Treatment of chlamydia during pregnancy: when to start, which regimens and drugs are considered safe. Pregnancy and chlamydial infection

Modern women, being in an "interesting" position, are increasingly faced with the need for additional tests for latent infections. The reason for this is the massive spread of sexual diseases, which in 80% of cases proceed latently, that is, asymptomatically affect the body. Unfortunately, such a situation is very unfavorable during pregnancy, because many bacteria can not only affect the development of the fetus, but also provoke its death. One of these common and very dangerous infections is chlamydia. Let's explore the impact of chlamydia on pregnancy, as well as all the available ways to diagnose and treat this disease.

This disease is caused by a bacterium of the same name - chlamydia. The carriers of the infection are mainly young and sexually active people. In them, the disease can proceed both in an active and in a latent form.

Official WHO data show that chlamydia has become one of the most widespread sexual infections, ahead of gonorrhea and ureaplasmosis.

Chlamydia is transmitted in several ways:

• domestic infection. Infection with chlamydia during pregnancy in this way is rarely recorded and mainly in the complete absence of norms and rules of hygiene in the house. You can “catch” chlamydia in this way when using a common towel, through sheets, dirty hands after visiting the toilet.
• Bacteria enter the body through sexual contact. Moreover, infection is possible with vaginal, oral, anal sex, as well as with contact with the vaginal or seminal fluid of the carrier in the eyes. It is possible to transmit chlamydia through common sexual attributes.
• Vertical transmission of chlamydia. This option involves getting chlamydia during pregnancy from a woman to a fetus. The percentage of infection is 15-45%, and if a woman has aggravating gynecological pathologies, this figure approaches 60%.

Chlamydial infection often goes to a woman paired with other sexually transmitted infections - gonococci, trichomonas, mycoplasmas. Therefore, pregnant women should undergo a comprehensive gynecological examination.

Chlamydia in women: symptoms during pregnancy

Quite often, the introduction of chlamydia into the body goes unnoticed, or the first signs of infection are perceived as ordinary vulvovaginitis. Therefore, chlamydia is simply “healed” with antimicrobial vaginal suppositories or antibiotics. As a result, the biological properties of chlamydia change, and the disease quickly transforms into a sluggish chronic process. In most cases, the infection is activated after the onset of pregnancy and begins to negatively affect its course.

It is possible to suspect chlamydia even before pregnancy by some non-specific symptoms, which will depend on the location of the infectious focus:

• Scanty vaginal discharge is yellow or clear with white streaks.
• Minor pains in the very bottom of the abdomen, which then appear, then pass.
• Acute pain in the projection of the ovaries (if the infection has spread to the uterus and appendages).
• Unpleasant odor of vaginal fluid.
• Discomfort during intercourse, both in the vagina and in the lower abdomen.
• An increase in the amount of secreted menstrual blood, the appearance of pain during PMS.
• A slight increase in body temperature, a general long-term malaise.
• Itching or burning sensation on the genitals.
• Frequent exacerbation of thrush or gardnerellosis (due to reduced local immunity).

I would like to note that chlamydia during pregnancy has symptoms similar to those described above. Therefore, if more than two signs appear together, you should immediately contact a gynecologist.

The effect of chlamydia in the blood on conception and future pregnancy

The course of chlamydia in an asymptomatic form without weighting from the side of the gynecological sphere often causes a woman to visit a gynecologist belatedly. And as a rule, this is not due to chlamydia, but already due to the development of severe complications from the reproductive system.

Chlamydia, penetrating into the body, are introduced into the immune and epithelial cells. In this place, they can exist for more than 5 years and, depending on the state of health of the woman, cause significant harm. In half of the cases of infections, the immune system is able to suppress the infection, preventing it from developing. True, at the first opportunity, when the immune system fails, the infectious process immediately activates. Therefore, chronic chlamydia is so often diagnosed during pregnancy, which causes a decrease in immunity.

The main complication of progressive chlamydia is an acute inflammatory process on the internal genital organs. This often ends with an extensive adhesive process in the pelvis.

As a result, the fallopian tubes become impassable and unable to pass a fertilized egg into the uterus. Pregnancy under such conditions becomes either unrealistic, or the fetal egg is implanted in the wrong place and an ectopic pregnancy develops.

Given such an unfavorable prognosis, it is rather difficult to predict how a pregnancy will proceed after chlamydia. Therefore, regular preventive examination by a gynecologist, even without clinical complaints, should be a priority in women of childbearing age.

Chlamydial infection can affect the inner ball of the uterus, causing chronic endometritis or regression of the endometrium, which makes it impossible to attach the ovum, even if the tubal patency remains. As a result, women can constantly miscarry.

Why is chlamydia dangerous during pregnancy?

Chronic chlamydia that occurs before conception is less tragic during pregnancy. After all, a woman already has a certain amount of antibodies in her blood that will protect the fetus in the first few weeks, while it is most vulnerable.

Much more serious is the situation with primary infection with chlamydia after pregnancy or at the time of fertilization. In conditions of insufficient immunity, bacteria will multiply rapidly and affect both the female body and the embryo.

Chlamydia during pregnancy: consequences for the female body

Chlamydia in the active phase greatly complicate the condition of a woman during gestation. They damage the endometrium, vaginal mucosa, appendages. This causes severe toxicosis in a woman, severe inflammation of the external genital organs, vagina, deterioration of health, polyhydramnios. In rare cases, inflammation of the ovaries and fallopian tubes develops.

In addition, the normal microbial environment of the vagina is disturbed, which causes thrush, inflammation of the cervical canal, vaginitis. Such complications of chlamydia in early pregnancy greatly increase the risk of spontaneous abortion, embryo freezing, bleeding.

At a later gestational age, uncontrolled chlamydia is also dangerous. The defeat of the outer ball of the uterus and endocervix causes premature damage to the amniotic membrane, and unplanned childbirth. This is accompanied by prematurity of the baby, complicated by the birth process, sepsis.

Childbirth with chronic chlamydia during pregnancy is much more difficult. The chlamydia-inflamed vagina and cervix are prone to severe ruptures. Contractions may be insufficient, and the uterus may take much longer to shrink back to its original size after delivery.

Chlamydia during pregnancy: consequences for the child

Infection of the baby in the womb does not always occur. In some women, the phytoplacental barrier performs its functions well, in others not so much. But in any case, gynecologists assure that a significant danger to the fetus occurs only with primary infection in the first trimester.

It is not the bacteria themselves that affect the fetus much more seriously, but the disorders caused by chlamydia in the blood during pregnancy. So, the baby can feel oxygen hunger and a deficiency of nutrients as a result of phytoplacental insufficiency, which is provoked by chlamydia. But with sufficient maintenance of the placenta with medicines, the consequences will be minimal.

There is a certain risk of infection of the baby during childbirth, when fragile immunity has to face a strong threat for the first time. After infection, the newborn may develop chlamydial conjunctivitis, pneumonia, or otitis media.

When intrauterine infection of the fetus with chlamydia occurs during pregnancy, the consequences are tragic. Histological studies of dead embryos as a result of chlamydia in the first trimester show that the cause of fading or miscarriage was a hemorrhage in the brain and lungs, a massive lesion of internal organs.

Options for diagnosing chlamydia in women during pregnancy

Chlamydia is determined in the body by suitable methods for diagnosing other sexually transmitted infections. Chlamydia can be confirmed using any biological material - urine, venous blood, separated from the endocervix.

An analysis for chlamydia during pregnancy is carried out through the following laboratory tests:

1. PCR diagnostics is a supersensitive method for identifying chlamydia nucleic acids. Its accuracy ranges from 80 to 100%. For the study, swabs taken from the urethra and cervical canal, as well as urine sediment, are used.
2. The cultural diagnostic method is a deep bacteriological inoculation on a nutrient medium. It makes it possible to determine viable chlamydia in a taken smear. Due to the difficulty of transporting the biomaterial and the laboriousness of growing bacterial colonies, the effectiveness of this method does not exceed 70%.
3. Enzyme immunoassay is a study of venous blood to determine the presence or absence of antibodies to chlamydia. The method is quite accurate, which allows you to clearly indicate at what stage chlamydia is. It is often used during gestation to determine how to treat chlamydia during pregnancy and whether it should be done at all. Indeed, in the presence of a large number of antibodies, it is inappropriate to prescribe harmful drugs to a woman.
4. Immunofluorescent diagnostics - determination of antigens in scrapings under a fluorescent microscope. It is considered an additional diagnostic method for enzyme immunoassay.

Specialists who treat sexually transmitted infections, including chlamydia, say that conducting PCR diagnostics or a seeding tank without a blood test is not very informative. After all, it often happens that the study of the smears obtained was carried out in inappropriate sanitary conditions. For this reason, a false positive result may occur. Or there may be another option - chlamydia were found in the vaginal discharge, but strong immunity does not allow them to damage female organs. In both cases, treatment is not needed, which can be confirmed by a venous blood test.

On the other hand, chlamydia can only exist in the uterus or appendages. Then no bakposev will be able to identify them. As a result, the treatment will not be prescribed and the woman will have complications. While enzyme immunoassay can show an active inflammatory process. Therefore, in the diagnosis of chlamydia in pregnant women, complementary tests should always be performed.

Chlamydia treatment during pregnancy

The definition of chlamydia in a woman in position is not considered a reason for terminating a pregnancy. To clarify the diagnosis and phase of infection, an analysis is performed to count antibodies to chlamydia. The form always indicates two indicators IgM and IgG.

If type M antibodies predominate in the blood, then chlamydia is acute. Then the treatment of chlamydia during pregnancy is carried out according to the generally accepted scheme after the 12th gestational week.

In obstetric practice, tetracycline antibiotics, macrolides, and the latest generation ofloxacins are used. The choice is made taking into account the sensitivity of chlamydia to the antibiotic, the severity of the disease, as well as the tolerance of the drug by the woman.

Additionally, the immune status of the pregnant woman is maintained with the help of drugs based on interferon. Chlamydia in women during pregnancy requires treatment of the liver with hepatoprotectors to improve its functioning and prevent toxicosis. In case of violations of the intestinal flora, eubiotics, enzymes, vitamin preparations are prescribed.

During antibiotic therapy, a woman should be under the close supervision of an infectious disease gynecologist. It is important to strictly follow the antibiotic regimen. Skipping regular doses of medication or abruptly interrupting treatment will not cure chlamydia. In addition, this will make chlamydia resistant to the antibiotic being taken, which will greatly complicate further treatment.

After the end of the course of treatment, control tests are carried out to make sure that the woman is cured of chlamydia. After 14-21 days, a PCR study is done, and a week later, an enzyme-linked immunosorbent assay. This determines the presence of chlamydia in the vaginal fluid and the increase in antibodies to the infection. If there is no positive dynamics, treatment is resumed.

It is important to note that the treatment of chlamydia is carried out in both sexual partners at the same time. After all, chlamydia in a pregnant woman will be impossible to cure if the husband does not take a course of anti-chlamydial treatment and infects her regularly. During therapy, a woman is shown sexual rest, and compliance with strict hygiene rules.

If there are no IgM antigens in the blood, and there is a large amount of IgG, then chlamydia is completely isolated by the immune system, and it is not necessary to prescribe antibiotics. After all, the woman in this case is not sick, but simply a carrier of the infection.

Chlamydia is much easier to treat before pregnancy, but if you miss the moment, don't despair. Just contact a good specialist and conscientiously approach the prescribed treatment. Remember, fully cured chlamydia will not harm you or your baby.

Video "Chlamydia - symptoms, treatment, complications"

What causes disease

Chlamydia can also be transmitted in the home. This route of transmission accounts for no more than 5% of infections. Chlamydia during pregnancy penetrate the amniotic fluid, and then affect the fetus. Infection is facilitated by the ingestion of amniotic fluid.

possible, but the disease must be cured before conception. Only in this way will a woman have every chance to give birth to a healthy child. During the planning period of pregnancy, it is necessary to pass the appropriate tests. If pregnancy has already occurred, such an examination is included in the standard scheme for its management. Chlamydial infection is currently treated without any consequences for the unborn child.

Bacteria enter the human body through close contact with the mucous membranes of the infected. After some time, they infect immune and epithelial cells, where they stay for 3–5 years. A few days later, human immunity recognizes the causative agent of the infection and begins to produce. As a result, an acute inflammatory process occurs. Its intensity may vary.

How does an infection occur during pregnancy?

In most cases, the disease proceeds in a latent form. This is what makes chlamydia dangerous. More than half of women do not know that they are infected. In other cases, chlamydia has mild symptoms:

The signs described above may indicate not only chlamydia, but also other infections of the genitourinary system. There are no typical signs that help recognize the disease. However, this is not a reason for refusing the examination. The presence of the above discomfort should make a woman see a doctor.

What is dangerous disease

With improper treatment, chlamydia has a negative impact on the body of a woman and her unborn child. Against the background of this infection, an inflammatory process develops in the small pelvis, which can culminate in peritonitis. is one of the most common complications of chlamydia. This affects the joints and organs of vision. The narrowing of the urethra contributes to the violation of the processes of excretion of urine.

Increased muscle tone is one of the least dangerous complications found in a child born to a mother with chlamydia. In other cases, severe lesions of the central nervous system are detected. With pronounced hypoxia, the child is born dead. Consequences for the child can manifest themselves in the form of nutritional deficiencies. The fetus has a low weight and signs of iron deficiency anemia.

In the later stages of chlamydia penetrate the child's body. Most often, a lesion of the digestive and excretory systems is detected. The risk of death depends on the severity of the disease. Early treatment can help reduce the risk of complications.

Congenital chlamydia in children is manifested by:

• conjunctivitis;
• pneumonia;
• encephalopathy;
• convulsive syndrome.

The most dangerous consequence of chlamydia is Fitz-Hugh-Curtis disease, which combines hepatitis, ascites and peritonitis.

How the disease is diagnosed

It is not difficult to identify chlamydia in the blood during pregnancy at this stage in the development of medicine. Immunological and serological tests can detect both the pathogen itself and antibodies to it. To begin with, a smear is taken from the vagina, cervix or urethra. If the test result is positive, a blood test is performed.

In certain cases, it is necessary to know if the fetus is infected. For this, amniotic fluid is taken. Pregnant women are afraid of this procedure, but it is not considered dangerous for the unborn child. The material is taken under ultrasonic control. There is a certain risk, but it is assessed as insignificant. Amniocentesis allows you to detect the disease in time and protect the child from its negative consequences.

Therapy

Treatment of chlamydia during pregnancy begins with the identification of concomitant infections that are no less dangerous than the underlying disease. Analyzes are required for:

• syphilis;
• ureaplasmosis;
• herpes;
• cytomegalovirus.

Based on their results, a comprehensive therapeutic scheme is drawn up. Equally important is the diagnosis of non-communicable diseases, such as kidney or liver failure. The use of drugs can adversely affect the general condition of the body and disrupt the functions of internal organs.

Therapy should take place under the supervision of the attending physician. Do not stop it after the disappearance of symptoms of infection. Remaining in the body of chlamydia develop resistance to the antibiotic used, which makes it almost impossible to completely get rid of the disease. Not all drugs used to treat chlamydia are suitable for pregnant patients. For example, tetracycline antibiotics, which have a large number of side effects, are contraindicated. Macrolides are the safest.

It is strictly forbidden to take drugs on your own. Only an experienced specialist can choose the safest medicines for mother and child.

May involve a single dose of a drug to which chlamydia is hypersensitive. Complex therapy includes the intake of enzymes and immunostimulants. All drugs are selected taking into account the characteristics of the organism, the duration of pregnancy and the presence of certain symptoms. Immunomodulating agents are not always used. The need for their reception is determined by the results of the immunogram.

Enzymes play an important role in eliminating chlamydial infection. With their help, the permeability of cell membranes is normalized and the risk of allergic reactions to drugs is reduced. In addition, enzymes have analgesic and anti-inflammatory effects. To determine the effectiveness of treatment, control tests are carried out.

Preventive measures

It implies the rejection of casual intimate relationships and the use of barrier methods of contraception. A condom should also be used when a woman is not sure about the health of her husband. You need to get tested regularly for chlamydia. The disease during pregnancy is not uncommon, it is found even in women living in normal social conditions.

All women during the period of bearing a baby are extremely careful about all possible diseases, since any of them can cause a lot of discomfort and anxiety. Some women during pregnancy meet with a disease such as chlamydia. This infection poses a great danger to a woman who is waiting for the birth of a baby.

Chlamydia can be in the human body for a very long period of time and infect it, while not showing any symptoms. If this disease is not detected in a timely manner, then the consequences can be very deplorable, the fetus may die while still in the womb.

What is chlamydia and what are the ways of infection with it?

There is a large list of diseases that are sexually transmitted. Chlamydia is the most common of these diseases. The causative agents of the infection are chlamydia. They are endowed with features of both bacteria and viruses. The similarity of chlamydia with viruses is that they can only exist in the host's body, and outside it they die.

Chlamydia are not able to produce energy, they take energy from the cells of the person in which they exist. These microorganisms are slightly larger than bacteria, but smaller than viruses.

The most suitable and comfortable conditions for chlamydia are in the genitals, for this reason, the infection most often affects the organs of the genitourinary system. In some cases, microorganisms can be localized in the lower part of the small intestine, more precisely in its epithelial tissues, but this happens quite rarely. During pregnancy in women, chlamydia, in addition to the organs of the reproductive system and urinary tract, also affects the amniotic membranes.

The source of this infection is a person who has chlamydia. You need to know that chlamydia may not manifest itself for a long period of time. A person who is a carrier of the infection may not even know that they are sick.

Chlamydia is transmitted most often through unprotected intercourse. During pregnancy, chlamydia can be transmitted to a woman through everyday life. But this happens extremely rarely, about five times out of a hundred.

There is also a vertical route of transmission, that is, when the infection is transmitted to the fetus from an infected mother. From a pregnant woman who has chlamydia, chlamydia is transmitted to the fetus through the amniotic fluid. Chlamydia in some cases settle on the mucous membranes of the baby.

Women who have met with such a disease are wondering if they can get pregnant with chlamydia. Naturally, chlamydia is not a barrier to pregnancy and all women who have chlamydia can become pregnant without any problems. But it is worth thinking about the future health of the baby, so you still should not get pregnant until the woman gets rid of this disease. If the pregnancy was not planned, then there is still no need to fall into despair and panic.

In modern medicine, there are a lot of methods by which you can cure chlamydia, while not harming the baby.

Chlamydia. The mechanism of infection during pregnancy

Chlamydia enters the body of a healthy person after close contact with the mucous membranes of an infected person. Once in the body, chlamydia actively begin to affect epithelial cells and cells of the immune system. Chlamydia can stay there for a very long time, close to three to six years.

After some time (two - three days), the human immune system begins to respond to such an introduction - leukocytes begin to be produced. As a result of this process, an inflammatory process begins in the body. It can be expressed in different ways. In some, the inflammatory reaction is very pronounced, and in some it is practically not noticeable.

The risk of chlamydia during pregnancy

If chlamydia is not detected in time and adequate treatment is not started, then serious complications can occur. The most basic of them:

• Chlamydia can cause pelvic inflammatory disease. They can penetrate into the uterus, into the fallopian tubes, into the uterine appendages, while provoking an inflammatory process (,).
• Refter's disease may occur, which occurs with symptoms such as,.
• On the mucous membrane of the urethra, cicatricial changes occur, because of this, the urethra narrows.

Women who are expecting a baby and find out they have chlamydia worry a lot about how chlamydia can affect childbearing. How is this disease reflected in pregnancy?

If the infection was transmitted to a woman in the early stages of pregnancy, the consequences can be very deplorable. A woman may have a spontaneous abortion (miscarriage) or stop the development of the fetus inside the mother. This is due to the fact that the disease provokes placental insufficiency, due to which oxygen reaches the child in insufficient quantities.

With a lack of oxygen occurs (suffocation). Hypoxia can be expressed in different ways. If the lack of oxygen is moderate, then the organs and systems of the baby will be affected. In this case, in a baby who was born, at best, light muscle tone can be detected. In a severe case, complex lesions of the nervous system can be observed. If hypoxia is sufficiently pronounced, then this leads to the death of the fetus in utero.

Also, with chlamydia, nutrients can be poorly supplied to the child. A woman who is sick with chlamydia during pregnancy can have babies with very low weight, s, s.

The baby can be infected with chlamydia in the later stages of pregnancy. The infection mainly affects the kidneys, pancreas and liver. The health of the crumbs depends on how strongly the microorganisms affected certain organs. The sooner adequate treatment is prescribed, the less harm will be done to the baby.

In children, the congenital form of chlamydia can manifest itself:

• Ophthalmochlamydia (conjunctivitis with inclusions);
• Chlamydial pneumonia;
• Fitz-Hugh-Curtis syndrome. This syndrome manifests itself as perihepatitis, which is accompanied by ascites, acute form).

What are the symptoms of chlamydia during pregnancy?

Chlamydia often occurs without severe symptoms. More than half of the women who have chlamydia do not even know about it. If this disease makes itself felt, then the symptoms are so weak that a woman may not pay attention to them.

In women who are sick with chlamydia, but do not know about it, mucous or mucopurulent discharge may occur from the vagina, they differ from the usual discharge in that they have an unpleasant odor and a yellowish tint.

A woman may feel a burning sensation, a tooth and mild pain in the area of ​​​​the external and internal genital organs.

When a woman is not pregnant, her pain may increase before menstruation. Also during this period, women may have a rise in body temperature, they may feel general weakness, fatigue.

You should know that all of these symptoms may occur not only in the case of chlamydia. All infections of the genitourinary system have similar manifestations. There is no such sign by which a woman could accurately determine that she is sick with chlamydia.

Diagnostics

In modern society, women are surprised how their mothers and grandmothers gave birth to children. Wasn't there such a disease as chlamydia in those days? Of course it was. Quite often there were cases of spontaneous abortion, stop the development of the child, congenital diseases of the baby. Just in those days, doctors could not diagnose this serious disease.

But times go by and medicine improves. Today, fortunately, it is very easy to detect infections in the blood that provoke this disease. Chlamydia can be detected using serological and immunological studies. In a woman, secretions are taken from the cervix, urethra, and vagina. These strokes are completely painless.

In some cases, you need to find out if the fetus is infected. In this case, a sample of amniotic fluid is taken. This procedure is alarming for expectant mothers. But she's not really scary. When the sampling is carried out, all the manipulations of medical workers are carried out under the control of ultrasound, while observing the condition of the baby.

Naturally, any intrusion into a child's space poses a risk, but it's still small. With the help of amniotic fluid sampling, you can timely detect the danger and do everything possible to protect the unborn baby from negative consequences.

How to treat chlamydia during pregnancy?

Chlamydia begins to be treated with the fact that the patient is assigned additional diagnostics. In many cases, this infectious disease is accompanied by other infections. A woman is prescribed an examination for the herpes virus, syphilis, HIV, cytomegalovirus, gonococcus, mycoplasma (including ureaplasma). Only after all these examinations have been carried out, the doctor will be able to prescribe the correct and effective treatment.

To cure chlamydia, doctors prescribe drugs that worsen the general condition of a woman if she has any diseases of the internal organs. For this reason, it is very important to identify all non-infectious diseases, for example, chronic diseases of the liver, heart, kidneys, before prescribing treatment.

The entire period of treatment for a woman is best under the supervision of a doctor. Very often there are cases when women, after the disappearance of the manifestations of chlamydia, stop taking medication. But you don't have to do that. Microbes that survive in this case become resistant to the drug that the patient took. After that, it becomes much more difficult to heal.

But how to treat this insidious disease during pregnancy? This question is of interest to many expectant mothers. After all, women in position are not allowed to use all the drugs that are prescribed for the treatment of chlamydia. Antibiotics, which belong to the group of tetracyclines, are strictly forbidden to be taken by women in position, because they can cause various side effects.

The safest are antibiotics that belong to the group of macrolides. But women should not self-medicate because it is dangerous. Only a professional doctor will be able to choose the right medications that will not affect the health of the baby and will not worsen the condition of his mother.

Chlamydia can be treated with a single dose of an antibiotic that is susceptible to chlamydia. Complex treatment can also be prescribed, which is longer in time, which involves the use of enzymes, immunomodulators and antibiotics.

In the treatment of chlamydia, enzymes are very important. They help diseased cells restore membrane permeability. Enzymes also reduce the body's tendency to allergic reactions to those drugs that are used to treat chlamydia. In addition, enzymes have a decongestant and analgesic effect. In combination with enzymes, antibiotics begin to act much more actively.

Much less often, immunomodulatory drugs can be prescribed for the treatment of chlamydia during pregnancy. They are prescribed if a woman has disorders of the immune system, they can be detected by doing laboratory tests. After an immunological examination, the doctor may prescribe medications that help increase immunity.

After the prescribed course of treatment, the pregnant woman is prescribed enzymes that stimulate the recovery processes of the body and vitamins.

Control of cure for chlamydia in pregnant women

After the course of treatment, it is necessary to check whether chlamydia has been cured or not. This can be done in several ways. One method is not enough, since the result of one must confirm the result of the second.

From the moment the woman took the last pill, two weeks should pass. After that, sowing is carried out. But in some cases, this method may show an unreliable result, so you do not need to fully trust this method.

In order to make sure that chlamydia is no longer in the body, you need to conduct a control analysis. For this purpose, the PCR method is used (polymerase chain reaction or PIF (direct immunofluorescence). These methods are carried out about a month after the last pill has been taken. But there are cases when this method shows false results - when chlamydia in the body no longer shows their presence. This is due to the fact that an infection is detected, but using this method it is impossible to determine whether it is alive or already dead.

pregnancy after chlamydia

A woman's body can be severely affected after suffering a disease such as chlamydia. The infection negatively affects the functioning of internal organs. Many women are interested in whether it is possible to become pregnant after chlamydia. Of course, it is possible, but not in all cases. Sometimes an infection can cause infertility, an ectopic pregnancy, when the fetus begins to grow not in the uterus, as usual, but in the fallopian tube.

If a woman has had chronic chlamydia, then the chances of getting pregnant are reduced. Chlamydia leads to inflammation of the inner and outer membranes of the uterus, provoking endometriosis. With such a disease, the fetus cannot normally attach to the walls of the uterus. As a result, pregnancy may not occur.

If a woman has successfully cured chlamydia and no complications have occurred, then there should be no problems with conception.

Prevention of chlamydia in pregnant women

Chlamydia, like any other disease, is easier to prevent. What to do with his treatment. Prevention of chlamydia is exactly the same as the prevention of other diseases that are transmitted through sexual contact.

The best way to avoid chlamydia infection is to change your sexual behavior. Sexual contacts with casual partners should be excluded. If a woman is not sure if her partner is healthy, then a condom should be used during intercourse. It is best to have one sexual partner, in whose health there is no doubt. In this case, the risk of infection with chlamydia and other infections is reduced to a minimum.

During pregnancy, for prevention and other diseases, it is necessary to regularly visit a doctor and be tested for the presence of chlamydia in the body. Tests should be taken two to three times a year if there is doubt about the health of your partner or if you have several sexual partners. Remember that if you detect this disease in a timely manner and begin to carry out the correct treatment, then there will be no negative consequences.

A woman and a man who plan to conceive a child must be tested for the presence of chlamydia before this. In case of detection of microorganisms that cause this disease, it is necessary to be treated before conception. Thus, future parents protect their baby from exposure to chlamydia.

Chlamydia is quite common in pregnant women. According to the data, chlamydia can be found in almost every tenth pregnant woman. Chlamydia can occur in women who are in good health and live in good social conditions.

If a woman has previously had inflammatory processes of the appendages, they have a high risk of contracting chlamydia during pregnancy. Therefore, expectant mothers, given the danger of this disease, should be very careful.

Pregnancy is not only a wonderful time of waiting for the baby, but also a period of excitement and anxiety for his health. In the following months after conception, immunity weakens, and all hidden diseases remind of themselves. So, in any trimester, such a nuisance as chlamydia can appear.

What is chlamydia

Chlamydia is one of the most common sexually transmitted diseases. Chlamydia, the causative agents of this infection, are very viable microorganisms, as they successfully combine the properties of viruses and bacteria.

In size, these microorganisms are larger than bacteria, but smaller than viruses.

A typical localization of chlamydia is the genitourinary system. Therefore, unprotected sex is the most common way to contract this disease.

During pregnancy, women are most concerned about the possibility of transmission of infection from mother to unborn child. This is quite possible, since chlamydia easily penetrate the amniotic fluid, and then, when the amniotic fluid is swallowed, they enter the baby's mucosa. Therefore, it is so important even when planning a pregnancy to get rid of possible existing infections, including chlamydia.

In the event that the pregnancy occurred unplanned, subject to all the prescriptions of the attending physician, the expectant mother has the opportunity to recover and give birth to a healthy child. It is important to complete therapy before the baby is born, since during childbirth it is also possible for the baby to become infected from the mother.

It is worth noting that chlamydia is often found in women with high incomes and good health, and in general this diagnosis is quite common among pregnant women. According to statistics, every tenth expectant mother is diagnosed with chlamydia during tests.

Video: Dr. Komarovsky about pregnancy and genital infections

Chlamydia during lactation

Many are concerned about the possibility of infecting an infant through breast milk from a nursing mother with chlamydia. Definitely, it is unrealistic to infect a child in this way because of the remoteness of the pathological focus. Even with a generalized form of the disease, chlamydia spreads through the body with blood, but does not enter breast milk. This is due to the large size of microorganisms that will not be able to overcome the cell barrier.

Interruption of breastfeeding to treat the mother for chlamydia is not justified

Moreover, breastfeeding stimulates the immune system of the newborn and, even when infected, is a good helper to overcome the infection.

Complications and consequences of chlamydia during pregnancy

Infection with chlamydia early or before conception can damage the fetus and cause the placenta to fail to function. The causative agents of this disease significantly complicate the course of pregnancy, affecting the mucous membrane of the uterus and vagina.

First of all, the woman's condition worsens due to the development of severe toxicosis. There is also a risk that the fetus will freeze in development or a sudden miscarriage will occur. In the presence of a focus of infection in the uterine cavity, changes occur in the endometrium, provoking the occurrence of an ectopic pregnancy, which can lead to serious consequences. Also, the damage and diseases of the embryo provoked by the pathology in the future serve as the beginning of various malformations in the fetus.

When infected with chlamydia in the second trimester, the risks of premature delivery are significantly increased. The placenta loses some of its functions: the transport of nutrients from mother to child is disrupted, oxygen ceases to flow in the required volume. Such placental insufficiency caused by infection ultimately leads to the formation of varying degrees of malnutrition and hypoxia in the fetus, with deeper disorders, the consequence of chlamydia is a stop in the development of pregnancy.

Chlamydia can lead to premature delivery and the birth of a premature baby

Fetal growth retardation is the most common complication of chlamydia during pregnancy.

At a later date, the infection causes premature birth and rupture of the membranes. The latter provokes the occurrence of sepsis, as well as the birth of a premature baby. Insufficient functioning of the placenta leads to the development of anemia in the unborn baby and interferes with its proper nutrition. In cases where the infection has spread to the amniotic membranes, chlamydia contributes to the development of polyhydramnios.

Infection of the fetus with chlamydia

The probability of transmitting a contagious disease from mother to child is very high, so every second baby in this case after birth has symptoms of chlamydia. With natural delivery, chlamydia enters the baby's body and leads to the development of conjunctivitis (10-50% of cases), pneumonia (about 15%).

Newborns develop chlamydial conjunctivitis as a result of infection

The birth of a child by caesarean section can also cause damage to certain organs, such as the lungs, rectum or conjunctiva.

The possibility of transplacental and hematogenous infection of the fetus has also been confirmed. In these cases, the infection affects vital organs, primarily the vessels of the brain and lungs, and there is also a risk of hemorrhage in the liver and kidneys. All this invariably leads to the death of the fetus in utero or shortly after birth.

Infection of a woman with chlamydia during lactation does not pose a threat to the baby, but a nursing mother needs to receive appropriate treatment. Usually the problem is that the drugs prescribed by the doctor are incompatible with breastfeeding, and doctors recommend interrupting breastfeeding. In this case, there are two options for solving the problem: either choose medications that are compatible with lactation, or wean the baby from the breast for the period of therapy and express this time to save milk. In the latter case, it is worth considering the risk that the child may not return to breastfeeding after a long weaning.

Causes of chlamydia in pregnant and breastfeeding women

As mentioned above, the main route of transmission of the infection is sexual (vaginal, oral, anal sex). You can get infected from a partner both before pregnancy, during the bearing of the baby and after, during breastfeeding. It does not matter whether the disease occurs in an infectious person in the acute or chronic stage.

Pathogens enter the body of the expectant mother through close contact with the mucous membrane of an infected person. Initially, chlamydia begin to penetrate into the cells of the immune system or epithelial cells. In this state, they can exist for a significant amount of time, consuming the energy of the carrier. Sometimes this stage can last for years, while the infection has no external manifestations.

If the woman's immune system works smoothly and without failures, the incubation period will be 1-3 weeks, at which time there is an active increase in the number of leukocytes in the blood. An inflammatory reaction begins to occur, with which the body tries to fight in varying degrees of intensity.

There is a small chance of contracting chlamydia in a household way (about 5% of cases of the total). The source of pathogenic microorganisms can be:

• bed sheets;
• towels;
• napkins;
• sponges and washcloths;
• underwear;
• public toilet seat.

Chlamydia can exist for a short time outside the body of an infected person, usually this period does not exceed two days. Also, for the transmission of the disease, it is necessary that dangerous microorganisms be on a household item in large quantities and at a temperature of no more than 20 0 C. Usually, the pathogen gets from dirty hands to the mucous membrane of the eye from various common items.

As statistics show, cases of infection with chlamydia through the household route took place in medical practice.

At-risk groups

The risk group for infection with chlamydia includes:

• women involved in prostitution;
• teenage girls and women under 25 who lead an active sex life;
• women with a history of sexually transmitted infections;
• women who have sexual contact with a partner who has chlamydia or has symptoms of a sexually transmitted disease.

Symptoms of chlamydia

About 70% of women are unaware that they are infected with chlamydia. At the initial stage, the disease has no external manifestations and can only be detected through laboratory tests.

The first symptoms of infection are vaginal discharge, which is distinguished from normal by a yellowish tint and an unpleasant odor. Also, chlamydia can manifest itself as a burning sensation, pain in the area of ​​​​the internal and external genital organs. A woman often feels a feeling of discomfort in the lower abdomen, her body temperature may rise, there may be a feeling of weakness and impotence.

Before pregnancy or during breastfeeding, chlamydia can cause increased pain before critical days.

Involvement of the bladder (cystitis) in the pathological process is accompanied by indefinite pulling pains in the lower abdomen, urge or frequent urination

The most common clinical form of genital chlamydia in women is cervicitis (inflammation of the cervix), while in pregnant women this disease is more difficult to diagnose. Therefore, more often doctors pay attention to the development of signs characteristic of cystitis:

• frequent trips to the toilet;
• urination accompanied by pain;
• a feeling of incomplete emptying of the bladder;
• lower abdominal pain.

Often, these symptoms, manifested in the expectant mother, indicate the course of a chlamydial infection.

The above signs are common with manifestations of any other sexually transmitted diseases. There is no specific symptom that would indicate the development of a chlamydial infection.

Video: signs of chlamydia infection

Diagnosis of chlamydial infection

In pregnant women, it is not always possible to obtain such an analysis, therefore, non-invasive research methods are more common. In general, the following diagnostic methods are used to detect the disease:

1. PCR method (polymerase chain reaction). The most sensitive and more likely to give the correct result (up to 100%). Also, the advantages include the fast speed of analysis (1-2 days) and a small amount of material needed for research (scraping from the cervical canal, from the conjunctiva of the eyes, blood, saliva, etc.). also in violation of the study. If a positive result is obtained, there is no need to re-confirm it. The PCR method is the most preferred in the diagnosis of chlamydia.

   

   The PCR method today has the highest sensitivity and specificity - up to 100%

2. Enzyme immunoassay (ELISA). It is a determination of antibodies to the pathogen in the blood (IgG, IgA, IgM), which are produced by the body in response to infection. The essence of the method is to detect a reaction to chlamydial antigens, which act on the cells of the taken biomaterial. In the case of a blood test, it is possible to identify the nature of the course of the disease (acute, chronic). The disadvantage of ELISA is the lack of accuracy, which is not higher than 60% due to the possibility of detecting antibodies to chlamydia in perfectly healthy people, as well as the detection of antibodies to several pathogens at once.
3. Chlamydia culture. A rather time-consuming and lengthy method, the results of which become known only after a few days. The undoubted advantages of this cultural technique is the inability to make a false positive diagnosis, because if chlamydia is sown, then there is no doubt about their presence in the patient's body. Also, an additional bonus is the determination of the sensitivity of the microorganism to antibiotics, which helps in the treatment of an infected patient. The accuracy of the analysis is from 70 to 90%.
4. General smear. In women, smears are taken from several points at once: the vagina, cervix and external opening of the urethra. Over time, the study does not lose its relevance. This microscopic analysis is the most accessible diagnostic method - it can be taken free of charge in every antenatal clinic. At the same time, the probability of detecting chlamydia is only 15%, so the main purpose of taking a smear is to obtain information about the course of the inflammatory process. The results of such an analysis cannot be used to make an accurate diagnosis, since the number of leukocytes in a smear in the presence of chlamydial infection increases slightly or remains at the same level.

   

   The smear is applied to glass and stained with special dyes that allow bacteria to be more clearly distinguished under a microscope.

5. Immunofluorescence reaction (RIF). During the analysis, the biomaterial taken from the cervical canal is stained with a certain reagent and evaluated on a special fluorescent microscope. Chlamydia, if any, begin to glow in the lens of the device, like fireflies. The method is fast in execution, the result can be known in just a few hours. The downside is the accuracy of the study, which depends on the professionalism of the doctor and laboratory assistant and is only 50%. Also, the disadvantages include the inability to determine the disease in the early stages and making an incorrect result due to the possible glow of staphylococci instead of chlamydia.
6. Mini test. Serves for home diagnosis of chlamydia. The test can be purchased at the pharmacy kiosk. The advantages of this method: cheapness and ease of use, quick results. A significant disadvantage is the low accuracy of diagnosis - only 20%.

   

   No doctor will prescribe treatment to a patient based on the results of this study alone - it is insufficient to make a diagnosis

Differential Diagnosis

Differential diagnosis is carried out with other sexually transmitted infections:

• gonorrhea;
• trichomoniasis;
• mycoplasmosis.

Chlamydia is also differentiated from inflammation of the pelvic organs. The final diagnosis is based on clinical symptoms and the results of several studies of the patient's biomaterial at once: microbiological, colposcopic, cytological, etc.

Most often, doctors face difficulty in differentiating chlamydia and mycoplasmosis, since these two diseases are very similar to each other. However, effective therapy requires specific medications, different dosages and timing of antibiotics, which is why it is so important to make a correct diagnosis.

Laboratory diagnostics for setting the final verdict consists of the following studies:

• bacterioscopic examination of the smear;
• linked immunosorbent assay;
• immunofluorescent reactions;
• polymerase chain reaction (PCR);
• complement fixation reaction.

Table: differential diagnosis of chlamydial infection and mycoplasmosis in women

Distinction criterion	Chlamydia	Mycoplasmosis
Route of infection	sexual; domestic; intrauterine; intranatal (during childbirth).	sexual; domestic; intranatal.
Main affected area	Cervix; the fallopian tubes; in rare cases, mucous membranes (for example, the conjunctiva of the eyes).	endometrium
Localization in complex lesions of the body	conjunctiva of the eye; pelvic organs; area of ​​the liver and lungs; joints; in rare cases - pharyngitis, endocarditis and encephalitis.	lungs
Response to therapy	with improper treatment, chlamydia can go into a protective form in which they are not exposed to the action of drugs	no protective gear
Incubation period	5– 30 days	3–27 days
Symptoms	Doesn't have overt symptoms. Usually: vaginal discharge with an unpleasant odor; cervicitis; cystitis;	often asymptomatic
Risk of provoking Reiter's disease	high	short
Specific impact	the development of adhesive processes in the affected tissues; polyhydramnios during pregnancy.	polyhydramnios; improper attachment of the placenta.
Consequences	infertility; miscarriage; ectopic pregnancy; premature birth; fetal damage.	miscarriage; increased uterine tone; premature birth; fetus is not affected.

Video: diagnosis of chlamydia

Treatment for chlamydial infection

In case of detection of chlamydia during pregnancy, the disease should always be treated and not wait until the baby is born. To choose the right path of therapy, the doctor prescribes additional studies that show possible infections that occur together with chlamydia:

• gonococci;
• cytomegalovirus;
• herpes virus;
• syphilis;
• mycoplasma;
• HIV, etc.

Also, to choose a treatment option, it is important to identify diseases that are not caused by various kinds of infections (these can be chronic kidney or liver diseases). Drugs used to treat chlamydia during pregnancy can adversely affect a woman's health if no violation of the function of internal organs has been announced in advance.

Antibiotics

Chlamydia can be treated in two ways:

1. Single use of an antibiotic sensitive to chlamydia.
2. Aggregate treatment by several groups of drugs at the same time: antibiotics, enzymes and immunostimulants is more effective, but costly and lengthy.

The main group of antibiotics that show high efficiency in the treatment of chlamydia in pregnant women (up to 98%) are the latest generation macrolides. They are allowed when carrying a child, are not allergic and rarely cause side effects.

The American Centers for Disease Prevention and Control (CDC) recommends an initial course of therapy with Erythromycin, and as a second-line drug, in case of failure of the treatment, use Azithromycin.

Treatment of infection in the acute stage begins no earlier than 12 weeks of pregnancy, when the main organs of the fetus are already laid. If chlamydia has taken a chronic form, therapy is carried out in courses at 20 and 30 weeks. It is important to take medicines together with a sexual partner.

During treatment, it is strictly forbidden to cancel the prescribed drugs on your own if there are signs of improvement in well-being. Surviving chlamydia become resistant to this substance and a complete cure is further complicated.

Not all antibiotics that can eradicate chlamydia are approved for use during gestation. Only a doctor can prescribe a suitable drug, self-medication is unacceptable. Only a professional can make the most safe and effective treatment regimen for a pregnant woman, taking into account several factors at once:

• acute disease or chronic;
• in mild or severe form;
• newfound disease or neglected;
• in which organs the foci of infection are localized;
• to which antibiotics chlamydia are sensitive (to be recognized after the seeding);
• whether there are additional infections;
• whether non-communicable diseases have been identified.

Immunostimulants

Immunomodulating agents in the treatment of genital chlamydia are not prescribed to all pregnant women. To begin with, certain studies are prescribed, according to which the doctor can judge the presence of disorders in the immune system. Based on laboratory data, the doctor prescribes drugs that can support immunity, the most prescribed of which is alpha-interferon (Viferon drug).

Viferon helps restore immunity, increase the body's resistance to infection and is safe for pregnant and lactating mothers.

Enzymes are designed to enhance the effect of antibiotics and increase their blood levels by 30-40%, while maintaining the same dosages. So diseased organs will receive more of the drug, while not increasing the amount of the drug taken.

Unlike immunostimulants, these medications are prescribed to pregnant women for the treatment of chlamydia much more often. Enzymes restore the reduced permeability of cell membranes, have anti-edematous and analgesic effects. In addition, taking them helps to reduce toxicity and reduce the risk of developing an allergy to the drugs used. One of the prescribed enzyme preparations is Wobenzym, which contributes to a faster recovery and a decrease in the clinical manifestations of chlamydia.

Wobenzym is a complex of enzymes of animal and plant origin (papain, trypsin, chymotrypsin, bromelain, pancreatin, amylase, lipase)

Folk remedies

Traditional medicine can supplement antibiotic therapy for a good result and a complete recovery. For treatment, plants are used that have anti-inflammatory and antibacterial effects, as well as enhance immunity.

Garlic infusion

Ingredients:

Cooking:

1. Peel the garlic cloves from the husk and chop until gruel.
2. Add water to garlic and stir.
3. Infuse the mixture for 12 hours.
4. Strain the infusion.

The infusion is applied topically, for douching and washing inflamed mucous membranes.

Anti-inflammatory decoction

To prepare a decoction, you can use any plants that relieve inflammation:

• chamomile flowers;
• calendula flowers;
• birch buds and leaves;
• oak bark;
• liquorice root;
• yarrow.

You can also purchase ready-made fees at the green pharmacy.

A decoction of chamomile can be used both for douching and inside before meals.

Decoction Ingredients:

• vegetable raw materials - 3 tbsp. l.;
• boiling water - 1 l.

Cooking:

1. Pour raw materials with a liter of boiling water and boil for about 10 minutes.
2. Decoction to insist for an hour, then strain.

You need to drink a decoction daily for a month, 100 ml each time before meals.

Ingredients:

Cooking:

1. Scald the container for tea with boiling water, fill in the raw materials.
2. Pour boiling water over St. John's wort, leave for 5 minutes.

St. John's wort tea is drunk daily before meals. You can not brew it tightly, as this can lead to spasms in the intestines.

Planning for pregnancy after treatment

After suffering chlamydia, a woman does not always have the opportunity to safely become pregnant. This is due to the irreversible changes that the infection left in the body. Even cured chronic chlamydia can be fraught with subsequent ectopic pregnancies, endometriosis, and adhesions.

A timely noticed and cured disease will not leave significant complications and will not lead to serious problems with conceiving a child.

Childbirth in pregnant women with chlamydia

A pregnant woman with chlamydia is registered with an infectious disease specialist for the entire period of gestation. If it is not possible to recover before childbirth, then the woman is sent for delivery to the observation department or to the infectious maternity hospital. Childbirth can occur naturally, while the birth canal is treated and sanitized, but more often a caesarean section is used to prevent intranatal infection of the fetus. However, this way of artificial delivery does not guarantee that the baby will not be infected.

Observation (from the Latin observatio - observation) is the isolation of sick or healthy (after contact with infectious patients) people in a special room

Prevention

As with other sexually transmitted diseases, the preventive actions of chlamydia are:

• lack of promiscuity;
• the use of a condom in case of uncertainty about the health of a partner;
• timely visits to the doctor and testing for infections;
• use of personal hygiene products.

A lower risk of contracting chlamydia in faithful women who have one healthy partner. Also important is pregnancy planning and testing for infections before conception, which also applies to expectant mothers and fathers.

Taking preventive measures before pregnancy will be the best option for its successful completion and the birth of a healthy baby. When chlamydia is detected during the period of gestation, every effort must be made to completely eradicate the infection, in which case the chance to give birth to a healthy baby increases significantly.

A woman can become infected with chlamydia before pregnancy, during conception, and directly during childbearing.

Infection occurs imperceptibly, and chlamydia multiply not earlier than after 3 days. Diseases caused by chlamydia trachomatis in women during pregnancy occur in an erased form. This is especially bad, because the expectant mother may not even suspect that she is sick.

Why are chlamydia dangerous for a pregnant woman, how to recognize chlamydia and how to treat it - we will tell you the most important thing about this.

How does chlamydia appear during pregnancy?

Chlamydia can live and multiply only in the cells of the human columnar epithelium. This tissue is just lined with the cervical canal and its cavity. Therefore, bacteria “with pleasure” settle on the surfaces of these organs if they enter the body of a pregnant woman.

On the left is a normal cervix, on the right is an eroded cervix

However, there is a difference between how chlamydia occurs in pregnant women and in other people.

During pregnancy, particularly favorable conditions occur for chlamydia, because the woman's immunity during this period is simply “not up to them”. The fact is that the body's defense system is being rebuilt - it stops wasting energy on diseases if they do not threaten the child in the very near future. Therefore, in the future mother, the manifestations of diseases that "distract" from bearing disappear. As a result, chlamydia during pregnancy occurs almost without symptoms.

Symptoms of chlamydia during pregnancy appear only in 10-15% of expectant mothers. For example, when examining the cervix, the doctor may detect erosion. This is a non-healing wound on the surface of the cervix caused by chlamydia. It may be an indirect sign of chlamydia, but still does not directly indicate the presence of chlamydia.

Chlamydia during pregnancy occurs almost without symptoms

Unfortunately, there are almost no other visible or tangible signs of chlamydia during pregnancy. A sick woman looks normal, the external condition of her genitals is also normal, and her health reflects only how the pregnancy proceeds in general, without hinting at chlamydia.

As for the manifestations of chlamydia during breastfeeding, they are also practically non-existent. The condition of a woman during this period is no different from the usual, because most often the disease occurs in an erased form.

However, this does not mean that chlamydia cannot be diagnosed during pregnancy or while breastfeeding. You can detect chlamydia in a future mother or in a nursing woman in the same ways as in other people. For example, antigens against chlamydia in the blood can be detected if the infection occurred sexually - both before pregnancy and during childbearing.

Treatment of chlamydia while breastfeeding is also quite possible. There are antibiotics for chlamydia that are allowed while breastfeeding. Therefore, it is not necessary to stop it during treatment. Chlamydia itself does not penetrate into breast milk and it is impossible to infect a child in this way.

Consequences and complications of chlamydia for pregnant women

Although during pregnancy chlamydia itself is sluggish and rarely manifests itself outwardly, its complications are very dangerous both for the general health of the woman and for her pregnancy. They appear during the period of gestation, during the birth of a child and after childbirth.

Often these complications are not even associated with chlamydial infection, although it actually turns out to be the cause of many sad consequences. Let's take a closer look at the dangers of chlamydia for pregnancy.

Chlamydia and ectopic pregnancy

chance of getting pregnant after an ectopic pregnancy

When chlamydia enters the uterus (this is possible in the first half of the menstrual cycle), they reach the fallopian tubes. There they multiply and cause changes in the pipes - adhesions (that is, internal scars). Adhesions block the passage through the tube to the uterus for a fertilized egg. Because of this, the embryo does not enter the uterus, and is attached to the wall of the fallopian tube. This is how an ectopic pregnancy develops, which is interrupted for up to 10 weeks.

In an ectopic pregnancy, a tube rupture can occur and the woman is at risk of bleeding to death. If doctors manage to help, they remove the damaged fallopian tube. Unfortunately, this reduces the chances of getting pregnant again by 50%.

Miscarriage due to chlamydia

If adhesions inside the tube do not form, and a normal pregnancy occurs, can chlamydia cause a miscarriage then? Maybe at any time.

If a woman becomes pregnant without being treated for chlamydia or chlamydia enters the woman's body already during her pregnancy, then the fetal egg (the membrane that surrounds the fetus at very early stages of formation) is most likely to become infected. An inflammatory process begins, which leads to suppuration of the fetal egg and death of the fetus. Then the mother's body rejects the dead child.

Sometimes there is a state of so-called missed pregnancy- when a miscarriage does not occur, but the child has already died. This is especially dangerous for a woman's life: she still considers herself pregnant (there is no menstruation, she feels normal), but at this time the dead fetus releases highly toxic substances. This can lead to infection of the woman's blood and her death.

Chlamydia and preterm birth

If chlamydia "reached" the child at later stages of pregnancy, then premature birth may occur. This happens when bacteria invade the fetal membrane and cause it to become inflamed. It ends with a rupture of the fetal bladder: amniotic fluid departs too early.

Such a development of events threatens the death of the fetus. If doctors manage to help, the premature baby is removed by caesarean section. Unfortunately, in this case, the baby is highly likely to become infected with chlamydia. Therefore, the answer to the question: “Is it possible to give birth to a healthy child with chlamydia?” it is clear: it is possible, but the risk of infection is high.

Ways of transmission of chlamydia from mother to child

The transmission of chlamydia from mother to fetus occurs during pregnancy at different times or directly during childbirth.

Ways of transmission of infection:

• intrauterine
• transplacental (through the child's place - the placenta)

Penetration of chlamydia occurs through the vessels of the placenta - this is how chlamydia penetrate the circulatory system of the fetus.

• hematogenous (through the blood)

Hematogenous infection occurs when chlamydia enters the mother's blood. This can happen during anal intercourse. In the rectum, during intervention from the outside, microcracks are always formed, through which chlamydia freely penetrate into blood cells and travel throughout the body. Including they get to the child. This can occur both through the vessels of the placenta and the uterus. It turns out that anal sex during pregnancy is a fairly common cause of chlamydia entering the bloodstream.

• intranatal (generic)

The defenses of a woman's body can prevent the reproduction of chlamydia during the gestation period. But then infection can still occur - already during childbirth. When the baby passes through the birth canal, he receives all the bacteria that the mother has in her vagina. This route of infection is called intranatal (obtained during childbirth).

How does chlamydia affect the fetus?

Depending on the way in which the infection has penetrated, chlamydia in the fetus (and later in the newborn) proceeds in different ways. The beginning of the inflammatory process is different for each route of entry of chlamydia. Different consequences of chlamydia in the fetus depend on the place through which the bacteria enter the body - doctors call these places the entrance gate. Consider separately how chlamydia affects pregnancy and the fetus.

Consequences of intrauterine infection

It is important to know that chlamydia can cause miscarriage. When intrauterine infection with chlamydia first develops chorioamnionitis- purulent inflammation of the membranes, which can lead to miscarriage or premature birth.

If this does not happen, then from the fetal membrane, chlamydia enters the amniotic fluid, and from them into the fetus. Then the bacteria infect the mucous membranes: the eye (conjunctivitis), the intestines (enteritis) and the intermediate tissues of the lungs (pneumonitis). This happens because the baby makes respiratory movements, swallows amniotic fluid and thereby passes the infected fluid through the lungs.

After childbirth, when air enters the lungs of such a child, the chlamydial lesion also spreads to the alveoli - pneumonitis becomes severe pneumonia. Also, chlamydial infection affects the genitourinary system of the fetus, because the amniotic fluid is excreted from the baby's body in the urine, and before that it passes through the liver and kidneys.

Consequences of transplacental infection

If the infection of the fetus occurred through the placenta, then chlamydia immediately enters the largest vessels of the child. Therefore, when the infection enters the blood of the fetus in this way, the mucous membranes of all organs suffer from chlamydia.

In particular, the child develops:

• intrauterine chlamydia of the meninges - meningitis;
• chlamydial inflammation of the mucous membranes in the kidneys - pyelonephritis;
• chlamydia of the mucous membranes of the lungs - pneumonitis.

Infection by the transplacental route can result in fetal death at any stage of pregnancy.

Consequences of hematogenous infection

The hematogenous route of infection differs from the placental one in that chlamydia enters the fetus not through the vessels of the placenta, but through the umbilical vein and in much larger quantities.

In this case, the fetus is simultaneously affected through the blood and mucous membranes of the digestive, respiratory and urinary systems. Hematogenous damage to the body can also cause fetal death at any stage of pregnancy. The child may have hemorrhages in the brain, adrenal glands, kidneys and lungs.

Complications of chlamydia in a woman after pregnancy

Chlamydia is dangerous for a woman not only during pregnancy, but also after. The changes that occur to the body after childbirth or an abortion make a woman's genitals more vulnerable to the destructive activity of chlamydia.

Chlamydial endometritis

Inflammation is manifested by an increase in body temperature up to 30-40°C. Treatment of endometritis in severe cases may result in removal of the uterus. This is what chlamydia can cause in pregnant women.

Treatment of endometritis in severe cases may result in removal of the uterus.

Cervical erosion

As we already wrote at the beginning of the article, due to chlamydia, a woman may begin to erode the cervix - even before or during pregnancy. But even worse, hormonal changes after childbirth worsen the course of erosion: anatomical changes occur in the cervix that turn the disease into a chronic form.

If outside of pregnancy, erosion can be cured with antibiotics, then after childbirth, this disease can provoke oncological problems. Therefore, it is necessary to treat only with the help of surgery.

Symptoms of chlamydia in newborns

The course of chlamydia in newborns manifests itself in two ways: either as an exacerbation of intrauterine chlamydia (i.e., which the baby acquired before birth), or as an initial acute infection - if the infection occurred during childbirth (when chlamydia passes to the child during the birth ways).

Manifestations of chlamydia in a newborn with intrauterine infection

If chlamydia is not treated during pregnancy, the baby can develop pneumonia before birth. As we have already said, the unborn baby makes respiratory movements, passing amniotic fluid into the lungs. If they contain chlamydia, then they are deposited in the lung tissue and begin to multiply actively.

On the left - normal airways, on the right - airways in bronchial asthma

After some time, these inflammatory changes lead to "sticking" of the alveolar vesicles. After giving birth, such a child cannot take his first breath and needs artificial ventilation. That's why chlamydia is dangerous for a newborn with damage to the lung tissue.

If congenital pneumonia is asymptomatic, then the child develops hypersensitivity to allergens. Children born to mothers infected with chlamydia often suffer from bronchial asthma.

A separate form of chlamydia in newborns who have received an infection through the blood (hematogenous route) leads to dangerous consequences affecting the central nervous system. These children may develop meningitis in infancy or mental retardation at school age.

Manifestations of chlamydia in children infected during childbirth

How chlamydia manifests itself in newborns can be seen on the right - in hidden photos. In this case, acute chlamydial infection in newborns occurs in the form of the following diseases:

• conjunctivitis - inflammation of the eyelids;
• rhinitis - runny nose;
• pneumonia;
• urethritis/vaginitis.

Chlamydia, obtained during childbirth, manifests itself in newborns with symptoms of conjunctivitis almost immediately after birth: abundant discharge from under the eyelids, characteristic of congenital chlamydia, has a glassy consistency.

Also, with chlamydia, babies often have a runny nose - it appears after about 4 days after birth. This is the first sign of a respiratory (respiratory) form of chlamydia infection in newborns.

Chlamydia in infants can proceed according to the same scenario as in an adult. In the chronic form, boys develop urethritis, and girls develop vaginitis.

In some cases, with a healthy immune response (in breastfed babies), chlamydia forms L-forms that do not manifest themselves. A person becomes a carrier of a sexual infection even before the onset of sexual life.

Due to the fact that chlamydia occurs in an erased form during pregnancy, it is especially dangerous for expectant mothers: a woman does not know about her illness and infects a child either in the womb or during childbirth.

In some cases, chlamydia does not appear in a child, but he becomes a latent carrier of the infection - in this situation, both his own health and the people he can infect by starting a sexual life suffer greatly.

Without treatment for chlamydia during pregnancy, a woman will not be able to avoid all the dangerous complications, both for the child and for her body.

In some cases, chlamydia does not appear in a child, but he becomes a hidden carrier of the infection.

To find out about the presence of chlamydia, it is very important to take tests for sexually transmitted infections before or at least during pregnancy. You can seek help from the antenatal clinic or KVD at the place of residence.

Treatment of chlamydia is possible at any period of gestation. Wherein the drugs themselves do not harm the health of the child. However, if you are late, you can face serious irreversible consequences for the baby and mother, which antibiotics will no longer be able to remove.