Ureaplasmosis symptoms in pregnant women. Is ureaplasma dangerous in women during pregnancy - consequences for the fetus, the norm in tests and treatment. Ureaplasma and ureaplasmosis
And there were tests.
This is necessary to identify various diseases and infections that can harm the unborn baby and lead to serious complications.
Basically, these are infectious diseases of the genital tract, which include ureaplasmosis.
By learning about the disease before conception, you can receive the necessary treatment and get rid of the infection. However, this does not always work out.
According to medical statistics, most people suffer from a latent and asymptomatic form of ureaplasmosis, without even knowing it. After all, very often a problem in a woman is detected already during pregnancy.
It is impossible to ignore the infection, as it threatens with serious complications and a negative effect on the child, but antibiotics that will have to treat the disease can also adversely affect the formation of the fetus. Therefore, expectant mothers are lost in conjecture, in search of the right solution.
The disease took its name from the pathogenic protozoan Ureaplasma urealyticum, parvum (ureaplasma urealyticum and parvum). It is this bacterium that is the main causative agent of infection.
Affected by infection, the cervical os of the uterus may open prematurely, expelling the fetus.
- risk of ectopic pregnancy.
- High risk of developing postpartum endometritis.
After childbirth, ureaplasmosis increases the risk of developing inflammation of the uterine mucosa, that is, endometritis. Also among postpartum complications, inflammation of the appendages is noted.
If the baby was infected while passing through the birth canal, so that the infectious agents got on the mucous membranes of the genital organs or the membranes of the respiratory tract, then the consequences can be very serious.
There are rare cases when ureaplasma caused the development of diseases of the brain and lungs, up to death.
To determine the degree of danger to a woman or fetus, it is necessary to conduct a special diagnosis.
What are the symptoms of the disease?
During pregnancy, ureaplasma in women manifests itself in exactly the same way as any other classic disease of the genitourinary organs. Often a woman may not feel or notice anything special at all.
If you do not go to the doctor, then the disease is already detected in a chronic form, when it affects not only the genitourinary organs, but also the organs of the abdominal cavity and small pelvis. Usually, signs of ureaplasmosis can make themselves felt a few weeks (3-5) after infection.
Possible symptoms include:
- small clear vaginal discharge;
- discomfort during urination;
- with inflammatory processes in the appendages or in the uterus, a woman may feel pain and spasms;
- in case of oral infection, pharyngitis or tonsillitis occurs;
- in men, symptoms of prostatitis are possible;
- the most pronounced symptom is vulvovaginitis in various forms and other inflammatory processes.
Often the first symptoms go unnoticed, they may even disappear after a while. But the micro-organisms remain, waiting for an even greater decline in your immunity to manifest with renewed vigor the next time.
Diagnosis of a dangerous infection
The ideal option is to identify and treat the disease before pregnancy.
It is possible to plan pregnancy after treatment of ureaplasma only after 2-3 months. It takes time for the drugs to be completely eliminated from the body.
If a woman is already expecting a baby, but the examination has not been previously carried out, then the diagnosis is made only in cases where there is a suspicion of the presence of an infection.
Now there is a whole combination of different methods to determine the presence, type and extent of the disease. Only a doctor will be able to advise you on which examination to undergo.
PCR method
This analysis is able to detect ureaplasmas in a smear from the affected area of the mucosa (vagina, urethra, cervix). Thanks to the polymerase chain reaction, it is possible to identify the DNA of the pathogen and understand whether microorganisms are contained in the material obtained.
As a rule, most women have them. True, it will not be possible to determine in what quantity they are present in you by this method.
The norm of opportunistic microorganisms during pregnancy is considered to be: less than 10 * 3 per 1 ml. If this titer becomes larger, only then do doctors talk about inflammation and make a diagnosis of ureaplasmosis.
Culture method or bacteriological seeding
To conduct this study, ureaplasmas will be grown on an artificial nutrient medium in the laboratory.
For analysis, you will need your smears from the vagina (or urethral mucosa), from the cervical canal, as well as the collection of morning urine.
Thanks to the results obtained, specialists will be able to determine how much ureaplasma is present in your body.
This can only be done by a bacteriological method, which allows not only to talk about the possible degrees of development of the disease, but also allows you to identify how resistant and sensitive the microorganisms are to specific antibiotics. This is how the effectiveness of the treatment is tested.
In parallel, the doctor will ask you to take general tests.
Detection of antibodies in the blood or serological method
This study is used to identify certain antibodies to the characteristic structures or antigens of ureaplasmas.
He will need to donate blood from a vein.
In addition, a woman should undergo examinations by a gynecologist. To make an overall assessment of the disease, experts sometimes recommend screening for other infections that may accompany ureaplasmosis.
Serious reasons serve as indications for tests: pathologies or miscarriage, frequent miscarriages and spontaneous abortions, infertility, signs of acute inflammation, etc.
How to treat ureaplasmosis during pregnancy?
This point remains the subject of controversy in the medical community.
Since the treatment of the infection includes taking antibiotics and other drugs that are unsafe for the developing baby, then in the early stages of pregnancy, ureaplasmosis is simply observed.
Experts believe that the treatment of infection is advisable only when clinical manifestations of inflammatory processes are present, and when microorganisms are found in a titer exceeding the norm.
Since doctors do not focus on isolated cases of the consequences of an infection, if its single stamps are found in the analyzes or in the absence of complaints, treatment is not prescribed.
If the pregnant woman has complications, then they begin a slow phased complex therapy, which must pursue two goals: to maintain the pregnancy and cure the disease.
The most important condition is to abstain from sexual intercourse (even with contraception). Also remember that both partners must be treated, otherwise they will continue to infect each other.
To destroy harmful microorganisms, you will have to take antibiotics.
True, the infection may well adapt to them. As already described above, the effectiveness of the treatment will be able to testify to the bacterial culture.
You will definitely need to complete the full course of admission, following all the rules of the instructions and recommendations of the doctor. As a rule, the antibacterial method is used only after 20-22 weeks of pregnancy in order to allow all the main systems and internal organs of the baby to form correctly and normally.
Among the drugs that are usually prescribed for ureaplasmosis, the most common are: Erythromycin, Viferon, Vilprafen and others.
Treatment of ureaplasmosis should begin only in the second trimester of pregnancy.
In the 1st trimester, treatment of ureaplasma is not advisable, since the harm from antibiotic therapy will be greater than the presence of an infection in the body.
After long-term treatment, a woman needs to be re-tested for ureaplasmosis, as well as conduct a comprehensive diagnosis of the fetal condition:, in the 3rd trimester.
The body of each woman requires an individual approach, therefore, only a doctor can manage the treatment, based on a specific case. If ureaplasmosis has not been cured during pregnancy, then the newborn is examined without fail, since the consequences of infection are very severe. Treatment for the baby is prescribed depending on what tests and examinations show.
Disease prevention
Get rid of a lot of unpleasant moments will help you. So you can safely pass the examination and be treated without much fear if the infection is detected.
The expectant mother should be attentive to her health: avoid promiscuous sexual intercourse, protect herself during sexual intercourse, maintain her immunity at the proper level, regularly visit a doctor for preventive examinations.
Do not diagnose yourself and do not make any appointments on your own, especially during pregnancy. If infection with ureaplasma did occur, you should not panic: by seeking qualified medical help in time, you can recover from the infection and give birth to a healthy and strong baby.
During pregnancy, a woman is recommended to undergo a series of tests, during which it is possible to detect parvum ureaplasma. Under favorable conditions, an opportunistic bacterium begins to activate and multiply, which leads to ureaplasmosis. Until recently, this pathology belonged to a number of STDs, but later, according to the international classification of ailments, it was excluded from the list of diseases that are sexually transmitted.
It is worth noting that parvum ureaplasma may not manifest itself in any way. Therefore, during pregnancy planning, a woman may be completely unaware that she is a direct carrier of a pathogenic microorganism. If special tests have not been carried out and ureaplasma parvum has not been detected, then the bacteria are transmitted from mother to fetus.
If a woman is planning a pregnancy, it is recommended that you first conduct all the necessary tests, and in particular those that detect infections that are sexually transmitted by unprotected. In this way, the presence of bacteria can be detected and treatment can be started immediately. Otherwise, parvum ureaplasma can be confirmed already during the gestation period, then there is a possibility of infection of the child.
The complexity of the disease lies in the fact that the visible symptoms are completely absent, and the pregnant woman absolutely does not complain about her condition. If the results of the analysis show a concentration of 10 * 4, then urgent treatment is necessary. This is explained by the fact that at such a concentration, the bacterium affects the respiratory system of the child, causing a neonatal form of pneumonia.
Carefully! In the absence of timely treatment, the prognosis is not favorable - spontaneous abortion.
Deciphering the diagnosis
After receiving the test results, the patient should go for an examination to a gynecologist, who will determine the possible risks and treatment regimen. Detected bacteria from the ureaplasma series can be included in a single definition - ureaplasma spices. In the absence of pregnancy, these bacteria are less dangerous for a woman, on the contrary, they pose a great danger to a pregnant woman - pregnancy failure, since during this period the bacteria have excessive activity. An indicator over 10 * 3 is considered dangerous, because then the inflammatory process begins. This titer determines the diagnosis of ureaplasmosis.
When it is planned to conceive a child, then parvum ureaplasma should be completely cured by taking antibiotics. If therapy is not used, then pathologies can be observed when carrying a baby. The course of treatment and the drug complex for the elimination of ureaplasma during pregnancy is determined by the attending physician. Self-medication is strictly prohibited!
What is ureaplasma titer?
To diagnose the presence of ureaplasma parvum, a special PCR method is used. To determine the sensitivity of pathogenic bacteria to antibiotics and other drugs, it is necessary to conduct a quantitative analysis, followed by sampling of microflora for inoculation.
Indicators of ureaplasma parvum
The influence of bacteria on the condition of the fetus and the well-being of a woman is determined by their number in the body, according to research.
| Indicators during pregnancy | a brief description of |
|---|---|
| Norm | All results that show less than 10 * 3 microbial bodies per milliliter of discharge are within the normal range and do not pose a threat to pregnancy |
| within 10*3 | This indicator is determined by a mild degree of danger, therefore, it does not require the use of antibiotics. Treatment is based on vaginal suppositories and other drugs that can restore the vaginal microflora |
| Over 10*4 and 10*5 | Such indicators in the body report the activation of the inflammatory process, which threatens the fetus, therefore, antibiotic therapy is mandatory. |
The influence of ureaplasma parvum on the condition of the fetus and the health of women
According to gynecologists, the maximum threat to the fetus is determined if the infection occurred for the first time through sexual contact during pregnancy. Then this can lead to the following serious consequences:
- Freezing fetus.
- Fetoplacental insufficiency, which ends with fetal fading.
- premature delivery.
- Infection of the fetus through plasma, which leads to developmental delays and the subsequent occurrence of various ailments.
- A child is born underweight and with defects in the internal organs.
Attention! Parvum ureaplasma is extremely dangerous if infection occurs in the first months of pregnancy - this, in most cases, ends in a miscarriage or fetal fading. Therefore, it is very important during pregnancy to take all additional tests in a timely manner, as well as use barrier contraception.
Despite the above complications, it is possible to become pregnant and maintain pregnancy with ureaplasmosis if the correct therapy is started on time. That's just all the same, the baby will suffer from a violation of the uteroplacental blood flow, which will negatively affect his condition during gestation.
It is very important to note that this ailment is dangerous both in the initial months of pregnancy and during childbirth. A dangerous effect on the body after childbirth is not excluded. Two main reasons have been identified:
- Vertical infection of the baby when he overcomes the birth canal.
- Positive indicators of ureaplasma can lead to inflammatory processes in the appendages after childbirth.
Do not forget that treatment can do enough harm, because only antibiotics can block the reproduction of pathogenic microbes. Taking this group of drugs leaves the risk of abnormal development of the fetus, and in the worst case, the fading of pregnancy. As a result, a woman needs to undergo all sorts of tests before getting pregnant, so as not to become a victim of unforeseen diseases.
How to recognize ureaplasma parvum without tests?
It is almost impossible to determine the presence of bacteria in the body without additional laboratory diagnostics. The presence of ureaplasma parvum is completely asymptomatic for a long time. If the bacteria become active and begin to multiply uncontrollably, then the disease progresses, which leads to a weakened immune system and the manifestation of visible symptoms:
- uncharacteristic discharge begins to stand out from the vagina;
- there is an unpleasant burning sensation, and then itching in the genital area;
- over time, urination becomes painful;
- possible pain in the lower abdomen;
- slight and almost imperceptible increase in body temperature.
The detection of a pathogenic microorganism in the third trimester leads to a negative effect on the fetus, which suffers from malnutrition and oxygen starvation. Often, children whose mothers during pregnancy were carriers of ureaplasma parvum are born with physical pathologies or mental disorders.
A miscarriage occurs when a microorganism acts on the uterus, which softens, and the cervical os opens prematurely. If a child becomes infected during the passage of the birth canal, then due to exposure to parvum ureaplasma, meningitis, sepsis, or conjunctivitis may occur.
Attention! It is very important to treat ureaplasmosis in a timely manner, which even after childbirth can lead to serious consequences, leading to the development of endometritis.
How is the treatment?
To prevent unpleasant consequences during childbearing, it is recommended to conduct comprehensive tests before the start of pregnancy to identify any pathologies and the presence of pathogens that can threaten the fetus. Treatment in the first weeks of gestation is also considered effective.
Later periods of pregnancy require careful and long-term treatment of ureaplasma. The main drug in such cases is considered Viferon. The popularity of the use of this drug is due to the absence of side effects and negative effects on the condition of the fetus. In addition, Viferon is able to strengthen the immune system.
Carefully! It is forbidden to use Viferon in the first weeks after conception in order to avoid a negative effect on the fetus, since the baby's organs and systems have not yet been formed. A justified result of therapy should be expected with treatment after the twentieth week.
Additionally, a woman is prescribed the intake of vitamin-mineral complexes and other general strengthening immunostimulants. Re-infection is not excluded if the partner is a carrier of a pathological microorganism, so the man must also undergo complex treatment without fail. Only then can you conceive a healthy child or prevent re-infection during gestation.
The presence of ureaplasma in the body of a pregnant woman is not a reason for terminating the pregnancy, since effective treatment will help maintain a healthy fetus.
Ureaplasma refers to conditionally pathogenic microorganisms. It enters the vaginal mucosa from a carrier partner sexually, and for a long time it may not make itself felt, being in a latent state. Very often, it is pregnancy that becomes the factor of influence that provokes the development of ureaplasmosis. How dangerous is the disease for the expectant mother and fetus? What are its symptoms? And how to treat an infection during pregnancy?
What is ureaplasmosis
There are more than thirty types of microorganisms on the vaginal mucosa. Most of them are beneficial lactobacilli, which form the basis of the normal flora of the female genital organs. The active development of pathogenic and conditionally pathogenic microflora is observed when, for some reason, the protective functions of the immune system weaken.
Ureaplasmosis is an infectious disease caused by the bacterium ureaplasma. Its constant presence on the mucous membranes of a healthy woman is uncharacteristic - the bacillus is classified as a transistor microflora of the human genitourinary system. The infection enters the body mainly through sexual contact and develops on the mucous membrane of the internal genital organs.
The bacterium ureaplasma belongs to the conditionally pathogenic microflora of the mucous membranes, which means that it provokes inflammation only with weakened local immunity. About half of the women and men on the planet are infected with this bacillus. Ureaplasma causes inflammation of the mucous membrane when the balance of the vaginal microflora is disturbed.
And this happens:
- with concomitant infection - infection of the mucosa with other pathogens (gardnerella, chlamydia, fungi of the genus Candida) changes the ratio of beneficial and pathogenic bacteria, which leads to the development of inflammation;
- with weakened immunity, including against the background of pregnancy;
- with frequent colds and hypothermia;
- with active sexual life and frequent washing (douching);
- with chronic fatigue, exhaustion of the body, after stress.
In scientific circles, to this day, there is a debate about the classification and pathogenicity of ureaplasma. The question of the influence of these microorganisms on the bearing of pregnancy also remains open.
Exciter characteristic
Ureaplasma parvum and Ureaplasma urealyticum are the smallest specific bacteria; in the classification of microorganisms, they occupy an intermediate position between unicellular microbes and viruses. They belong to mycoplasmas (Mycoplasmataceae), but are isolated in a separate genus due to their ability to split urea to ammonia.
Ureaplasmosis is diagnosed when the concentration of bacteria in a smear on the flora significantly exceeds the permissible norm. The presence of ureaplasma on the vaginal mucosa within the normal range is not an indicator of a disease, but only of infection. At the same time, a woman is a carrier of the infection and can infect her sexual partner.
Against the background of active reproduction of ureaplasma, inflammation of the mucous membrane of the internal genital organs develops, which is reflected in the indicators of the urogenital smear: it will reveal an increased content of leukocytes - immune blood cells that are designed to fight the inflammatory process.
Infection with ureaplasma occurs mainly during unprotected intercourse. How bacteria enter the body
Infection with ureaplasma in the vast majority of cases occurs sexually - with unprotected sexual intercourse. Moreover, oral sex can also cause infection, but in this case, the mucous membrane of the oropharynx will become the site of infection.
Household methods of transmission of the pathogen, when pathogens enter the mucous membranes while visiting a bathhouse or pool, a public toilet, swimming in open water, etc., are unlikely. Very rarely there are cases of bacillus infection through personal items.
During pregnancy, there may be several ways of transmitting ureaplasma infection from mother to child.
- Ascending or vertical. From the vagina, ureaplasma spreads vertically into the cervical canal, uterus, and appendages. Then, through the amniotic sac, the bacteria penetrate into the amniotic fluid and lungs of the embryo. Infection in this way occurs more often in the early stages.
- The transfer route. When bacteria enter the placenta from the mother's systemic circulation. Theoretically, this can happen at any stage of pregnancy.
- Intranatal route of transmission of infection to the fetus. In the presence of ureaplasma in the mother's vagina, it is implemented much more often than previous methods. The mucous membranes of the child become infected during childbirth - during the passage of the birth canal.
The penetration of ureaplasma to the fetus by ascending and transplacental routes is very rare. After the birth of the child, a complete examination is carried out, including for the presence of a ureaplasma infection on the mucous membranes of the newborn (genital organs, nasopharynx, respiratory tract), upon detection of which treatment is prescribed immediately.
Intrauterine infection of the fetus most often occurs when a woman becomes infected with ureaplasma during pregnancy.
Video: when to treat ureaplasmosis - Dr. Komarovsky and gynecologist Sergey Baksheev
infection and pregnancy
After numerous studies, scientists came to the conclusion that ureaplasma may well cause miscarriage and pathologies of fetal development. And the impetus for the reproduction of bacteria on the mucous membranes is often precisely the conception and development of the child in the mother's womb.
The weakening of immunity during pregnancy is a physiological phenomenon. The protective functions of the immune system should not interfere with the implantation of the ovum into the uterine wall. But just at this time, the ureaplasma, which was previously in remission, can begin to actively develop, causing inflammation of the mucous membranes. It is important to cure ureaplasmosis in a future mother at the stage of pregnancy planning or before delivery. This will significantly reduce the risks of infection of the baby during childbirth and prevent deeper infection of the woman.
Ureaplasma in the early stages causes the development of chorioamnionitis (inflammation of the membranes of the fetus), bronchopulmonary dysplasia in the fetus. In the first trimester of pregnancy, with an acute infection and the development of inflammation, the formation of the embryo may stop and its intrauterine death may occur. Then a missed pregnancy is diagnosed.
In the second and third trimesters, against the background of inflammation caused by ureaplasma and deep infection of the mother's body, the cervix becomes loose, and the external pharynx softens and opens. Why does the expulsion of the fetus from the uterus begin prematurely - premature birth.
Against the background of ureaplasmosis, fetaplacental insufficiency develops - a deficiency of nutrients and oxygen from the placenta to the fetus. Why the child has intrauterine growth retardation, he is born prematurely - weak, "immature", with low weight. During childbirth, the baby passes through the birth canal, the mucous membranes of which are infected with ureaplasma. If the child was not infected in utero, the bacillus penetrates to him during childbirth.
When a newborn is infected intranatally, ureaplasma can affect not only mucous membranes, but also enter the bloodstream, provoking the development of a generalized infection in an infant - meningitis, pyelonephritis, pneumonia, sepsis. In the postpartum period, ureaplasmosis causes endometriosis (inflammation of the uterine mucosa), salpingo-oophoritis (chronic inflammation of the appendages, with ascending infection) in the mother, which in the future leads to infertility or the onset of an ectopic pregnancy.
Infection with ureaplasma during pregnancy (or detection of infection after conception) is not a reason for its termination. Timely diagnosis and a properly developed treatment strategy will help a woman bear and give birth to a completely healthy baby.
Video: ureaplasma, its effect on pregnancy and fetus - expert opinion
Types and symptoms of the disease
Referring to opportunistic microorganisms, ureaplasma after penetration into the mucous membranes can not manifest itself for a long time at all or give out very mild symptoms. Often it is discovered during a planned smear test for microflora, and the woman herself does not even suspect that she is a carrier of the infection. The incubation period after infection with ureaplasma lasts 4 weeks.
Then you may see:
- vaginal discharge - mucous, transparent or whitish, not very abundant (and more often in the morning), and therefore in most cases go unnoticed;
- itching and burning of the external genital organs - these sensations are the result of an irritating effect on the skin of vaginal discharge;
- cramps during urination - this symptom appears more often in men, but it also occurs in women;
- a feeling of discomfort during intercourse - ureaplasmas developing on the mucous membrane of the genital organs cause inflammation, swelling and increased sensitivity to mechanical stimuli;
- slight pains in the lower abdomen - harbingers of the beginning inflammatory process;
- rarely, an increase in body temperature and signs of intoxication of the body with the waste products of pathogenic microflora.
Just a few days later, the manifestations of the disease gradually weaken, and the infection settles on the mucosa in anticipation of favorable conditions for its development - primarily, weakening of local immunity. It may take several years before the next relapse.
Symptoms of ureaplasmosis differ depending on the individual characteristics of the woman's body, the stage of its development (acute, recurrent), location, complications of the course of the disease and concomitant infections. If the mucous membranes of the oropharynx are affected by ureaplasma, the bacteria cause a sore throat, which is accompanied by all its characteristic signs - redness and swelling, pain when swallowing, fever, and if a secondary infection joins, then purulent plaque.
If the mucous membranes of the genitourinary system are affected, the symptoms will differ as the infection spreads from the vagina to the uterus, bladder, and kidneys.
- Ureaplasma can cause inflammation of the vaginal mucosa - colpitis (vaginitis). Symptoms of this pathology are redness and swelling of the vaginal mucosa, itching, discomfort, mucous or spotting, pain during sexual contact.
- Getting from the vagina into the uterus, the infection causes inflammation of its walls - endometritis (after childbirth). Then the woman has severe pain in the lower abdomen, fever, foul-smelling discharge, signs of intoxication.
- The inflammatory process caused by ureaplasma in the urethra and bladder has characteristic signs of urethritis and cystitis - frequent urge to urinate, itching and pain during the passage of urine, discharge from the urethra, redness of the urethra.
- From the bladder, bacilli enter the kidneys, causing inflammation of the parenchyma and pelvis - pyelonephritis (rarely). Its manifestations are lower back pain, a violation of the outflow of urine from the kidneys, an increase in blood pressure, and edema.
The longer the infection stays in the body and the further (deeper) it penetrates, the worse it can be treated and the more complications it causes. Even being in a latent state, without exacerbation, ureaplasma creates a favorable background for the development of other pathogens.
Weak symptoms in the initial stages do not force an infected woman to see a doctor. As a result, the disease is diagnosed already when the inflammatory process caused by it is in full swing.
It is necessary to treat ureaplasma during pregnancy only when characteristic symptoms of inflammation of the mucous membranes of the internal genital organs appear. Diagnostics
In Russia today, without exception, all pregnant women are not examined for ureaplasmosis. Analyzes are prescribed for women who have a history (medical history) of premature birth or miscarriage, and also if the attending physician, when examining the expectant mother, suspects that she is infected with ureaplasma (taking into account the symptoms).
At the stage of pregnancy planning, it is recommended to take an analysis for ureaplasma for both spouses. To identify the infection, to determine the degree of infection and the sensitivity of bacilli to antibiotics, laboratory studies of biomaterial taken from the mucous membranes of the internal genital organs - a smear on the flora, a polymerase chain reaction is performed to detect the DNA of the bacillus, to determine antibodies to the ureaplasma antigen, blood is taken from a vein. The most reliable will be the results of different types of studies, the combination of which the doctor chooses.
PCR method
Polymerase chain reaction allows you to detect the presence of ureaplasma DNA on the mucous membranes of the internal genital organs. For the study, mucus samples (smears) are taken from the vagina, cervical and urethra. Already after 5 hours it is possible to draw conclusions about infection.
However, the degree of development of pathogenic microflora and its sensitivity to antibiotics cannot be determined by this method. The effectiveness of the treatment of ureaplasmosis also cannot be assessed using PCR, since traces of the pathogen's DNA may remain on the mucous membranes for another 2–3 weeks after therapy. 
Bacteriological culture allows you to determine the degree of activity of ureaplasma and make an antibiogram
Culture method or bacteriological seeding
For laboratory research, morning urine is collected, and a urogenital smear is also made - the biomaterial is taken from the mucous membrane of the vaginal vaults, cervical canal and urethra. The collected samples are placed in an artificial nutrient medium (each separately), where microflora develops within 48 hours.
10⁵ bacteria in the field of view under a microscope is the norm for the content of ureaplasma in a smear, if this number is much larger, ureaplasmosis is diagnosed. Bakposev allows you to determine the degree of infection activity, the location of the inflammatory process caused by ureaplasma, and the sensitivity of pathogens to antibiotics. Based on the results of the analysis, the doctor selects the most appropriate drugs for the treatment of the disease. In addition, with the help of cultural analysis, it is possible to monitor the effectiveness of therapy over time.
Detection of antibodies in the blood or serological method
To determine the presence in the body of antibodies to the ureaplasma antigen, blood is taken from a vein for analysis. The characteristic structures of bacteria in the blood are detected to diagnose the causes of miscarriage, infertility in women, as well as the development of inflammatory diseases of the reproductive and urinary systems in the postpartum period.
The serological method is used to diagnose relapses of the disease. The control of the cure of ureaplasmosis is carried out after the end of treatment - 2-3 weeks later - by the cultural method and using PCR.
How to treat ureaplasmosis in a future mother
In the absence of serious complications and the threat of termination of pregnancy in the early stages, diagnosed ureaplasmosis in a future mother begins to be treated after 20 weeks, when the organs of the fetus are already fully formed. Since in most cases the infection of a child with ureaplasma occurs during delivery, ureaplasma should be treated before the onset of labor.
Many doctors consider it appropriate to start treating ureaplasmosis at 30 weeks (with a successful pregnancy). Then the risks of infection of the child during the passage of the birth canal will be minimal. If there is a threat of miscarriage or complications of the course of pregnancy develop, treatment of ureaplasmosis is started immediately, regardless of the duration of pregnancy.
Therapy of the disease necessarily includes antibacterial agents, which in the first trimester can cause disturbances in the development of the embryo. In parallel, treatment is also prescribed to the spouse (sexual partner) of the woman. For the duration of therapeutic measures, it is recommended to refrain from sexual intercourse. With the threat of abortion due to a progressive ureaplasma infection in the early stages, treatment is started immediately.
Therapy for ureaplasmosis in pregnant women is always complex, it can be carried out in a hospital or on an outpatient basis, with mandatory regular monitoring of effectiveness. The doctor selects the drugs individually, depending on the history, gestational age, stage and location of the disease. 
If treatment of ureaplasmosis during pregnancy is necessary, it is started no earlier than 20 and no later than 30 weeks of the term
Treatment involves the use of:
- antibiotics - fluoroquinolones, macrolides (Erythromycin,) - to combat ureaplasma infection;
- drugs to restore the microflora of the intestinal and vaginal mucosa - Linex, Lacidophila, Bifidumbacterin - antibiotics kill not only pathogenic bacteria, but also beneficial ones, upsetting the balance of microorganisms, so mucous membranes have to be populated with useful lactobacilli to restore their protective function;
- vaginal suppositories - Hexicon, Terzhinan, Livarol - for the treatment and prevention of the development of a secondary infection;
- immunomodulators - Viferon, Interferon - to enhance the immune response to the development of pathogenic microflora in the body;
- medicines to improve placental blood flow - Magne B6 or iron preparations - in order to increase the delivery of nutrients and oxygen to the fetus to normalize growth and development processes;
- vitamin complexes - for the general strengthening of the body of the expectant mother and a speedy recovery - Elevit Pronatal, Vitrum Prenatal.
It is important to strictly follow the prescribed scheme and complete the course of treatment completely. Transferred ureaplasmosis does not form stable immunity, and therefore re-infection and the development of the disease are possible. After antibiotic therapy, it is necessary to check whether the treatment was effective.
Table: medicines for treatment
| Name of the drug | Pharmacological group | Active substance | Indications | Contraindications | Features of use during pregnancy |
| Macrolide antibiotic with bacteriostatic and bactericidal effects | Hypersensitivity to macrolide antibiotics, severe liver dysfunction | During pregnancy, it is used only as directed by a doctor, after a thorough analysis of the balance of benefits and harms. Better after 20 weeks, when the organs of the fetus are formed. The course of treatment is 7-10 days (according to indications). The drug is recommended to be taken one hour before a meal (or 2 hours after a meal) and drink plenty of liquid - 150-200 ml | |||
| Macrolide - antibacterial agent for systemic use | Josamycin | Infections of the genitourinary system, including ureaplasmosis | Hypersensitivity to macrolides or other components of the drug, violations of the liver and biliary tract | To date, there is no data on the embryotoxic effect of the drug, however, during pregnancy, it is recommended to use it only as directed by a doctor (after a thorough risk analysis) and preferably in the second half of the term. Tablets should be swallowed without chewing, between meals, and washed down with a sufficient amount of water. The course of treatment - up to 10 days |
|
| Combined preparation containing three types of lyophilized viable lactic acid bacteria that are part of the normal intestinal flora | Lactobacillus acidophilus, Bifidobacterium infantis, Enterococcus faecium | Dysbacteriosis of the intestines and mucous organs of the genitourinary system, including those caused by antibiotics - maintain and regulate the physiological balance of microflora | Hypersensitivity to the components of the drug | It is recommended to take with food, but not with hot drinks. To increase the effectiveness of the drug is taken 3 hours after taking antibiotics. | |
| Means for restoring the microflora of mucous membranes, normalizing the activity of the gastrointestinal tract, with immunomodulatory properties | Dried microbial mass of live bifidobacteria, which are part of the normal microflora of the intestines and mucous organs of the genitourinary system | Intestinal dysbacteriosis, including that caused by taking antibiotics, sanitation (elimination and prevention of diseases) of the female genital tract, prenatal preparation of pregnant women with a violation of the purity of the vaginal secretion | Individual intolerance to the components | The drug during pregnancy is used orally (inside in the form of a solution), as well as intravaginally (in the vagina - in the form of tampons soaked in a solution) | |
| Hexicon (candles) | Antiseptic and disinfectant | Chlorhexidine | Prevention of sexually transmitted infections, including ureaplasmosis | Individual hypersensitivity to the components of the drug | During pregnancy, use only when the expected benefit to the mother outweighs the potential risk to the fetus. |
| Livarol (candles) | Antimicrobial and antiseptic agent for use in gynecology | Ketoconazole | Prevention of fungal infections of the vagina with reduced body resistance and against the background of treatment with drugs that disrupt the normal microflora of the vagina | Increased individual sensitivity to the components. With the development of hypersensitivity reactions, the drug should be discontinued and consult a doctor. Should not be used in the first trimester of pregnancy | In the II-III trimester of pregnancy, the drug should be used only when the expected benefit to the mother outweighs the potential risk to the fetus. |
| Viferon (candles) | Complex immunostimulating drug | Recombinant human interferon alfa-2b, tocopherol acetate | Treatment and prevention of intrauterine and urogenital infections | Individual intolerance to the components of the drug | The use of suppositories is permissible from the 14th week of pregnancy |
| Vitamin B complex with minerals | Magnesium lactate dihydrate, pyridoxine hydrochloride | Hypertonicity of the uterus during pregnancy, the threat of miscarriage, fetal growth retardation | Hypersensitivity to the components of the drug, severe renal failure | The simultaneous use of Magne B6 during pregnancy and iron or calcium-containing preparations reduces the absorption of each of them | |
| Multivitamins with trace elements for pregnant women | A complex of vitamins and minerals necessary for the normal course of pregnancy | Prevention of vitamin and mineral deficiency in women during pregnancy | Hypersensitivity to the components of the drug, hypervitaminosis, impaired renal function, stomach ulcer (duodenal ulcer) | The doctor determines the duration of use and dosage individually. Do not exceed the recommended dose! Vitamin A doses greater than 10,000 IU may have a teratogenic effect on the fetus |
The control of the cure of ureaplasmosis in pregnant women is carried out:
- using a cultural diagnostic method - on the 7-8th day after the end of antibiotics;
- by polymerase chain reaction - 2-3 weeks after treatment.
In order to prevent the growth of bacteria on mucous membranes from the 14th week of pregnancy, the doctor may prescribe a Viferon suppository to a pregnant woman. Possessing immunostimulating properties, they prevent intrauterine infection of the fetus. What creates the prerequisites for the birth of a healthy, strong baby, even with ureaplasma found in the mother.
Photo gallery: drugs used as part of the complex therapy of ureaplasmosis in expectant mothers
Linex - a complex remedy for restoring the normal microflora of the intestinal mucosa and internal genital organs Bifidumbacterin - normalizes the microflora of the intestinal and vaginal mucosa during antibiotic therapy Erythromycin - an antibiotic approved for use in the treatment of ureaplasmosis during pregnancy Magne B6 - soothes, relaxes, relieves the tone of the muscles of the uterus, prevents abortion, improves placental blood flow and supply of useful substances to the fetus Hexicon - is used in the complex therapy of ureaplasmosis for the local treatment of infection Livarol - suppositories prescribed to prevent the attachment of a secondary infection in ureaplasmosis Viferon - a human interferon drug, an immunomodulating agent Vilprafen - an antibiotic prescribed for pregnant women for the treatment of ureaplasmosis Vitrum Prenatal - a complex of vitamins and minerals for pregnant women, which strengthens the immune system and speeds up recovery
The category of sexually transmitted diseases is very large. Each of the pathologies negatively affects the human body. Such diseases pose the greatest danger to pregnant women, since not only they, but also the fetus can suffer from them.
In this article, we will consider a disease such as ureaplasmosis. What effect does it have on pregnant women, what are its symptoms, dangers and how is it treated?
What is ureaplasmosis?
This is a disease that appears as a result of infection with a unicellular organism with ureoplasma. This is a unicellular organism that belongs to the caste of intracellular microbes. There are about 14 types of ureoplasms, but the causative agent of ureoplasmosis is U. Urealyticum. The incubation period of the microorganism is 1 month. The essence of ureoplasmosis is the appearance of inflammatory processes of different localizations.
Most often, ureaplasmosis develops in the following categories of patients:
- Beginning early sexual life;
- Practicing unprotected sex;
- Sexual contacts with a large number of partners;
- Background pathologies of the reproductive system;
- People over 30.
Ways of infection with ureaplasmosis
Ways of infection with ureaplasmosis
The disease is transmitted mainly through sexual contact.. Remarkably, it is also possible to become infected orally-sexually. Ureaplasmosis cannot be contracted through common household items. Infection in such public places as toilets, pools, baths is also excluded.
Children who were born to infected mothers can also become infected with ureaplasma. When the fetus passes through the mother's genital tract (microorganisms are found mainly in the vagina), it picks up this infection. For this reason, women are advised to carefully examine and treat various diseases before pregnancy.
Interesting: quite often, deep infection with ureaplasmosis occurs precisely during the birth process. Pathologies are exposed to the urinary tract, uterus.
If for some reason the disease has not been cured, then after the birth of the child, they are carefully examined for infection. After that, treatment begins, its specificity depends on the location of the foci of infection.
Symptomatic picture
After about 4 weeks, symptoms of infection begin to appear. They are very similar to those that appear with urethritis: 
- Pain and burning in the urethra;
- Pain when urinating;
If the infection occurred through oral sex, then a symptomatic picture of angina appears. Such symptoms are more typical for males and may not appear in women. They have the following symptoms: 
- Colpitis (inflammation of the vagina): whitish mucous discharge appears in large quantities (this is a symptom of thrush, so colpitis is often confused with it), pain in the lower abdomen;
- Endometritis (inflammation of the uterine wall): symptoms as in colpitis;
- Cystitis (inflammation of the bladder): pain when urinating, very frequent urination;
- Pyelonephritis (inflammation of the kidney tissue): back pain, fever and dysfunction of the urinary system.
They usually appear when the immune system is depleted due to severe stress, physical overload, or concomitant diseases.
Is it dangerous for pregnant women
Yes, it's dangerous. There is a threat of miscarriage, a lack of oxygen and nutrients in the child. The latter factors may be the cause of premature birth. Such children are born underdeveloped, there is a danger to their lives.
If the woman is not treated and the child is born infected, some complications may develop over time. These include: 
- Conjunctivitis;
- Meningitis;
- Pyelonephritis;
- Pneumonia.
In very advanced cases, sepsis begins.
Diagnosis of ureaplasmosis
Usually, when planning pregnancy, women are sent for a comprehensive examination of the body, which facilitates the process of identifying and treating underlying pathologies. If a woman is already pregnant, then an analysis for ureaplasma will be prescribed only if there is a suspicion of a pathology. Diagnosis of this disease is a rather complicated process, since it is difficult to detect ureaplasma and its extent in a smear on the flora. For this reason, additional gynecological examinations are prescribed: 
- PCR (so reduce the polymer chain reaction). The main goal is to identify the DNA molecules of a microorganism in the flora. The analysis does not take much time and is done within a few hours. Its disadvantage is that it does not make it possible to determine the exact number of ureoplasmas. PCR is not suitable for monitoring the effectiveness of drug therapy and is applicable only for the primary diagnosis of pathology.
- Detection of antibodies to ureaplasma. It is only used to determine the cause of a miscarriage or prolonged infertility. If a woman is just pregnant and everything is fine with her, the analysis is not used.
- Bacteriological culture. A swab is taken from the vaginal cavity, which is placed in nutrient media. By how quickly the pathogenic flora grows, it is determined whether a woman is threatened with some kind of disease or not. The advantage of such a study, among others, is that it allows you to determine whether certain antibiotics will be effective in infection. It is also suitable for monitoring the effectiveness of therapy. The analysis takes about two days.
How is pathology treated?
Many believe that if everything is fine with the health of the pregnant woman, it is not necessary to treat ureoplasmosis. This is the biggest misconception. It is important to select the duration and intensity of treatment depending on the gestation period and the characteristics of its course.
For treatment, there is one unshakable rule (it applies to all infections in the STD category): partners must be treated together. Ideally, you should not have sex at this time or do it only with a condom. If these nuances are not observed, re-infection will occur constantly and the effectiveness of the treatment will be reduced to nothing.
When to treat?
When to treat ureaplasmosis
The doctor who guides the woman during the entire period of pregnancy constantly monitors the health of the mother and baby. In the case of a normal pregnancy, ureoplasmosis is treated only if there is a threat of complications, miscarriage, or an increased risk of infection of the child.
If ureaplasmosis was diagnosed at the very beginning of pregnancy, then treatment does not begin immediately. Such promptness in starting therapy is also necessary when there is a threat of miscarriage. Specialists wait until the fetus has formed the main organ systems. This is due to the fact that various malformations may appear under the influence of drugs. Previously, pregnancy was interrupted with ureaplasmosis, because the disease was considered very dangerous for both the child and the mother.
If the pregnancy has already been going on for some time, then it is best to carry out antibiotic therapy from 20 to 22 weeks of the term. At this time, the fetus is already fully formed and can withstand antibiotic treatment.
How to treat?
All infectious diseases are treated with antibiotics. But as every pregnant woman knows, antibiotics can be harmful to the fetus. Previously, this was indeed the case, but today there are new generation drugs that have a minimal effect on the child.
Most often, patients with ureaplasmosis are prescribed a whole range of drugs. Moreover, only one of them acts against ureaplasmas. What then are the rest and why are they needed? These drugs belong mainly to the group of immunomodulators and drugs for dysbacteriosis. Such medicines are necessary because antibiotics destroy both harmful and beneficial flora in their path, and the work of these drugs is aimed at restoring it.
Antibiotics
Such funds can have a different format and form of release. As antibiotics, women are usually prescribed tetracycline drugs. The disadvantage of these drugs is that they need to be drunk for a long time and against this background, a woman may experience side effects. Among these drugs, Erythromycin is considered the best. It is safe for the child and at the same time effective against ureaplasma.
A remedy called Vilprafen has recently appeared on the domestic market. Compared with Erythromycin, it has a lesser negative effect on the digestive tract. The risks of such an impact on the fetus are also minimized.
Another commonly used antibiotic is Viferon. It is permissible to use it for those women who are 10-14 weeks old. Its advantage lies in the almost complete absence of side effects and negative effects on the baby. Also, this remedy has a beneficial effect on the immune system, the body begins to better defend itself against disease-causing agents. This drug is a preventive measure against the development of infections in a child in the womb and outside it. Due to the action of the remedy, the baby is born not only healthy, he has strong immunity.
Erythromycin 
Wilprafen 
Viferon
Immunomodulators and remedies for dysbacteriosis
As already mentioned, after undergoing treatment, the patient needs to restore normal microflora. Typically, the course of using such funds lasts about two weeks. The most commonly used remedies for vaginal dysbacteriosis are:
They contain lactobacilli, which restore the concentration of lactic bacteria in the vaginal mucous membranes. These medicines are mainly taken orally.
As for immunomodulators, their restoration of immunity and its ability to defend itself against third-party microorganisms and control the state of microflora. The doctor should choose a specific immunomodulator, since some of them cannot be used by pregnant women.
When is a disease considered cured?
To monitor the effectiveness of therapy, a woman and a man should periodically take a bacteriological culture. Healthy patients are considered in the absence of ureaplasma microorganisms. In men, treatment usually takes about a month, in women about the same.
An infected with ureaplasmosis can become pregnant. This pathology does not prevent conception in any way, and there are physical possibilities of pregnancy. At the same time, the expectant mother should understand what responsibility she takes on for the health of the child.
Ureaplasma, like chlamydia, and mycoplasma is a protozoan that causes urinary tract infections that are present in many women, but more often are hidden. Ureaplasma during pregnancy can become aggravated, becoming a threat to the fetus and maintaining pregnancy. Therefore, it is advisable to be examined and treated for all infections before pregnancy - a large number of problems will simply be removed.
Treatment of ureaplasma during pregnancy
But if, nevertheless, during the onset of pregnancy, ureaplasma is found in a woman, it is necessary to be treated, since these creatures can cause miscarriages and premature births, infect the fetal membranes, and after childbirth, the uterus itself, leading to endometritis - a severe purulent complication, as well as to infect the child at the time of childbirth when passing through the birth canal, which causes damage to various organs of the baby. Tests for ureaplasma - swabs taken from the cervical canal, and polymerase chain reaction (PCR - reaction), which is the only reliable confirmation of the presence of the disease, since it detects parts of ureaplasma DNA.
Ureaplasma - the cause of miscarriage
The cause of miscarriages, and later premature birth with ureaplasmosis, is the fact that the cervix affected by ureaplasma becomes loose, the external pharynx softens, so often isthmic-cervical insufficiency occurs - the opening of the cervical pharynx ahead of time and the subsequent premature expulsion of the fetus. Cervical suturing and some other methods of maintaining pregnancy, of course, help, but it is better that the cervix is closed throughout the pregnancy.
Stages of treatment of ureaplasma during pregnancy
Antibacterial treatment is not carried out in the first weeks of pregnancy, but better from 20-22 weeks - when all the main organs and systems of the fetus are formed and no malformations occur under the influence of drugs. Once upon a time, the detection of ureaplasma during pregnancy was an indication for interrupting it - the effect of the pathogen on the fetus was considered so dangerous. It is now believed that the feto-placental barrier protects the developing fetus from direct exposure to the protozoan, although it is theoretically considered possible. A wide range of options in terms of choosing antibacterial therapy made it possible to choose a “special antibiotic for pregnant women”, as doctors often say, although, of course, this statement should be taken with some criticism - nothing is desirable for a child, no medicines, and only the great danger of “non-treatment” makes to take risks.
What to look for with ureaplasma during pregnancy?
Usually, together with one antibacterial drug for ureaplasmosis, general strengthening, vitamins, various suppositories are prescribed to prevent a secondary infection, as well as linex-type drugs to prevent dysbacteriosis. In fact, these rules are the same for any antibiotic therapy, although this is not always prescribed.
With untreated ureaplasmosis, or its ineffective treatment, the child after birth should be examined, and if an infection with ureaplasmosis is detected, it should be treated with special methods that have been developed and exist. Well, a reminder - for all sexual infections, both sexual partners undergo treatment and use protected sex - otherwise they will infect each other endlessly and all efforts will go to waste.
