Infections during pregnancy

Bakterije, gljive, virusi i paraziti najčešći su uzročnici infekcija u trudnoći koji mogu dovesti do spontanog pobačaja, prijevremenog poroda te rađanja djeteta niske porođajne težine. Zbog promjena u imunosnom sustavu te zbog drugačije biološke flore u porođajnom kanalu, trudnoća pogoduje razvitku infekcija. Intrauterine i intrapartalne infekcije manifestiraju se u prvih 72 sata od porođaja, a nakon tog perioda govorimo o infekcijama u neonatalnom periodu. Dijete se može zaraziti tijekom migracije kroz porođajni kanal, zadobiti infekciju te shodno tome zdravstveno ugroziti. Analizom urina, tj. izradom urinokulture često se uspostavi upala mokraćnog mjehura kod trudnica. Rizik je najveći između 6. i 24. tjedna trudnoće. Bakterije iz probavnog sustava doputuju kroz mokraćnu cijev u urinarni trakt gdje se počinju razmnožavati. Učestalost je češća zbog kratkoće uretre (mokraćne cijevi) kod žena, a i anatomski položaj uretre (blizina rodnice i anusa) povećava rizik za razvoj urinarnih infekcija. Pod utjecajem hormona koji se luče u trudnoći, mokraćna cijev također postaje ranjivija i osjetljivija na prodor bakterija. Nadalje, genitalne infekcije nastaju zbog anatomske građe, promjene pH rodnice i promiskuiteta, a najčešći razlog je poremećena vaginalna flora. Određene infekcije mogu biti opasne kada se javljaju izvan trudnoće, a u trudnoći pogotovo mogu uzrokovati razne komplikacije i ugroziti plod. Zbog straha od mogućeg oštećenja ploda, trudnice često odbijaju liječenje urogenitalnih infekcija i spolno prenosivih bolesti. Nisu svjesne da posljedice ne liječenja ili lošeg liječenja mogu biti puno teže za nerođeno dijete nego potencijalna šteta od lijekova koji se rabe u liječenju. Važno je stoga rano, tj. pravodobno započeti sa liječenjem, a prije same trudnoće provesti ciljanu mikrobiološku obradu te (po potrebi) i terapiju ako se dokaže ugrožavajući uzročnik.Bacteria, fungi, viruses and parasites are the most common causes of infection in pregnancy that may subsequently lead to miscarriage, premature birth and low birth weight in the neonate. Due to changes in the immune system, as well as different biological flora in the birth canal, pregnancy favours the development of infections. Intrauterine and intrapartum infections manifest in the first 72 hours of birth, whereas after this period we are dealing with infections in the neonatal period. The child can be infected during migration process through the birth canal, which can possibly endanger child’s health. The analysis of the urine, i.e. urine culture is commonly used to establish bladder infection in pregnant women. The risk is highest between 6 and 24 weeks of pregnancy. The bacteria from the gastrointestinal tract arrive through the urethra into the urinary tract, where they start to propagate. The incidence is more common in women due to the short urethra, as well as its anatomical position (the proximity of the vagina and the anus), which in turn increases the risk of developing urinary tract infections. Under the influence of hormones that are secreted during pregnancy, urethra also becomes more vulnerable to the penetration of bacteria. Furthermore, genital infections are seen due to anatomical structures, changes in pH of the vagina and promiscuity, but the most common reason is perturbed vaginal flora. Certain infections can be dangerous when occurring outside pregnancy, but in pregnancy they are especially harmful as they can cause various complications and endanger the foetus. Out of fear from the possible adverse influence of treatment on the foetus, pregnant women often refuse antibiotic treatment of urogenital infections and sexually transmitted diseases. They are not aware that the consequences of lack or inappropriate treatment can be much more dangerous for the unborn child than the potential damage due to drugs used in the therapy. It is thus of utmost importance to start the treatment early, and to conduct complete microbiological assessment prior to pregnancy in order to institute adequate treatment timely, if necessary