

A classic example of this type of transmission of infection from mother to child is, of course, syphilis. Although this disease has become quite rare, there has been a slight increase in cases of infection. Another disease transmitted by mother to child during the prenatal period is typhoid fever. But most contagious bacterial diseases are well controlled.

Infectious disease exposure in utero came into the spotlight at the end of World War II when it was discovered that the rubella virus could damage the fetus in the first few weeks of pregnancy. A significant number of children whose mothers become infected with rubella in the first three months of pregnancy may become infected with the disease. Mothers themselves may not show symptoms.

The fetus can also be attacked by cytomegalovirus in the second half of pregnancy. Infection can occur through the placenta, and possibly when the baby passes through the affected cervix during childbirth. As with rubella, an infected baby can produce the virus for many months after birth and become a source of infection for others. A child in the womb is also vulnerable to microorganisms, one of which is the causative agent of toxoplasmosis.

After the baby is born, infection from the amniotic fluid and membranes can be directly transmitted to the baby. This can happen if the membranes have burst and labor has not begun. This is why it is so important that the maternity hospital knows that your membranes have ruptured and can advise you when to come to the maternity hospital. Many departments have different opinions regarding how long to wait for labor to begin after membrane rupture. Usually, contractions and labor begin a few hours after your water breaks. But it still happens that nothing happens.

It is generally accepted that if contractions have not begun six hours after the sudden rupture of the membranes, it is worth inducing labor with an intravenous infusion of oxytocin. The reason for this is that the more time passes from the moment the membranes rupture, the more opportunity microorganisms have to penetrate the uterus. A smear is usually taken and antibiotics are sometimes prescribed, but only if labor has not started within twelve hours of the membranes rupturing.

It is worth emphasizing once again that every maternity hospital, every clinic and every gynecologist and obstetrician has its own scheme of action. Nevertheless, today in every maternity hospital, obstetricians make notes about the delivery in order to record the sequence of actions in certain circumstances. These records should continue to be maintained because they allow the decision-making process to be based on the highest standards recorded in them.

Infection during childbirth used to be very common, but precautions taken by modern obstetricians have greatly reduced the risk of infection. Most babies are born in maternity wards under sterile conditions and then transported to the nursery, where the watchword is absolute cleanliness; here they are bathed in antiseptic solutions and the umbilical cord is treated with chemicals to reduce the growth of pathogenic bacteria.

After discharge from the maternity hospital, the child finds himself in a completely different situation. All families are susceptible to infectious diseases that can be passed on to the child, but fortunately, most of these diseases are not a cause for serious concern. Colds, sore throats, diarrhea and so on caused by the virus are common, and a child who has just arrived from the hospital is not protected from these ailments, but for reasons that are not entirely clear, these diseases cause much milder symptoms in the first few months of life.

Newborn babies are susceptible to urinary tract infections, respiratory diseases, cutaneous meningitis or skin infections. In other words, they are susceptible to the same types of infectious diseases as adults. The difference is the speed at which the disease spreads in the newborn. As a result, a disease that is easily curable in older children and adults is usually more of a concern when the patient is an infant. The doctor is more likely to admit an infant with a urinary tract infection, severe diarrhea, or high fever without any specific symptoms. Many infections, even very dangerous ones, can cause nonspecific symptoms in a newborn.

Sometimes an infection can be found in the bloodstream; this disease is known as sepsis; happens extremely rarely. Another possible target for infection is the umbilical cord stump, which is cut off from the bloodstream and not sufficiently protected to withstand the onslaught of bacteria. This inflammation, which is of great concern in underdeveloped countries, is called omphalitis. Proper care of the umbilical cord is mandatory in maternity hospitals, and sanitary conditions have significantly reduced the incidence of this inflammation.

Intestinal obstruction

There are many different causes of intestinal obstruction, even in young children. A foreign body, local inflammation, or tumor can block the intestinal passage. With early detection, most causes of intestinal obstruction can be detected and completely eliminated.

Although intestinal obstruction is rare, it is important to know the symptoms. This is spasmodic pain in the abdominal area, causing the infant to cry excessively, vomiting, flatulence (bloating due to the accumulation of gases) and gradual dehydration, manifested in the usual signs of a decrease in the amount of fluid in the body, such as a dry tongue, wrinkled skin, sunken eyeballs and so on. Whatever the cause of the obstruction, surgical treatment is required.

One of the common causes of obstruction is the so-called meconium ileus (impaired passage of contents through the intestines), which is a rare manifestation of cystic fibrosis. With this disease, something happens to the pancreas during fetal development, and the normal movement of the contents of the child’s intestines becomes impossible. The contents become so sticky that the intestines are unable to push them through, and the intestinal lumen becomes blocked in several places.

Other causes include intestinal volvulus and nodule formation, sometimes in the form of a hernia. In young children, one section of the intestine may nest into the adjacent one (intussusception - see below). It should be emphasized that these diseases are rare, all can be treated surgically and usually do not cause problems in the future.

Intussusception

This is a rare intestinal disease that occurs primarily in infants and young children. Requires medical supervision and surgical intervention. The child screams in severe pain, and his stool resembles lumps of currant jelly. This undeniable appearance of the stool is given by mucus mixed with blood. A section of intestine suddenly invades the adjacent one. Imagine holding a heavy flexible hose or nozzle with both hands, and then bringing your hands together to force the hose to fold. This illustrates with sufficient accuracy what happens during intussusception: a small section of intestine is inserted inside, and with subsequent spasms, an increasing length of intestine gets inside. Blood vessels also enter the interior, blood supply
is disrupted, swelling and necrosis of the area of the intestine that has undergone intussusception is formed.

Obviously the pain is very severe. It can be periodic, with intervals of calm, and is usually a serious reason for parents to contact a doctor. Jelly-like stools will confirm the diagnosis if required. Treatment consists either of administering an enema, which can straighten the intestines, or, if this method does not produce results, in surgery, which will be the only way out. During the operation, a small section of the intestine is either straightened or removed. The prognosis is positive.

Jaundice

This is not a disease, but a symptom that can indicate various diseases and appear at any age. Jaundice manifests itself as a characteristic yellowing of the skin and sclera of the eyes, and mild jaundice occurs in newborns often enough to be considered normal. More than 50% of all newborns experience jaundice within a few days: yellowing usually appears on the second or third day and gradually disappears by the end of the first week. This so-called normal (or physiological) jaundice does not bother the baby in any way and may not attract the attention of the mother, but doctors and nurses in the maternity hospital closely monitor this manifestation.

However, jaundice can be caused by medical conditions that are more serious. The actual physiological cause of jaundice is a yellow pigment called bilirubin, which is usually present in small quantities in the blood of any person.

This chemical is actually a breakdown product of hemoglobin, the red pigment in blood cells that transports oxygen. The body continuously undergoes the process of formation and destruction of red blood cells. They are formed in the bone marrow and live for approximately 120 days. Old cells, that is, those that have lived for more than 100 days, are then destroyed and removed from the blood circulation. These old cells break down and the hemoglobin undergoes a chemical change - the product of this chemical breakdown is bilirubin, which causes jaundice. Bilirubin is then transported by the bloodstream to the liver for further processing, and here, with the exception of a small amount, enters the bile. Bile flows through the bile duct into the duodenum, into the intestinal contents and is excreted from the body.

The remaining bilirubin in the body returns from the liver to the bloodstream. The amount of bilirubin normally present in the body is small, but it can be measured. A chemical analysis, or blood test, can distinguish bilirubin going to the liver from bilirubin that has already been processed and returned to the blood, and it is the amount of bilirubin that reaches a critical level in jaundice.

Hepatitis is a disease that most people associate with jaundice in an adult. In this case, the liver becomes inflamed and cannot fully perform its job of processing bilirubin formed during the normal breakdown of old cells. Therefore, bilirubin accumulates in the blood and the patient experiences yellowing. Another cause is gallstones blocking the gallbladder or ducts; and some types of anemia, in which red blood cells are destroyed so quickly that the liver can't handle all the bilirubin.

The type of jaundice that often occurs in a baby in the first week of life is caused by the fact that the baby's liver has only a limited ability to process bilirubin because it is not yet mature enough. Doctors and nurses can judge how severe a baby's jaundice is by skin color alone. If there is still any doubt, a laboratory test can be done to show the bilirubin level, and this test can be repeated several times to identify changes over the next few days.

In premature babies, again due to immaturity of the liver, the level of bilirubin in the blood increases and yellowing occurs. Breastfed babies are more likely to develop jaundice than formula-fed babies, but this is because the breastfeeding mother produces more of the hormone than normal and it passes into the baby's milk. The child's liver removes this hormone, but the load on the same enzyme that is used to process bilirubin increases.

Another cause of jaundice in newborns, often very serious, is incompatibility of the blood types of mother and child (Rh factor incompatibility).

Finally, as a result of very high levels of bilirubin, or in other words, excessive jaundice, a disease called kernicterus occurs. Not all babies with high bilirubin levels develop kernicterus, but there is a strong correlation between the two. If the level of jaundice becomes very high, degenerative changes can occur, severe damage to parts of the brain, resulting in cerebral palsy and deafness. Needless to say, this is extremely rare and jaundice is not allowed to reach critical levels. Obviously, the primary task of the physician is not only to discover the underlying cause of jaundice, but also to keep the jaundice within safe limits.

Pulmonary collapse

Sometimes air enters the pleural cavity and remains between the lungs, chest and diaphragm; this disease is called pneumothorax. In a newborn, pneumothorax can cause breathing difficulties caused by airway obstruction.

The air present in the pleural cavity can also press on the lungs and thereby reduce the volume of the lungs during inspiration. This may result in rapid breathing and blue coloring. A doctor may diagnose pneumothorax after listening to the chest and taking an X-ray if the child is having difficulty breathing. Treatment depends on the cause: for example, antibiotics if there is an infection, or sometimes the air can be released by inserting a small tube between the ribs and the air space.

Moniliasis (thrush)

This common fungal infection is very common in the vagina of women, and especially during pregnancy. It can also occur in a child, often in the mouth; a child can catch a disease “along the way.” It is easy to treat and does not cause serious problems.

Phenylketonuria

This disease, relatively rare, affects one in ten thousand children, but is very often talked about. First of all, it is a common practice to screen all newborns for phenylketonuria; secondly, this disease is a typical example of genetic transmission of disorders; thirdly, this disease demonstrates the complete interdependence of body and spirit.

Phenylketonuria is a metabolic disorder, or the body’s digestion (absorption) of one of the constituent proteins (proteins), which are called amino acids - phenylalanine. Think of amino acids as the building blocks needed to build all proteins, and the process of digestion as the breakdown of proteins into these small components. Each amino acid is essential for a specific step in the normal process of growth and development.

With phenylketonuria, the body is unable to convert phenylalanine into tyrosine due to a deficiency or impaired production of a certain enzyme. This can be detected by a routine test of a blood sample taken from the baby's heel around the third or fourth day. If this substance, phenylalanine, is not processed properly, it remains in the body in large quantities and its derivatives can damage the brain, causing developmental delays and seizures. Moreover, this can affect the child’s overall physical development and well-being. Children whose disease has become severe eat poorly, vomit, and do not gain weight.

This disease is easily treatable, which consists of switching to a special diet containing exactly as much of this amino acid as the body requires and no more. For example, vegetables and fruits contain little phenylalanine, and artificial milk has been developed that contains all the essential amino acids and a reduced amount of phenylalanine. But still, since treatment is necessary and observation is fraught with difficulties, it was considered necessary to organize treatment centers locally. Today, treatment for phenylketonuria can be completely completed for most children by school time.

Pyloric stenosis (narrowing of the pylorus)

This means that the muscle valve that ensures the outflow of food mixed with gastric juices from the stomach to the beginning of the small intestine (duodenum) thickens and partially or completely blocks the lumen. Since in this case there is no other way for milk and other food to leave the stomach except through the mouth, the child begins to vomit. Vomiting during or immediately after a feeding is the first symptom a parent will see, but for some babies, spitting up small amounts of milk during a feeding is common.

Usually the vomiting is rapid - like a fountain. This differs from regular regurgitation, in which milk flows out in a weak stream. If this vomiting continues, signs of dehydration and starvation develop. Very often, vomiting begins a few weeks after the child leaves the hospital, and is much more common in first-born children and boys. The diagnosis is made upon examination and confirmed by x-ray examination. The treatment is quite simple, consisting of a small surgical operation, well tolerated by infants, during which, under general anesthesia, a small incision is made in the stomach muscle in order to ensure patency of the gastrointestinal tract. Usually the child wakes up after a few hours.

Finally, there is no significant hereditary influence; Therefore, if one child in a family has the disease, subsequent children are only slightly more likely to have it than any other child.

Spinal column defects

Think of the spinal column as columnar rings of bone, held together by ropes, or ligaments, and adjacent to each other in such a way that together they can tilt forward, backward, or sideways. The spinal cord passes through a tube or canal formed by rings stacked one on top of the other, which connects to the brain at the base of the skull. The spinal cord can be compared to a biological cable, consisting of nerve endings that connect the control centers of the brain to the web of nerves that envelop the entire body. Signals in the form of encoded pulses travel through this cable in both directions.

At all levels, from the cervical region to the lumbar region, nerves branch from the spinal cord through spaces between rings of bone called vertebrae. The spinal cord, like the brain, floats in a fluid called cerebrospinal fluid and is located under membranes called the meninges. Thus, the fluid and membrane together form a safety cushion that protects the fragile brain and spinal cord.

Sometimes (the actual reason is unknown) there is a cleft in the bone ring of the vertebra, the ring does not close and a defect of the spinal column remains, the so-called spina bifida, while there is a hole in the spinal column, the length of which can vary from one to five or even six vertebrae.

Spina bifida can be very small and is only discovered when, upon examination, the doctor notices a small depression in the skin of the lower back at the site of the defect, which is sometimes completely normal. But in more severe cases, there is a skin defect and you can see membranes protruding from the cleft, and even see cerebrospinal fluid through the transparent membrane. This is called a meningocele. Some of these cases can be corrected with surgery, while others, unfortunately, can cause problems of varying severity, from mild disability to complete disruption of the functions of the intestines and urinary system.

Thirty years ago, the diagnosis could only be made after the birth of the child, but now this disease is detected with a reasonable degree of accuracy in two ways. First, through a blood test, which is usually done after the sixteenth week at the same time as the Down syndrome blood test, which measures the amount of a substance called alpha-fetaprotein. It is this substance that increases to high levels in spina bifida and sometimes in some cases of hydrocephalus. This analysis is not entirely accurate, but if it does not detect the disease, today most women in our country undergo a mandatory ultrasound examination during the pregnancy period of sixteen to nineteen weeks, during which such defects can be detected and, together with the parents, a decision on further action can be made.

In severe cases, when there is, for example, spina bifida and at the same time hydrocephalus and the prognosis for the child is very unfavorable, it is possible
but it is worth going for an abortion. If not, a prenatal diagnosis may be helpful either by ensuring that the birth takes place in an intensive care unit, where all the facilities necessary for surgery are available, or by ensuring that a variety of specialists are present during the birth so that so that the situation can be assessed as early as possible.

Unfortunately, to this day we do not know why this disease occurs, and once it happens, it often recurs in future pregnancies.

Esophageal tracheal fistula

Some children have a congenital surgical disease, which consists in the fact that the grachea and the esophagus are connected to each other. This is a rare birth defect that can take various forms, but always requires surgical treatment.

If you press at the base of your throat just below your Adam's apple, you can feel your windpipe. It starts from the pharynx, or glottis, and ends in the chest a few inches below the clavicular cavity. At its lower part, the trachea divides into two large branches called bronchi, through which the air you inhale passes into the right and left lungs. The esophagus is located directly behind the trachea, and normally these two tubes, of course, do not communicate. If, due to a developmental disorder, these two tubes communicate, or if the esophagus ends, as sometimes happens, in a blind cul-de-sac, then nothing swallowed - food, liquid or saliva - can enter the stomach.

A child with this disease is in serious danger, and to make matters worse, stomach acid is released through the esophagus into the trachea and lungs, causing a violent reaction with pneumonia. Children with this condition are unable to eat and are prone to lung infections; they regurgitate food back, choke and choke; a serious condition quickly develops. This disease undoubtedly requires surgical treatment in the first few days of life. The results are usually very satisfactory.

Undescended testicles

The testicles of a male child are formed early in fetal development, but they are initially located high in the abdominal cavity and remain there until late in pregnancy. Most boys' testicles descend into the scrotum by the time of birth, but sometimes one or both testicles remain outside the scrotum, and when the doctor examines the newborn, the testicles cannot be felt in the scrotum.

We don't know why this happens. This may be due to underdeveloped testicles and is more common in premature babies. It should be noted that testicles that remain in the abdomen will almost certainly not be able to produce sperm after puberty, even if surgery lowers them to their normal location, the scrotum. Therefore, treatment consists of a relatively simple operation that requires hospitalization for several days, and the prognosis is favorable. The length of the operation will depend on a number of factors. Unless one testicle is descended, it must be operated on no later than puberty, but usually between the ages of five and twelve years. If both testicles are not descended, usually one is operated on in infancy and the other at the age of five or six years.

Defects of the urinary system

Congenital defects of the urinary system are quite common, and since obstruction at any site can have serious consequences for the entire system, and because urine is the body's primary means of eliminating waste, the importance of this topic is obvious.

What do we mean by urinary system? There are two kidneys, ureters, a bladder and a urethra (urethra). Urine is produced in the kidneys, or more precisely, in the nephrons of the kidneys, and accumulates in the cavities of the kidneys, which are called the renal pelvis. The pelvis is drained through a long tube through which urine flows down to the bladder, where it accumulates until it is excreted from the body through the urethra. In women, the urethra is very short, and in men it runs along the entire length of the penis.

It is not difficult to imagine that a urinary tract obstruction in any area will increase the load on other parts of the urinary system. Suppose, for example, that a blockage occurs between the bladder and the urethra. The accumulated urine would stretch the bladder, the bladder would contract to get rid of the urine, thickening its muscle wall, the ureters would have to work harder to push urine into the already full bladder, the urine would begin to flow back up from the bladder and then into the bladder. kidneys Under the increasing pressure of the returned urine, the kidneys would begin to stretch, and this chain of degenerative changes could end in renal failure. A similar picture would arise if the blockage were present in any other area.

How can urinary obstruction be diagnosed?

Sometimes this can be detected by palpation: in the side of the newborn’s abdomen you can feel a kidney that is much larger than it should be. But in some cases, problems arise only after an infection enters the urinary system: difficulties with urination, a thin dripping stream and the complete impossibility of potty training are signals that require attention. Excessive urination, high fever, abdominal pain, nausea, vomiting, and cloudy or bloody urine are all symptoms of a possible urinary tract infection.

There are many tests available to determine if and where the obstruction is located. Today, the fetal urinary tract can easily be seen during ultrasound examination of the mother's abdominal cavity, and abnormalities are often detected. Most of the abnormalities in question can be corrected surgically in the first few years of life.

Source Sanders P. All about pregnancy: day by day. - M.: Eksmo Publishing House, 2005.

Intrauterine infections (UII) are a group of diseases that can affect a baby while still in the womb. They are quite dangerous and can lead to intrauterine fetal death, birth defects, central nervous system dysfunction, organ damage and spontaneous abortion. However, they can be diagnosed with certain methods and treated. This is done with the help of immunoglobulins and immunomodulators and other antiviral and antimicrobial drugs.

Intrauterine infections and their causes

Intrauterine infections - These are infections that infect the fetus itself even before birth. According to general data, about ten percent of newborns are born with congenital infections. And now this is a very pressing problem in pediatric practice, because such infections lead to the death of babies.

This kind of infection mainly affects the fetus in the prenatal period or during the birth itself. In most cases, the infection is transmitted to the child from the mother herself. This can occur through amniotic fluid or by contact.

In more rare cases, the infection can reach the fetus during any diagnostic methods. For example, with amniocentesis, chorionic villus biopsy, etc. Or when the fetus needs to administer blood products through the umbilical vessels, which include plasma, red blood cells, etc.

In the antenatal period, infection of the baby is usually associated with viral diseases, which include:

In the intranatal period, infection largely depends on the state of the mother's birth canal. More often these are various types of bacterial infections, which usually include group B streptococci, gonococci, enterobacteria, Pseudomonas aeruginosa, etc. Thus, Infection of the fetus in the womb occurs in several ways:

transplacental, which includes viruses of different types. More often, the fetus is affected in the first trimester and the pathogen reaches it through the placenta, causing irreversible changes, malformations and deformities. If infection by the virus occurs in the third trimester, the newborn may show signs of acute infection;
ascending, which includes chlamydia, herpes, in which the infection passes from the genital tract of the mother to the baby. More often this happens during childbirth when the membranes rupture;
descending, in which the infection reaches the fetus through the fallopian tubes. This happens with oophoritis or adnexitis.

Symptoms of intrauterine infection in a newborn and during pregnancy

When the fetus is affected by VUI, miscarriages and frozen pregnancies often occur, and the child may be stillborn or die during childbirth. A fetus that survives may have the following abnormalities:

In a pregnant state, it is not so easy to detect infection of the fetus, so doctors do everything possible to do this. It’s not for nothing that a pregnant woman has to undergo so many different tests several times a month.

The presence of intrauterine infection can be determined by tests. Even a smear taken in the chair can show some picture of the presence of infections, however, they do not always lead to intrauterine infection of the fetus.

When an intrauterine infection affects a child shortly before birth, it can manifest itself in diseases such as pneumonia, meningitis, enterocolitis or another disease.

The signs described above may not appear immediately after birth, but only on the third day after birth, and only if the infection strikes the child while moving through the birth canal, doctors can notice its manifestation almost immediately.

Treatment of intrauterine infections

It must be said that not all intrauterine infections can be treated. Sometimes it is impossible to cure them. For such therapy it is first necessary establish the condition of mother and child and only then prescribe appropriate treatment. Treatment with antibiotics is indicated only in particularly dangerous cases. It is also selected depending on the causative agent of the infection. Sometimes it is enough to prescribe immunoglobulins to a woman to maintain the immune system and increase immune resistance to the pathogen.

In some cases, vaccination is done during pregnancy. For example, they can provide a vaccine against herpes. In addition, the duration of pregnancy also influences the treatment methods.

And, it should be noted that the best thing an expectant mother can do is this will prevent the development of intrauterine infection, which will help avoid further problems and pathologies. THEREFORE, it is best to take preventive measures regarding this. Preventive measures include, first of all, pregnancy planning.

At the planning stage, a woman can take all the necessary tests, check her health and eliminate problems, if any. When planning, both partners need to undergo an examination, and if any diseases are detected in a man, he also needs to undergo the necessary treatment.

In addition, already during pregnancy, a woman needs to carefully monitor her hygiene, wash her hands, vegetables and fruits, and hygiene is also needed in relationships with her sexual partner.

Proper nutrition strengthens the body's defenses and has a beneficial effect on a woman's health, which means it is also a good preventive measure against all kinds of infectious diseases.

During pregnancy, a woman should especially closely monitor her health, take the necessary tests and undergo examinations in a timely manner. And even if the doctor talks about possible infection of the fetus, you should not panic ahead of time. Timely diagnosis and modern medicine in most cases have a positive impact on both the health of the expectant mother and the health of the newborn. And even with intrauterine infections, absolutely healthy babies are born.

How can you get an intrauterine infection?

A newborn can become infected in several ways- this is through the circulatory system connecting the mother with him or passing through the birth canal.

How the infection gets to the fetus depends on what is causing it. If a pregnant woman becomes infected with a sexually transmitted infection from her partner, the virus can reach the baby through the vagina and fallopian tubes. In addition, the fetus can become infected through the woman's circulatory system or through amniotic fluid. This is possible when infected with diseases such as rubella, endometritis, placentitis.

These infections can be transmitted both from a sexual partner, and through contact with a sick person, and even through drinking raw water or poorly processed food.

Danger of IUI during pregnancy.

If a woman has previously encountered an infectious agent, then she has developed immunity to a number of them. If it repeatedly encounters the causative agent of IUI, the immune system prevents the disease from developing. But if a pregnant woman encounters the causative agent of the disease for the first time, then not only the mother’s body but also the unborn baby may suffer.

The effect of the disease on the body and its degree depends on how far along the woman is. When a pregnant woman falls ill before twelve weeks, it can lead to miscarriage or fetal malformations.

If the fetus is infected between the twelfth and twenty-eighth weeks, this can cause intrauterine growth retardation, resulting in a low birth weight in the newborn.

At later stages of infection of a child, the disease can affect his already developed organs and affect them. Pathologies can affect the baby's most vulnerable organ - the brain, which continues to develop in the mother's stomach until birth. Other mature organs, such as the heart, lungs, liver, etc., may also be affected.

It follows from this that the future mother needs to carefully prepare for pregnancy, undergo all necessary examinations and cure existing hidden diseases. And for some of them, preventive measures can be taken. For example, get vaccinated. Well, carefully monitor your health so that the baby is born strong.

Today, the lion's share of pathologies in newborns is caused by intrauterine infection. But the most deplorable thing is that such an infection very often leads to serious problems with the child’s health, and even to disability or the death of the baby. Timely treatment can help avoid serious consequences.

Often, a mother who leads a healthy lifestyle and avoids any harmful influences gives birth to a child with serious pathologies. Why? Doctors explain this by low immunity - under any circumstances it decreases during gestation. Against the background of poor reactivity of the body, hidden infectious diseases begin to appear. More often, such a picture is observed in women in the first three months of pregnancy.

What exactly can threaten a newborn baby? Today, the most dangerous viruses for the fetus are:

Rubella.
Cytomegalovirus.
Hepatitis B.
Chicken pox.
Herpes.
Bacteria that cause syphilis, tuberculosis, listeriosis.

An extremely dangerous representative of the protozoan kingdom is Toxoplasma.

Let's take a closer look at each of them and the consequences of intrauterine infection in newborns.

Rubella

As for this virus, it rarely causes serious pathologies in an adult, but for an unformed baby in the womb it is very dangerous. The greatest risk for the baby is when infected before 4 months.

An expectant mother can become infected with this virus through airborne droplets. If the fetus becomes infected, the child may develop complications:

Eye damage.
Underdevelopment of the brain.
Meningitis (that is, inflammation of the membranes of the brain).
Pathologies of the cardiovascular system.
Congenital deafness.
Enlarged liver.
Intradermal hemorrhages.
Enlarged spleen.
Pneumonia.
Stillbirth.
Miscarriage.

It is impossible to cure a child while he is in the womb. Therefore, it is worth checking your immunity for the presence of antibodies to this virus at the preparatory stage for pregnancy and during it.

If the mother does not have immunity to rubella, then it is worth getting vaccinated when planning to conceive a child.

Cytomegalovirus

The main route of transmission of CMV is sexual. There is also the possibility of infection through saliva and blood. This virus migrates to the child only through the placenta. And it is very dangerous for the fetus if infected in the last months of pregnancy.

Possible pathologies due to intrauterine CMV infection:

Hearing loss or absence.
Hydrocephalus (excess fluid that puts pressure on the brain) and microcephaly.
Increased size of the liver and spleen.
Pneumonia.
Blindness.
Stillbirth.
Miscarriage.

The consequences of intrauterine infection in newborns depend on the degree of infection: in case of severe infection, the prognosis is unfavorable - for 30% of children, death occurs in the first year of life. If severe infection was avoided, then there is a high probability of giving birth to a completely healthy child.

AIDS virus

Today, doctors have achieved that an HIV-infected mother can give birth to a completely healthy baby. However, there is a risk of fetal infection.

Children with congenital HIV infection have very weak immunity, and without proper therapy they do not live to see a year. It is not HIV itself that kills them, but concomitant infections. Therefore, it is very important to identify the disease in a pregnant woman in time and begin therapy.

Hepatitis B

The virus that causes this disease can enter the mother's body through sexual intercourse or through the blood. It freely penetrates the placenta to the baby.

Complications in a newborn caused by the hepatitis B virus:

Liver diseases.
Retardation of mental and physical development.
Miscarriage or stillbirth.

It must be remembered that in the absence of symptoms in a pregnant woman, the disease is transmitted to the baby.

Chicken pox

It would seem that this is a harmless disease that almost all of us suffered from in childhood. But chicken pox can cause severe complications if a pregnant woman contracts it. The risk is especially high when experiencing the disease in the third trimester.

Intrauterine infection with chickenpox threatens:

Characteristic rash.
Blindness (due to optic nerve atrophy).
Underdevelopment of the limbs.
Pneumonia.
Underdevelopment of the central nervous system.

The above pathologies are classified as congenital chickenpox syndrome. A woman can become infected with chickenpox through airborne infection.

If at one time the expectant mother already had chickenpox, then upon contact with a person who has all the symptoms, she will transfer immunoglobulins to the child - creating passive immunity.

Herpes

The herpes virus, acquired by the mother through sexual contact, is transmitted to the child when he passes through the birth canal.

Consequences caused by this disease:

Characteristic rash.
Increased body temperature.
Pneumonia.
Yellowness of the skin.
Congenital anomalies of eye development.
Brain pathologies.
Miscarriage and stillbirth.

The herpes virus poses a great danger to the baby’s central nervous system. If brain damage occurs, meningitis, encephalitis, hydrocephalus, etc. develop. Such children have an increased risk of developing cerebral palsy. In this case, congenital herpetic infection does not appear immediately, but after about a month.

This virus is also characterized by transplacental transmission.

Syphilis

When a pregnant woman is infected with syphilis, there is a maximum chance that the fetus will also be infected. The expectant mother can only catch the disease through sexual intercourse. If, when hard chancre appears (the first stage of syphilis), you do not immediately begin treatment, then the following consequences are possible for the child:

Delayed mental and physical development.
Yellowness of the skin.
Rash.
Pathologies of the eyeballs of the ears, as a result – deafness and blindness.
Underdevelopment of the limbs.
Damage to tooth germs.
Premature birth, stillbirth.

Even in the absence of obvious signs of syphilis, a woman can become infected with the fetus, so monitoring the mother’s health is mandatory both when planning pregnancy and at all its stages.

Tuberculosis

One of the most dangerous infections for a child is the causative agent of tuberculosis. If the mother was already sick with tuberculosis before pregnancy, then it is possible to carry and give birth to a healthy child only under the careful supervision of doctors. Many forms of tuberculosis and its combinations with other diseases serve as a reason for termination of pregnancy for medical reasons.

If a woman becomes infected during pregnancy (tuberculosis is spread by airborne droplets), there is a possibility of giving birth to a child already sick with tuberculosis.

Listeriosis

A pregnant woman can encounter listeriosis by eating low-quality meat and dairy products, unwashed vegetables, and through dirty hands after contact with animals. If for a mother infection with Listeria can go unnoticed or with minor intestinal disorders, then penetrating through the placenta, this bacterium causes a number of complications in the baby:

Rash, ulcers on the skin.
Sepsis.
Brain lesions.
Premature birth and stillbirth.

For any manifestations of such an infection in newborns, the prognosis is disappointing (about 40% of infants survive).

Toxoplasmosis

Consequences of toxoplasmosis in pregnant women:

Brain lesions (meningitis, encephalitis, hydrocephalus).
Blindness.
Hepatomegaly, splenomegaly.
Delayed mental and physical development.
Premature birth, spontaneous abortion, miscarriage.

It is easy to avoid any of these infections - just take a responsible approach to the choice of sexual partners, maintain your immunity and regularly visit the doctor during pregnancy planning and the entire period of its management. Timely tests will help prevent the development of such terrible consequences.

Any infectious diseases during pregnancy can cause infection of the fetus. Signs of pathology do not appear immediately, but the consequences can be very severe. Intrauterine infection (IUI) is difficult to diagnose and difficult to treat. Changes in the fetus are manifested by nonspecific symptoms, which cannot always be used to suspect an infection.

Etiology and prevalence

The reasons for the development of intrauterine infection of the fetus are associated with infection of the mother during pregnancy or with the activation of a chronic infection. The exact frequency and prevalence have not been established, not all pregnancies with infection result in childbirth, and the causes of early miscarriage are not always possible to determine. According to various studies, intrauterine infection accompanies up to 10% of all pregnancies.

Etiological factors are various types of microorganisms:

rubella, herpes, hepatitis, HIV viruses;
bacteria of syphilis, tuberculosis, STIs;
protozoa: toxoplasma;
fungi of the genus Candida.

A combination of several pathogens is also common.

There is a concept of a TORCH complex. This abbreviation stands for the Latin names of the most common pathogens that cause fetal diseases. These include:

T – toxoplasmosis;
O – other pathogens, which include syphilis, hepatitis, mycoplasma, candidiasis and many other infections;
R – rubella;
C – cytomegalovirus;
H – herpes.

Intrauterine infections in newborns cause death before 1 year of age in 30% of cases, and congenital malformations in 80% of cases.

Most often, the fetus is affected by viruses, much less often by bacteria and fungi. They can cause disease secondary to viral activation.

Consequences depending on the duration of infection

The greatest danger to the unborn child is primary infection of the mother during pregnancy. Her body must intensively produce protective antibodies, and therefore is not able to protect the fetus. If activation or re-encounter with the pathogen occurs, the consequences are less significant. The mother already has antibodies to the pathogen, so the disease is much easier, and the child is protected by maternal immunity.

The consequences of intrauterine infection for the fetus depend on the period when the infection occurred. In the first 2 weeks of embryo formation, the laying of the main tissues is disrupted, so spontaneous development occurs. It would be more correct to call the outcome of blastopathy a biochemical pregnancy, because the fertilized egg may be at the initial stage of implantation, and the woman will not know about her position. In this case, pregnancy can only be registered through blood tests.

When the pathogen penetrates during 2-10 weeks of gestation, severe malformations are formed, which are a consequence of cell damage and disruption of organ formation. They are often incompatible with life and end in fetal death, stillbirth or death in the first months of life.

Infection of the fetus between 11 and 28 weeks of gestation causes fetopathies. The fetal body is already capable of an inflammatory response; only some organs are affected. But the mechanism of inflammation is not complete. After the first phase - alteration, there is no second - exudation, as a result of which there is an influx of leukocytes and the release of substances that are aimed at localizing the infectious agent. The third phase of inflammation is pronounced - proliferation, when increased synthesis of connective tissue occurs and delimitation of the pathological focus occurs. Therefore, children infected during this period are born with defects of individual organs, often with fibroelastosis, hydronephrosis, and polycystic disease.

If the infection of the fetus occurs late, 28-40 weeks, then a full-fledged inflammatory reaction occurs, which involves several organs. A child is born with encephalitis, nephritis, hepatitis, pneumonia.

Infection can also occur at the time of birth. Inflammation of one or two organs develops, most often the lower respiratory tract and liver are affected, pneumonia and hepatitis are diagnosed.

Signs of infection

Clinical signs of an infectious process in the fetus are nonspecific. During pregnancy, some infections can occur in women with minimal symptoms. Signs of intrauterine fetal infection include diagnosed fetoplacental insufficiency and (FGR). Inflammatory processes are often accompanied by polyhydramnios, less often oligohydramnios occurs.

Low placentation can also be an indicator of the presence of infection in the uterus, often chronic inflammatory processes such as endometritis.

An increase in the size of the fetal liver and spleen indicates an intrauterine disease. Pathology can be suspected at the birth of a child with stigmata of disembryogenesis. These are minor developmental anomalies that do not significantly affect the overall health, but indicate diseases that occurred in utero. These include:

abnormalities in the structure of the skull, low forehead, large brow ridges;
changes in the shape of the eyes, shape of the jaw and chin, curvature of the nose;
excessively protruding ears, lack of natural curvature, tragus;
curvature of the neck, folds of skin on it;
changes in the shape of the chest, abdominal hernia;
short or long fingers, their fusion, transverse groove on the palm, curvature of the fingers;
clitoral enlargement, cryptorchidism, small labia;
birthmarks and age spots, hemangiomas.

But to diagnose pathologies that arose in utero, it is necessary to detect 5 or more stigmas.

A newborn may have respiratory disorders and diseases of the cardiovascular system. Physiological jaundice is more difficult to tolerate and has a longer course. The skin may become covered with a rash, there are neurological disorders, and feverish conditions.

But an accurate diagnosis can only be made after diagnosis.

Risk factors

The mechanism of transmission of intrauterine infection can be of three types:

ascending – from the mother’s reproductive tract;
transplacental – from foci of chronic or acute infection in the maternal body;
descending - through the fallopian tubes;
intrapartum – during childbirth.

Taking into account the possible routes of infection of the fetus, during the preconception period, a woman needs to sanitize the foci of existing infection. It is necessary to achieve remission in chronic infectious pathologies (tonsillitis, sinusitis, cystitis), sanitation of the oral cavity, and treatment of carious teeth.

Risk factors have been identified that increase the likelihood of developing IUI. An acute inflammatory process that occurs during pregnancy, especially for the first time, significantly increases the chances of infection of the fetus. In the first trimester, when the placenta has not yet formed, there is a greater likelihood of influence from bacterial flora. In subsequent trimesters, when the placenta is already capable of retaining large cells of pathogens, viral pathology more often develops.

Chronic lesions can lead to the spread of pathogens hematogenously, lymphogenously or by implantation. The risk of disease increases with decreased immunity. Mild immunosuppression is a natural process. This occurs under the influence of progesterone, which suppresses local protection to prevent rejection of the fertilized egg, which is partially foreign to the mother's body. But long-term chronic diseases, somatic pathologies, hypothermia and overheating, and stressful situations can further suppress the immune system.

Violation of placental permeability, which occurs during a pathological course of pregnancy, increases the possibility of the infectious agent passing to the fetus. The placenta itself is also affected; foci of hemorrhages, calcifications and various inclusions may appear in it, which impair the flow of blood to the fetus. This leads to its chronicity and developmental delay.

Poor social conditions are also a risk factor. Conditions arise for poor hygiene, and contact with infectious patients is possible. Women from low social strata are more likely to be infected with sexually transmitted infections.

Characteristics of major infections

Each disease has its own characteristics, pathogenesis, course and intrauterine infection.

Toxoplasmosis

Congenital toxoplasmosis develops when infected after 26 weeks; the likelihood of such an outcome increases as the time of birth approaches. If infection occurs in the early stages, spontaneous miscarriage or fetal death occurs.

The classic triad of signs is chorioretinitis, microcephaly and hydrocephalus. But it doesn't always happen. Given the severe malformations of the fetus and its disability, pregnant women who have had toxoplasmosis are offered abortion for medical reasons up to 22 weeks.

Herpes simplex

Herpes simplex viruses are most common among adults. The first type predominantly manifests itself as a rash on the lips, while the second affects the anogenital area. Viruses can remain latent for a long time and only appear when the immune system is weakened.

The placenta protects the fetus well from infection, so cases of congenital herpes are rare. Intrauterine herpes infection is possible with viremia in the mother during primary infection during gestation. If this happens in the early stages, spontaneous abortion is possible. In later stages, IUI is characterized by damage to various organs.

Late-term genital herpes can lead to infection during childbirth. If this is a relapse of the disease in the mother, then the child will be protected by her antibodies. With primary infection, severe damage to the newborn occurs.

For a newborn, herpes threatens neurological complications. Their severity depends on the time of infection. The earlier, the more extensive the damage to the nervous system and the more severe the manifestations. Signs of damage to the nervous system, encephalitis, do not appear immediately, but 2 weeks after birth. If left untreated, death occurs in 17%.

With primary infection of genital herpes (in the later stages), severe damage to the newborn occurs, often leading to death

Measles

The virus is transmitted by airborne droplets. Pregnancy does not affect the clinical manifestations of the pathology. The effect of the measles virus on pregnancy is controversial. The risk of teratogenicity is low, but there is evidence of damage to the membranes and the threat of premature birth in women with measles.

A newborn only becomes ill if the mother becomes ill 7 days before birth or within a week after birth. Manifestations of pathology can be different - from a mild course to a fulminant course, which ends in death. Infection postnatally leads to mild manifestations of the disease that are not dangerous for the child.

Diagnosis is carried out based on the characteristic clinical picture and by detecting antibodies. Treatment is symptomatic.

Vaccination against measles during gestation is contraindicated. But this pathology is included in the calendar of preventive vaccinations carried out in childhood.

Numerous types of intrauterine infections are diagnosed during pregnancy only when clinical manifestations of the disease occur. The exception is such dangerous diseases as HIV and syphilis. Also, a woman must be examined for gonorrhea. Smears, which are taken at regular intervals and when complaints of discharge occur, help sanitize the genital tract and prevent infection during childbirth.

Intrauterine infections Localized and generalized purulent infection: causes and epidemiology Omphalitis, pyoderma, mastitis, conjunctivitis: clinical picture Treatment of localized purulent diseases Sepsis of newborns: etiology, pathogenesis, clinical picture, diagnosis, treatment, prognosis Prevention of purulent-septic diseases

Intrauterine infections

Intrauterine infections of newborns(IUI) are infectious diseases in which pathogens from an infected mother penetrate to the fetus during pregnancy or childbirth.

In newborns, IUI manifests itself in the form of severe damage to the central nervous system, heart, and organs of vision.

The time of infection of a pregnant woman, as well as the type and virulence of the pathogen, the severity of infection, the route of penetration of the pathogen, and the nature of the course of pregnancy are important in the development of the disease.

Infection of the mother occurs from Toxoplasma-infected domestic animals and birds (cattle, pigs, horses, sheep, rabbits, chickens, turkeys), wild animals (hares, squirrels). The mechanism of transmission is fecal-oral through unwashed hands after contact with soil contaminated with animal feces, consumption of unpasteurized milk, raw or undercooked meat; hematogenous - during transfusion of infected blood products. A person infected with toxoplasmosis for others not dangerous.

Infection from mother to fetus is transmitted through the placenta only once in a lifetime, if she was infected for the first time during this pregnancy. During a subsequent pregnancy or in the event of an illness before pregnancy, the fetus is not infected. This is due to the fact that the mother’s body has already developed high immunological activity to this pathogen.

Damage to the fetus in the first trimester of pregnancy leads to miscarriages, stillbirths and severe organ damage. When infected in the third trimester of pregnancy, the fetus is less likely to become infected, and the disease manifests itself in a milder form. Toxoplasmosis can be asymptomatic for a long time and can be detected in children at an older age, even at 4-14 years of age.

There are acute, subacute and chronic phases of the disease. Clinical symptoms of an infectious disease are varied and not always specific. For acute phase(generalization stage) is characterized by a general serious condition, fever, jaundice, enlarged liver and spleen, maculopapular rash. Possible dyspeptic disorders, interstitial pneumonia, myocarditis, intrauterine growth retardation. Damage to the nervous system is characterized by lethargy, drowsiness, nystagmus, and strabismus. The fetus becomes infected shortly before the birth of the child, and a severe infection that begins in utero continues after birth.

IN subacute phase(stage of active encephalitis) a child is born with symptoms of central nervous system damage - vomiting, convulsions, tremors, paralysis and paresis, progressive micro-, hydrocephalus are detected; changes in the eyes are observed - vitreous opacities, chorioretinitis, iridocyclitis, nystagmus, strabismus.

IN chronic phase Irreversible changes in the central nervous system and eyes occur - micro-, hydrocephalus, calcifications in the brain, delayed mental, speech and physical development, epilepsy, hearing loss, optic nerve atrophy, microphthalmia, chorioretinitis. Infection of the fetus occurs in the early stages, the child is born with manifestations of chronic toxoplasmosis.

Treatment. IN pyrimitamine preparations are used in treatment (chloridine, daraprim, tindurine) in combination with sulfonamides ( bactrim, sulfadimezin). Combination drugs are used fansidar or Metakelfin. Effective spiramycin (rowamycin), sumamed, rulid. For active inflammation, corticosteroids are indicated. Multivitamins are a must.

To prevent toxoplasmosis, it is important to carry out sanitary educational work among women of childbearing age, identify infected women among pregnant women (screening test at the beginning and end of pregnancy), and prevent contact of pregnant women with cats and other animals;

Wash your hands thoroughly after handling raw meat. Identified infected women are treated in the first half of pregnancy spiramycin or terminate the pregnancy.

Congenital cytomegalovirus infection. The causative agent of the disease belongs to DNA viruses from the herpes family. The disease is characterized by damage to the salivary glands, central nervous system and other organs with the formation of giant cells with large intranuclear inclusions in their tissues.

The source of infection is only a person (patient or virus carrier). The virus is released from an infected body in urine, saliva, secretions, blood, and less often with feces. Shedding the virus in urine can last for several years. The transmission mechanism is predominantly contact, less often airborne, enteral and sexual.

The source of infection for newborn children is mothers who are carriers of the cytomegaly virus. Viruses penetrate to the fetus through the placenta, ascending or during childbirth, to the newborn - with infected milk, through transfusion of infected blood. Infection during childbirth occurs through aspiration or ingestion of infected amniotic fluid or secretions of the mother's birth canal.

Signs of the disease may be absent in pregnant women. asymptomatic form). If a latent infection is activated in a pregnant woman, a less intense infection of the placenta is observed. Due to the presence of specific IgG antibodies in the mother, less pronounced damage to the fetus is observed.

Damage to the fetus in early pregnancy leads to miscarriages and stillbirths. A child is born with malformations of the central nervous system, cardiovascular system, kidneys, lungs, thymus, adrenal glands, spleen, and intestines. Organ damage is fibrocystic in nature - liver cirrhosis, biliary atresia, kidney and lung cysts, cystic fibrosis. Viremia and release of the virus into the external environment are not observed, since it is in a latent state.

If infection occurs shortly before birth, during labor, the child is born with generalized form disease or it develops soon after birth. It is characterized by clinical symptoms from the first hours or days of life, involvement of many organs and systems in the process: low birth weight, progressive jaundice, enlarged liver and spleen, hemorrhages - petechiae, sometimes resembling “blueberry pie” on the skin, melena, hemolytic anemia, meningoencephalitis and small cerebral calcifications around the ventricles. Chorioretinitis, cataracts, and optic neuritis are detected. When the lungs are affected, children experience persistent cough, shortness of breath and other signs of interstitial pneumonia.

Localized form develops against the background of isolated damage to the salivary glands or lungs, liver, or central nervous system.

Diagnostics. Laboratory diagnosis is based on the results of cytological, virological and serological studies. The virus is isolated in urine sediment, saliva, and cerebrospinal fluid. Serological methods - RSK, PH, RPGA - confirm the diagnosis. ELISA, PCR and D NK hybridization are used.

Treatment. During treatment, you should make sure that there are no pathogens in the mother's milk. A specific anti-cytomegalovirus 10% immunoglobulin solution is used - cytotect, sandoglobulin(IgG). Use pentaglobin - IgM, KIP, antiviral drugs (cytosine arabinoside, adenine arabinoside, iododeoxyuridine, ganciclovir, foscarnet). Syndromic and symptomatic therapy is carried out.

It is important to observe the rules of personal hygiene when caring for newborns with jaundice and toxic-septic diseases. All pregnant women are examined for the presence of cytomegaly.