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Infections that occur during childbirth are an important direct factor of maternal morbidity and mortality in all countries, and can have long-term sequelae in the mother, such as chronic pelvic pain, obstruction of the uterine tubes, and infertility. In addition, maternal infections before or during childbirth cause one million newborn deaths annually. In today's post I want to tell you what the most common infections in pregnancy that can complicate delivery.
Infectious diseases represent a common problem for the obstetrician in the management of pregnant women. Some, such as urinary tract infections, endometritis (infection inside the uterus) and mastitis (infection at the level of the breast), pose a risk mainly to the mother.
Others, such as group B streptococcal infection, herpes simplex infection, rubella, cytomegalovirus infection, and toxoplasmosis are the main concern for the gynecologist and for the pregnant woman due to the risk of complications of the baby in the gut. mother or at birth. Still others, such as human immunodeficiency virus (HIV) infection and syphilis, can cause serious problems for both mother and baby.
Under normal conditions, the vagina has germs that coat its walls and protect it naturally. Of these, the most abundant is the Doderlein bacillus, which protects the vagina from infection. In the months of pregnancy it is important that this delicate balance is maintained and, in this way, prevent dangerous germs from growing.
When you are pregnant, hormonal changes and the pH of the vagina occur, which can favor the appearance of infections, which can complicate the moment of delivery, so you must be very vigilant and inform your doctor without delay if you feel or suspect that you can have some. The most commons are:
It is very frequent and does not necessarily imply that the infection is from abroad, it is generally due to a change in pH, an increase in the consumption of sugars or the taking of antibiotics. Its symptoms are itching accompanied by lumpy white discharge. Its treatment is with ovules or vaginal cream.
It is an infection generally caused by Gardnerella vaginalis. It produces abundant fluid flow with a bad smell and can predispose to premature labor, premature rupture of membranes, chorioamnionitis (infection of the bag or sac in which your baby is wrapped, of the placenta and of the amniotic fluid) and endometritis. The diagnosis is made by the clinical findings and a vaginal smear will corroborate it. Treatment is medical, and generally the cure rate is 90%.
It is caused by a protozoan that has movement and is very well seen under a microscope. This infection is transmitted sexually, causes itching, pain and discharge with small bubbles. Generally it inflames the cervix and the treatment is indicated as a couple.
- Syphilis, herpes, HIV or hepatitis
They produce infection, malformations or sequelae in the baby. They are sexually transmitted and tests are indicated throughout the pregnancy to verify if the mother has them. On the other hand, listeriosis, Escherichia coli or Streptococcus agalactiae infections can lead to infections in the baby, even compromising his life.
Group B Streptococcus (GBS) infection
They are bacteria that can be found in the vagina and rectum of the pregnant woman. From 10% to 30% of pregnant women are colonized with Group B Streptococcus in the vagina or rectum, transiently, chronically, or intermittently. The risk of infection in the newborn is 25 times higher in mothers in whom the presence of GBS has been detected than in those with negative cultures. On the other hand, between 1 and 2% of newborns of a colonized mother will develop an early neonatal infection (commonly septicemia, pneumonia or meningitis), hence the importance of intrapartum antibiotic prophylaxis, which has been shown to be very effective in reducing the incidence of early neonatal infection.
We have already tried the risk of infection at the time of deliveryHowever, there are preventive measures to minimize this risk of infection, such as:
- Carry out the preconception consultation. Your doctor will evaluate your risks and will order laboratory tests to rule out the presence of any of these infections and will make sure that you have been vaccinated against rubella, chickenpox, hepatitis B before trying to get pregnant.
- Start prenatal care early and if you have any infection they will indicate the appropriate and timely treatment.
- Go to scheduled prenatal checkups on time and perform all the laboratory tests that they indicate.
- Eat a balanced diet rich in fruits and vegetables and exercise outdoors (if there is no contraindication).
- Wash food well and cook it very well especially meat, chicken, seafood and fish (do not eat them raw).
- Regularly wash your hands with soap and water (before and after preparing food, before eating and after going to the bathroom).
- Avoid contact with cat and other animal feces to reduce the risk of contracting bacteria and parasites that cause infections such as listeriosis and toxoplasmosis.
- Do not eat fresh cheeses or raw milk.
- Practice safe sex (with protection) to avoid contracting sexually transmitted diseases (STDs) that can lead to congenital infections.
And, above all, if you have any doubts, consult your doctor!
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