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

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

In more rare cases, the infection can get to the fetus with any diagnostic methods. For example, during amniocentesis, chorionic villus sampling, etc. Or when the fetus needs to inject blood products through the umbilical vessels, which include plasma, erythrocyte mass, etc.

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

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

The predominance in the female body of pathogens that tend to provoke inflammatory processes in the genitals and other systems is called intrauterine infection (IUI). The most negative of the disease is the possibility of infection of the future fetus in the female body. The factor of infection of the fetus is the blood that circulates through the body of a woman and a conceived child.

This is the most basic route of infection, but the possibility of infection entering the body of a conceived child through the birth canal is not excluded. Mostly the disease is detected in women who lead an unhygienic lifestyle, but not in all cases. So, let's consider what types of infections are and how they enter the body of the embryo?

Intrauterine infectious diseases in newborns occur due to infection of the fetus with a pathogen during pregnancy or during childbirth. Most often, the infection of the child comes from the mother. Much less often, cases of infection are possible with specific types of maternal diagnosis (invasive prenatal diagnosis), the introduction of various blood products through the umbilical cord to the child, and other ways.

During the period of intrauterine development of a child, various viruses (rubella, HIV, herpes, hepatitis B, hepatitis C, cytomegaly) and intracellular microorganisms (mycoplasmosis, toxoplasmosis) most often occur as infectious agents.

During the birth period, the degree of infection directly depends on the state of the mother's birth canal. Provided the integrity and healthy functionality of the placenta, the child is inaccessible to the simplest viruses and most of the harmful bacteria. True, with placental insufficiency or various injuries, there is a high probability of infection of the child.

Infection with the pathogen in the first fourteen weeks leads to stillbirth and the occurrence of severe defects and disorders in the development of the child. The disease in the second and third trimesters causes damage to individual organs or a widespread infection.

It is possible that the clinical manifestation of infection in the mother may not coincide with the symptoms or severity of the infection in the child. The low intensity of symptoms or the asymptomatic course of the disease in a pregnant woman often causes severe consequences that affect the fetus - from pathologies to death.

Infection of the infant with intestinal infections occurs mainly by the oral-fecal method, when bacterial pathogens from the feces fall on the hands and various household items. Given that babies try to suck everything into their mouths that gets into their hands, the penetration of bacteria or viruses is not such a rare occurrence.

Usually, the reason for the penetration of pathogenic microflora into the children's body is the banal neglect of the rules of personal hygiene by parents when caring for a baby. For example, the cause of the infection may be an unwashed bottle or unwashed hands after the street, etc.

Also, infection occurs through the mother's body if she is a carrier or has contracted intestinal infections in the process of bearing a child.

The very fact of infection can happen even in the mother's womb, when the fetus swallows amniotic fluid or through the common circulatory system between mother and baby, or the baby becomes infected when it passes through the birth canal.

It is possible to identify intrauterine infection even during childbirth. Signs of infection can be:

• unpleasant odor and turbidity of amniotic fluid;
• unsatisfactory condition of the placenta;
• asphyxia in a newborn.

In the future, other manifestations of the disease can be diagnosed:

• enlargement of some internal organs (liver);
• microcephaly;
• jaundice;
• sudden febrile syndrome;
• pyoderma;
• different pigmentation on the skin;
• convulsions.

Manifestations of intrauterine infection can be a grayish skin color of a newborn, a syndrome of depression of the central nervous system and profuse regurgitation. In the future, in a protracted period of development, infections can cause osteomyelitis, various types of encephalitis and meningitis.

Acute manifestations begin in the first days of life after birth and are characterized by inflammation in the organs, nephritis, various manifestations of diarrhea, jaundice, and fever. Convulsions and edematous syndrome are possible.

The chronic form leads to strabismus, microcephaly, atrophy of the optic nerves and iridocyclitis. Much less often there are cases of monosymptomatic and latent forms of the disease. Late complications entail blindness, epilepsy, mental retardation.

congenital rubella

Rubella disease of a pregnant woman in different periods of pregnancy with varying degrees guarantees the possibility of infection of the child. When infected during the first eight weeks, the disease in the fetus is 80% and the consequences have a high degree of risk - up to spontaneous miscarriage. The disease in the second trimester will reduce the risk by up to 20%, and in the third by up to 8%.

A baby with rubella is often born low birth weight or premature. The typical clinical presentation includes congenital heart disease, auditory nerve and eye lesions. Deafness may develop.

Atypical manifestations and consequences may develop:

• hepatitis
• hydrocephalus;
• microcephaly;
• cleft palate;
• skeletal anomalies;
• vices of various systems;
• mental or physical developmental delay.

Cytomegaly

Defeat by pathogens of cytomegalovirus infection often leads to damage and abnormalities in the development of various internal organs, impaired functioning of the immune system, and various complications.

Most often there are congenital pathologies that manifest themselves:

• cataract;
• retinopathy;
• microphthalmia;
• microgyria;
• microcephaly and other serious diseases.

In the future, cirrhosis of the liver, blindness, pneumosclerosis, encephalopathy, and deafness may develop.

This disease occurs in three forms - wide, mucocutaneous and neurological. The broad form of the disease is characterized by toxicosis, jaundice, hepatomegaly, pneumonia, and distress syndrome. Other forms occur with the manifestation of rashes and encephalitis. Sepsis may develop.

Hepatitis can cause defects of varying severity - dwarfism, retinopathy, microcephaly. Later complications are developmental delay, blindness, deafness.

It is a shortness of breath and a varying degree of circulatory disturbance of the child, and manifests itself immediately after childbirth, leads to oxygen deficiency.

Asphyxia is distinguished between congenital and acquired.

• Congenital occurs due to impaired placental circulation, preeclampsia, entanglement of the fetus with the umbilical cord. A child is born with a slow heartbeat, weak muscle tone, and bluish skin color.
• Acquired asphyxia is the result of difficult childbirth, entanglement of the umbilical cord, muscle spasm of the birth canal of the woman in labor.

Almost every fifth baby is born with such a diagnosis and most of them cope with this problem themselves. There are times when you can not do without resuscitation procedures. In any case, the doctors of the maternity hospital do everything possible for the child so that he does not have neurological problems in the future.

It is an anemia in which red blood cells are destroyed in the body of a newborn.

This is a serious disease, which leads to the incompatibility of the blood of the fetus and mother. If the mother's Rh factor is negative, and the unborn child is positive, then there is a possibility of an Rh conflict, since antibodies can form in the mother's body that can destroy red blood cells in the fetal blood.

• hereditary factor;
• difficult pregnancy;
• birth trauma;
• Rhesus conflict in mother and unborn child;
• toxicosis and gestosis during pregnancy;
• lack of vitamins and minerals during pregnancy, incorrect mother-to-be nutrition;
• non-compliance with the rules of personal hygiene and hygiene of the baby;
• infection with staphylococcal and streptococcal infections in the maternity ward.

Common causative agents of intrauterine transplacental infection

In children, intestinal infections are most often bacterial or viral in nature.

The most common such infections are rotavirus, better known among the population as intestinal flu, shigellosis or dysentery. Salmonella, Escherichia, Yersinia, Staphylococcus, etc. can also be pathogens of pathology.

Often in infants, the causative agents of AEI are opportunistic microorganisms that belong to the normal flora, but under some circumstances provoke infectious lesions.

Such circumstances include the immaturity of immune defense, the use of antibacterial drugs, etc.

Most viruses and bacteria known to man are able to penetrate the fetus and cause various damage to it. But some of them are particularly contagious or pose an increased danger to the child. Some viruses (almost all that cause SARS) are not transmitted to the baby, but are dangerous only with a strong increase in the temperature of the pregnant woman.

Diagnostics

The method of identifying specialized markers using widely used ultrasound is often used. This method allows you to determine low and polyhydramnios, turbidity of amniotic fluid, developmental disorders and damage to the placenta, various fetal pathologies and developmental disorders of various organ systems of the child.

In the postpartum period, a complex of various laboratory tests is carried out in order to confirm or refute the presence of intrauterine infections. Tests for microorganisms, viruses and bacteria are widely used. The molecular biological research method based on DNA, serological and histological analyzes are used.

In the first days of life, if an infection is suspected, the child should be examined by specialists in various fields - cardiology, neurology, ophthalmology and other fields. It is recommended to carry out various studies on the reactions of the child's body.

For modern medicine, one of the most urgent tasks is the diagnosis of intrauterine infections in the initial stages. To do this, a wide range of different analyzes is carried out in order to detect pathologies - smears and cultures for the flora from the vagina of a pregnant woman, PCR diagnostics, specialized laboratory tests for a complex of intrauterine diseases in newborns.

Treatment of intrauterine infections is a complex of multidirectional therapies that together help to cope with the disease. The main types of treatment are aimed at ridding the body of pathogens, restoring the full spectrum of the functioning of the immune system, and restoring the body after a disease.

To strengthen the immune system, immunomodulators and immunoglobulins are prescribed. Most antibiotics for newborns and pregnant women help fight viruses and bacteria. Restoration of the body consists in getting rid of the residual symptoms of intrauterine infections.

Symptoms of intrauterine infection in a newborn and during pregnancy

In a pregnant state, it is not so easy to detect infection of the fetus, so doctors do their best to do this. No wonder a pregnant woman has to take so many different tests several times a month.

The presence of intrauterine infection can be determined by analysis. Even a stand swab that is taken on a chair can show some picture of the presence of infections, however, they do not always lead to intrauterine infection of the fetus.

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

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

Mom should sound the alarm already at the very first signs of infection of the crumbs. These include:

• A sharp hyperthermic reaction. In infants, it is almost impossible to miss this moment, because as a result of a rise in temperature, their face turns red, and their eyes begin to shine feverishly.
• Another characteristic manifestation of intestinal infection in infants is the occurrence of repeated vomiting. The kid can completely refuse food, spit out and bite his chest, be capricious, because everything he eats is immediately outside.
• Intestinal activity is disturbed, which is accompanied by severe painful sensations that force the baby to cry, kick his legs and press his knees to his tummy.
• Kal also changes. If normally it is yellow and mushy, then with intestinal infections it becomes liquid and green interspersed with mucus or blood, pus, etc.

When this symptomatology appears, it is necessary to urgently consult a doctor, while the disease has not yet become complicated and has not spread throughout the body.

With intrauterine penetration of infectious agents, miscarriages, pregnancy fading, antenatal fetal death and stillbirths quite often occur. Surviving fetuses may experience the following symptoms:

• intrauterine growth retardation
• Micro- and hydrocephalus
• Chorioretinitis, cataract (eye damage)
• Myocarditis
• Pneumonia
• Jaundice and liver enlargement
• Anemia
• Dropsy fetus (edema)
• Rash on the skin
• Fever

Prevention

First of all, preventive examination of partners at the stage of pregnancy planning will help to avoid the occurrence of intrauterine infections. Very often, vaccination is used to prevent the occurrence of herpes viruses.

An important element of prevention is the full and unconditional observance of the rules of personal and general hygiene, maintaining a healthy lifestyle, regular examinations for various infectious diseases.

In general, pathology with timely diagnosis and treatment has quite favorable prognostic data, especially when pathology is detected at its early stages.

The symptomatic picture of intestinal infections only worsens with further development, therefore, it is immediately necessary to take preventive measures, which include breastfeeding the baby and strengthening his immunity, high-quality heat treatment of products.

Prevention of intestinal infections requires parents to strictly control the water consumed by the child and thoroughly wash fruits and vegetables.

Intestinal acute inflammation in children is widespread, because the immune defense has not yet been formed, and the digestive system itself is characterized by some features. The disease is characterized by a rather complicated course in children, so you need to be treated.

Intestinal infections, or abbreviated AII among babies, occupy an "honorable" second place after SARS, and often cause hospitalization of young children in a hospital, and in infancy can be the cause of death with the addition of formidable complications (dehydration, infectious-toxic shock, convulsions, coma).

Contents: What is meant by OKI? What pathogens are responsible for the development of AII? Features of the digestion of babies that contribute to AII The role of microflora in the genesis of AII How infants become infected with intestinal infections Manifestations of intestinal infection in infants Features of lesions of different parts of the digestive tract What is special about AII in infants

What is meant by OKI?

Under the term AII (acute intestinal infection), doctors mean a whole group of pathologies of infectious origin, which have different causes, but a single mechanism of infection (“diseases of dirty hands”) and are manifested by similar clinical symptoms - diarrhea, vomiting, abdominal pain, malaise, fever.

These diseases in infancy are severe, have every chance of a complicated course, which threatens with hospitalization and intensive care.

Both in our country and throughout the world, the incidence of acute intestinal infections is extremely high, and up to two years these diseases and their complications are one of the leading causes of death of babies, especially in the first year of life. Often, acute intestinal infections take the form of epidemic outbreaks - that is, whole families or organized groups, departments of hospitals and even maternity hospitals fall ill at once.

What pathogens are responsible for the development of AII?

Based on the cause, all acute intestinal infections can be divided into several groups. So, allocate:

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Often, at an early age, the exact cause of AEI cannot be identified due to the early start of treatment and the suppression of pathogenic flora due to drugs by the time the culture is taken and its result is obtained. Sometimes a whole group of microbes is sown, and it is impossible to determine the exact cause. Then a clinical diagnosis of OKINE is made, that is, it is an OKI of unknown or unexplained etiology.

The difference in diagnosis practically does not affect the clinical manifestations and methods of treatment, but it is important for epidemiological surveillance and measures to prevent the spread of infection (current and final disinfection in the outbreak).

Features of the digestion of babies that contribute to OKI

In childhood, especially up to three years, the digestive system has a special structure and functional activity, as well as specific immune reactions, which is a contributing factor for the development of acute intestinal infections. The most sensitive to these diseases of the chest.

With AII in children, various sections of the digestive tube can be affected, starting with the stomach (the esophagus and oral cavity are not involved in the process), ending with the rectum. Once in the oral cavity, food is processed by saliva, which contains lysozyme, which has a bactericidal effect. Babies have little of it and it is of low activity, and therefore food is less disinfected.

On the intestinal mucosa there are a lot of villi that are actively involved in digestion. In young children, they are very delicate and vulnerable, pathogenic objects easily damage them, which leads to swelling and secretion of fluid into the intestinal lumen - which immediately forms diarrhea.

The walls of the intestine secrete a protective (secretory) immunoglobulin-IgA, up to three years its activity is low, which also creates a predisposition to AII.

Add to this the general decrease in immune protection due to immaturity and early age.

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If the child is an artificial one, another negative factor acts, the absence of breast milk immunoglobulins and protective antibodies that will break the baby in the fight against pathogenic agents.

The role of microflora in the genesis of AII

At birth, the digestive tract of infants is populated by microbes that form a specific intestinal microflora that plays an important role in immunity, vitamin synthesis, digestion and even mineral metabolism, food breakdown. The microbial flora (creating a certain level of activity, pH and osmolarity of the medium) also, due to its activity, suppresses the growth and reproduction of pathogenic and opportunistic agents that enter the intestine.

A stable balance of microbes helps the baby to protect itself from AEI, so the state of the microbial flora is extremely important at an early age, and the state of dysbacteriosis is a predisposing factor for the formation of AEI.

If we talk about all microbes, they can be divided into groups:

• Obligate (permanently located in the intestines), it also refers to beneficial flora. Its main representatives are bifido- and lactoflora, Escherichia coli and some others. They make up to 98% of the volume of all intestinal microbes. Its main functions are to suppress incoming pathogenic microbes and viruses, help digestion, and stimulate the immune system.
• optional flora(it is also transient and conditionally pathogenic). This group of microbes, the presence of which in the intestine is permissible, but not necessary, in a small amount they are quite acceptable and do not harm. Under special conditions, a group of opportunistic microbes can lead to the development of acute intestinal infections (if immunity is reduced, intestinal dysbacteriosis is pronounced, potent drugs were taken).
• pathogenic flora (atypical) getting into the intestinal lumen, leads to intestinal infections, and therefore dangerous for children.

For infants, it is the pathogenic flora that is most dangerous, and with a decrease in immunity, severe dysbacteriosis and some special conditions, it can become dangerous and give OKI even its conditionally pathogenic representatives.

How do babies get intestinal infections?

The most common source of infection for infants are adults with acute intestinal infections or who are carriers of pathogenic objects. The incubation period for AII is usually short, except for some pathogens, and lasts from several hours to several days (usually 1-2 days). For viral infections, contagiousness can last throughout the entire period of clinical symptoms and even up to two weeks after the disappearance of all symptoms. In addition, food and water can be sources of AII pathogens for infants if they are infected with viruses or microbes of a dangerous group.

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The causative agents of AII enter the body through the mouth - from dirty pens, with food or water, and for some infections, the airborne route is also relevant (as with ARVI). Household appliances, utensils and things that are contaminated with pathogenic viruses and microbes can also be sources of infection. Bathing water taken from open reservoirs that gets into the mouth can become dangerous, as well as non-compliance with personal hygiene by parents, especially if they themselves are sick or carriers of the infection.

It is infants who are most susceptible to AEI, although people of any age can get sick with them. Children typically have a more severe course, with rapid onset of dehydration and negative consequences in the form of seizures, dehydration, or other complications. For infancy, there are certain risk factors that form a more severe course of AEI:

• Formula feeding from birth
• Children with prematurity or immaturity
• The introduction of complementary foods that are unsuitable for age and improperly prepared, seeded with pathogens
• Summer period, when the activity of dangerous pathogens is higher (for microbes)
• Cold season (for viruses)
• Immunodeficiency states of congenital or acquired origin
• Damage to the nervous system of traumatic or hypoxic origin.

It is important to understand that immunity to these infections is extremely unstable, and infants can, having been ill with one AII, subsequently become infected with other types of it if precautions are not followed.

• Vaccination of children and adult women before pregnancy planning
• Caring for women's health
  • limiting contact with children, especially in educational institutions
  • restriction of visits to crowded places
  • careful contact with pets, avoiding cleaning the cat litter box
  • nutrition with thermally processed foods, the exclusion of soft cheeses and semi-finished products
  • an adequate method of protection against infection during sexual intercourse
• Determination of the level of immunoglobulins for the main intrauterine TORCH infections before pregnancy planning

What examination can the doctor prescribe?

Infections of intestinal localization for infants are often the cause of death, so the timely detection of pathology and its etiology is very important. The doctor examines the child and prescribes additional studies aimed at determining the causative agent of the pathology.

Scatology of feces is carried out, which allows to identify a specific pathogen and detect violations in the structure of the gastrointestinal tract. Bacteriological culture, biochemistry and general blood and feces, urine tests are also carried out. If necessary, ultrasound diagnostics, etc.

Treatment and monitoring for intrauterine infection

I must say that not all intrauterine infections can be treated. Sometimes they cannot be cured. For such therapy, first of all, it is necessary to establish the condition of the mother and child, and only then prescribe the appropriate treatment. Treatment with antibiotics is indicated only in especially dangerous cases.

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

And, it should be noted that the best thing a future mother can do is to prevent the development of intrauterine infection, which will help to avoid further problems and pathologies. Therefore, it is best to observe preventive measures in relation to this. Preventive measures include, first of all, pregnancy planning.

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

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

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

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

Therapy of intestinal infections in infants who are breastfed proceeds much faster and easier than in artificial ones. After all, mother's milk strengthens the immune defense and increases the body's resistance to pathogenic microorganisms.

The primary task is considered to be cleaning the intestinal structures from pathogenic pathogens, which helps to stop the intoxication effect and prevent dehydration. It is necessary to treat such small children under strict medical supervision, then the microclimate in the intestine will quickly return to normal.

It is important to exclude food for 12-18 hours, during which it is allowed to give the baby some water or weak tea.

The use of sorbent agents (Enterosgel, Smecta) is shown, which help to quickly remove all toxic substances from the structures of the gastrointestinal tract and contribute to the rapid restoration of water and electrolyte balance.

If the baby often vomits, then you need to rinse the stomach cavity. If the baby still vomits, then you need to provide drip-infusion nutrition for the child. If the infection has a severe bacterial form, then antibiotic treatment with a wide area of ​​​​impact is indicated.

As medical practice shows, in the human body there are always microorganisms that are the causative agents of all kinds of diseases. And if a man, having become infected with them, is responsible only for himself, then it is more difficult with the fair sex. In addition, if she is in an interesting position at the time of infection.

From what pathogen will cause infection of the mother's body, this will be the disease of the baby. According to doctors, the disease is caused by:

• Herpes, rubella, influenza viruses, cytomegaly;
• Bacteria - streptococci, Escherichia coli, pale treponema, chlamydia;
• Protozoa (toxoplasma);
• Mushrooms.

The presence of the following factors in the expectant mother will increase the risk of infection of the newborn:

1. The woman's health is undermined by various ailments of a chronic nature;
2. The female body is affected by many negative factors such as smoking and alcohol busting and employment in hazardous industries;
3. Constant stress throughout pregnancy;
4. Mom suffers from chronic ailments of the genitourinary system.

T - toxoplasmosis;

Oh - others. This refers to almost all ailments of an infectious nature;

R is for rubella. In Latin rubella;

C - cytomegalovirus infection of the newborn;

N - herpes.

From the period at which the infection occurred, the degree of influence of the infection on the further development of the baby will be manifested;

• Up to twelve weeks - infection at such an early stage often leads to the fact that spontaneous interruption occurs or, in the future, the development of a small one will pass with large defects;
• Infection occurred between 12 and 28 weeks - usually at this time, infection will lead to developmental delay. The consequence of this will be that the newborn will be born underweight;
• Infection after 28 weeks is dangerous because it has a negative effect on the well-formed organs of the child. The brain, heart, liver and lungs are primarily affected. That is, all vital organs.

If infection is detected during pregnancy, this is not a reason to give up. The disease is well treated with antibiotics. Representatives of the penicillin group excel here. After all, despite their venerable "age" among antibiotics, they are still one of the most effective drugs in the treatment of viral infections. Moreover, they are practically safe for the health of the baby.

At the same time, antimicrobial drugs are actively used. Their use often saves the life of a child, and also reduces the negative consequences.

With a viral infection, treatment is a rather difficult process, but if you start it in a timely manner, the consequences can be prevented. But if they have already formed, then antiviral drugs are useless. In this case, surgical methods often come to the rescue. In cases of cataracts or CHD, the child will have a chance to live the rest of his life on his own, with a minimum of outside help. It is not uncommon for such children to need hearing aids many years later.

Already mentioned above, acute herpes with rashes on the labia of the mother is clearly an indication for caesarean section. In other cases, nothing interferes with natural childbirth.

Intestinal infection in infants is a common occurrence. Basically, pathogens enter the child's oral cavity through dirty hands and toys.

These microorganisms take part in the processing of food and form the feces of the baby. Normally, the stool of a breastfed baby occurs more than 4 times a day. Feeding a child with artificial nutrition is less useful: stools are noted no more than 2 times, and problems with constipation often occur.

But not only beneficial microorganisms inhabit the children's intestines: pathogenic bacteria enter it along with mother's dirty hands, unwashed pacifiers and toys. Intestinal infections in infants have a favorable prognosis only in the case of early diagnosis of the pathology and timely treatment.

If the infection is started, the disease can cause dehydration and serious intoxication of the child's body. Signs of intestinal infection in infants are repeated vomiting and diarrhea that occur already in the first hours from the onset of the disease.

For an infant, this is dangerous due to severe dehydration, disruption of the urinary system, the development of pathological conditions from the respiratory, cardiovascular and nervous systems. In extreme cases, in the absence of adequate treatment, intestinal infection in infants can lead to the death of the child.

How does infection occur?

The route of infection is oral. Pathogens initially enter the child's mouth and then spread through the gastrointestinal tract.

You can get infected in several ways:

1. By direct contact with a sick person.
2. Through dirty objects that have fallen into the child's mouth.
3. Through food. Pathogenic viruses and bacteria are found in spoiled or low-quality products.
4. Poor quality water.

The first signs of infection

The first symptoms of an intestinal infection in a baby, which should alert a young mother:

1. Sudden rise in temperature. It is impossible to miss this moment, since even in the absence of a thermometer, a fever in an infant is clearly visible due to a change in the color of the skin and an increase in their temperature to the touch.
2. The second symptom of an intestinal infection in infants is repeated vomiting. In this case, the child can completely refuse food, since everything eaten immediately leaves the stomach in the opposite direction.
3. Change in color and consistency of stool. Normally, a baby's stool looks like a yellow, mushy mass. If the stool has become greenish and very liquid, and even mixed with mucus, you need to sound the alarm.
4. Violation of the intestines and the pain associated with this is expressed in the external discomfort of the baby. He cries plaintively, bends his knees to his stomach, shudders, as if asking for help.

How to deal with an infection?

Treatment of intestinal infection in infants is aimed at the destruction of pathogenic microflora. The complex course includes antibiotics, adsorbents, as well as drugs that eliminate dehydration and intoxication of the body.

Common causative agents of intrauterine infection

Statistics show that this list includes the following infections in descending order:

• Toxoplasmosis;
• Cytomegalovirus;
• Staphylococcal infection.

Cytomegalovirus in newborns

Staphylococcal infections, in turn, are divided into two types:

• Purulent-inflammatory processes with a local character;
• Generalized infection or sepsis.

The most dangerous for a child is Staphylococcus aureus. The fact that its pathogen is present in the child's body can be recognized by the pustules on the skin. This also includes purulent inflammation of the umbilical wound. The consequences of a staphylococcal infection are quite severe, up to toxicological shock.

One of the decisive factors in this sense is the health of the mother during pregnancy and the successful outcome of childbirth. If the parents, after being discharged from the maternity hospital, notice unusual behavior of the child or uncharacteristic changes in appearance, you should immediately consult a doctor.

When is hospitalization indicated?

Doctors warn that if you have some symptoms, you need to urgently call an ambulance:

1. If small bloody clots are found in the crumbs' vomit;
2. If the baby cannot drink, he vomits constantly, after each sip of plain water;
3. If the baby has not asked to use the toilet for the last 5-6 hours, and his skin has dried up;
4. If hyperthermic reactions suddenly appear, which are difficult to stop;
5. If there are allergic rashes on the body or the child complains of severe headaches.

With the appearance of such dangerous symptoms, the baby must be urgently taken to the hospital.

Risk groups for diseases dangerous to the fetus

Children's doctors have long compiled a list of those who are included in the so-called risk group. In the same list, in addition to living persons, doctors also included subjective reasons. Here is the list:

• Mothers with previously born children. Pupils of schools and pupils of preschool institutions;
• Workers of kindergartens and schools;
• Health workers working directly with children;
• Pregnant women who have inflammatory diseases with a chronic course of the disease;
• Those women who have had repeated abortions for medical reasons;
• Women who have already had infected children;
• Those women who in the past had children or pregnancies with fetal malformation and fetal death in utero;
• The amniotic fluid broke long before the birth.

A pregnant woman should seek medical attention as soon as she feels the following symptoms:

1. A sharp rise in temperature;
2. Lymph nodes enlarged and became painful to the touch;
3. The skin is suddenly covered with a rash;
4. Appeared cough, shortness of breath;
5. Drowsiness, lacrimation;
6. The joints are swollen and hurt when moving.

It is not necessary that all these signs are dangerous for the little one. But they are mandatory for contacting doctors. It is better to be safe than to be treated for a long and difficult time.

There are three main ways of transmission of intrauterine infection during pregnancy:

• Transplacental (hematogenous) - viruses (CMV, herpes, etc.), syphilis, toxoplasmosis, listeriosis

The pathogen passes from the mother's blood through the placenta. If this happens in the 1st trimester, then malformations and deformities often occur. If the fetus becomes infected in the 3rd trimester, then the newborn shows signs of acute infection. Direct entry of the pathogen into the baby's blood leads to a generalized lesion.

• Ascending - mycoplasma, chlamydia, herpes

The infection goes from the mother's genital tract to the child. This usually happens after the rupture of the membranes, at the time of childbirth, but sometimes it happens during pregnancy. The main cause of intrauterine infection is its entry into the amniotic fluid, and as a result, damage to the skin, respiratory and digestive tract of the fetus.

The infection descends to the fetus through the fallopian tubes (with adnexitis, oophoritis).

Infecting a baby before birth can be dangerous at any stage of pregnancy. But some infections pose a great threat to life and health in the first trimester (rubella virus, for example), and some diseases are terrible when infected a couple of days before childbirth (chickenpox).

Early infection often leads to miscarriages and severe malformations. Late infection is usually associated with a rapidly occurring infectious disease in the newborn. More specific risks and the degree of danger are determined by the attending physician based on the results of tests, ultrasound, gestational age and the characteristics of a particular infection.

• Women with older children attending school and preschool
• Employees of kindergartens, nurseries, schools
• Medical workers
• Pregnant women with chronic inflammatory diseases
• Indication of repeated medical abortions
• Women with a history of giving birth to infected children
• Malformations and antenatal fetal death in the past
• Untimely rupture of amniotic fluid

Preventive measures

It has long been known that any disease is best prevented than treated later. TORCH infections are no exception. Preventive measures are divided into two types: before conception and pregnancy.

Measures up to

First of all, this is the delivery of all tests for the presence of immunity to diseases included in the list of prenatal. If the tests show that there is such an indicator as IqG in the credits, then this will indicate that the woman's body has the necessary antibodies. If this is not available, then this means only one thing - the woman's body is open to infection.

Therefore, if pregnancy is planned, then she must first be vaccinated against rubella. In order to avoid toxoplasmosis, you can temporarily remove all animals from the house before delivery and be examined together with a partner for infection with herpes and cytomegalovirus. If the IqG is very high, then this indicates that there is an acute infection in the female body. And before you plan the birth of a baby, you need to be completely treated.

But if the IgG titer turns out to be in the analyzes of the pregnant woman, then here it already clearly indicates infection of the female body. In theory, this means that the unborn baby is also in danger. And in order to exclude this, the expectant mother needs to pass some additional tests, by which you can determine the condition of the fetus and work out your actions further.

And keep track of your contacts.

Important facts about IUI

• Up to 10% of all pregnancies are accompanied by transmission of infection from mother to fetus
• 0.5% of babies born have some form of infection
• Infection of the mother does not necessarily lead to infection of the fetus
• Many infections that are dangerous to the fetus are mild or asymptomatic in the mother.
• Infection of the fetus most often occurs with the first infection in the mother
• Timely treatment of a pregnant woman can reduce or eliminate the risks to the fetus.

How is the fetus infected?

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

In what way the vui gets to the fetus depends on what is its causative agent. If a pregnant woman becomes infected with a sexually transmitted infection from a partner, the virus can enter the child through the vagina and fallopian tubes. In addition, the fetus can become infected through the woman's circulatory system or through the amniotic fluid. This is possible when infected with diseases such as rubella, endometritis, placentitis.

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

Danger of IUI during pregnancy.

If a woman has previously met with an infectious agent, then she has developed immunity to a number of them. If it repeatedly meets with the causative agent of IUI, then the immune system does not allow the disease to develop. But if a pregnant woman meets a pathogen for the first time, then not only the body of the mother and the unborn baby can suffer.

The effect of the disease on the body and its degree depends on how long the woman is. When a pregnant woman falls ill for up to twelve weeks, this can lead to miscarriage or fetal malformations.

If the fetus is infected during the period from the twelfth to the twenty-eighth week, then this can cause intrauterine growth retardation, as a result of which the newborn has a small weight.

At later stages of infection of the child, the disease can affect his already developed organs and affect them. Pathologies can affect the most vulnerable organ of the baby - the brain, which continues its development in the mother's abdomen until birth. Other formed organs, such as the heart, lungs, liver, etc., can also suffer.

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

Consequences of intrauterine infection for a child

Congenital infection can develop according to 2 scenarios: acute and chronic. Acute infection is dangerous with severe sepsis, pneumonia and shock. Signs of ill health in such babies are visible almost from birth, they eat poorly, sleep a lot, and become less and less active. But often the disease received in the womb is sluggish or has no obvious symptoms. Such children are also at risk for long-term consequences: hearing and vision impairments, delayed mental and motor development.

- a group of diseases of the fetus and newborn, developing as a result of infection in the prenatal period or during childbirth. Intrauterine infections can lead to fetal death, spontaneous abortion, intrauterine growth retardation, premature birth, the formation of congenital malformations, damage to internal organs and the central nervous system. Methods for diagnosing intrauterine infections include microscopic, cultural, enzyme immunoassay, molecular biological studies. Treatment of intrauterine infections is carried out using immunoglobulins, immunomodulators, antiviral, antibacterial drugs.

General information

Intrauterine infections are pathological processes and diseases caused by antenatal and intranatal infection of the fetus. The true prevalence of intrauterine infections has not been established, however, according to generalized data, at least 10% of newborns are born with congenital infections. The relevance of the problem of intrauterine infections in pediatrics is due to high reproductive losses, early neonatal morbidity, leading to disability and postnatal death of children. The issues of prevention of intrauterine infections lie in the plane of consideration of obstetrics and gynecology, neonatology, and pediatrics.

Causes of intrauterine infections

Intrauterine infections develop as a result of infection of the fetus in the prenatal period or directly during childbirth. Usually, the source of intrauterine infection for a child is the mother, i.e., there is a vertical transmission mechanism, which in the antenatal period is realized by transplacental or ascending (through infected amniotic fluid) routes, and in the intranatal period by aspiration or contact routes.

Less commonly, iatrogenic infection of the fetus occurs during pregnancy when a woman undergoes invasive prenatal diagnostics (amniocentesis, cordocentesis, chorionic villus biopsy), administration of blood products to the fetus through the vessels of the umbilical cord (plasma, erythrocyte mass, immunoglobulins), etc.

In the antenatal period, infection of the fetus is usually associated with viral agents (rubella, herpes, cytomegaly, hepatitis B and Coxsackie, HIV) and intracellular pathogens (toxoplasmosis, mycoplasmosis).

In the intranatal period, microbial contamination occurs more often, the nature and degree of which depends on the microbial landscape of the mother's birth canal. Among bacterial agents, enterobacteria, group B streptococci, gonococci, Pseudomonas aeruginosa, Proteus, Klebsiella, etc. are the most common. The placental barrier is impermeable to most bacteria and protozoa, however, if the placenta is damaged and placental insufficiency develops, antenatal microbial infection can occur (for example, by the causative agent of syphilis ). In addition, intranatal viral infection is not excluded.

Factors in the occurrence of intrauterine infections are a burdened obstetric and gynecological history of the mother (nonspecific colpitis, endocervicitis, STDs, salpingo-oophoritis), an unfavorable course of pregnancy (threat of interruption, preeclampsia, premature detachment of the placenta) and infectious morbidity of the pregnant woman. The risk of developing a manifest form of intrauterine infection is significantly higher in premature babies and in the case when a woman becomes infected primarily during pregnancy.

The severity of clinical manifestations of intrauterine infection is affected by the timing of infection and the type of pathogen. So, if infection occurs in the first 8-10 weeks of embryogenesis, pregnancy usually ends in spontaneous miscarriage. Intrauterine infections that occur in the early fetal period (up to 12 weeks of gestation) can lead to stillbirth or the formation of gross malformations. Intrauterine infection of the fetus in the II and III trimester of pregnancy is manifested by damage to individual organs (myocarditis, hepatitis, meningitis, meningoencephalitis) or a generalized infection.

It is known that the severity of the manifestations of the infectious process in a pregnant woman and in a fetus may not coincide. The asymptomatic or oligosymptomatic course of infection in the mother can cause severe damage to the fetus, up to his death. This is due to the increased tropism of viral and microbial pathogens for embryonic tissues, mainly the central nervous system, heart, and organ of vision.

Classification

The etiological structure of intrauterine infections involves their division into:

To designate a group of the most common intrauterine infections, the abbreviation TORCH syndrome is used, which combines toxoplasmosis (toxoplasmosis), rubella (rubella), cytomegalovirus (cytomegalovirus), herpes (herpes simplex). The letter O (other) denotes other infections, including viral hepatitis, HIV infection, chicken pox, listeriosis, mycoplasmosis, syphilis, chlamydia, etc.).

Symptoms of intrauterine infections

The presence of intrauterine infection in a newborn may be suspected already during childbirth. In favor of intrauterine infection may indicate the outflow of turbid amniotic fluid contaminated with meconium and having an unpleasant odor, the state of the placenta (plethora, microthrobosis, micronecrosis). Children with intrauterine infection are often born in a state of asphyxia, with prenatal malnutrition, an enlarged liver, malformations or dysembryogenesis stigmas, microcephaly, hydrocephalus. From the first days of life, they have jaundice, elements of pyoderma, roseolous or vesicular skin rashes, fever, convulsions, respiratory and cardiovascular disorders.

The early neonatal period with intrauterine infections is often aggravated by interstitial pneumonia, omphalitis, myocarditis or carditis, anemia, keratoconjunctivitis, chorioretinitis, hemorrhagic syndrome, etc. An instrumental examination in newborns can reveal congenital cataracts, glaucoma, congenital heart defects, cysts and brain calcifications.

In the perinatal period, the child has frequent and profuse regurgitation, muscle hypotension, CNS depression syndrome, and gray skin. In the later stages, with a long incubation period of intrauterine infection, the development of late meningitis, encephalitis, osteomyelitis is possible.

Consider the manifestations of the main intrauterine infections that make up the TORCH syndrome.

Congenital toxoplasmosis

After birth in the acute period, intrauterine infection is manifested by fever, jaundice, edematous syndrome, exanthema, hemorrhages, diarrhea, convulsions, hepatosplenomegaly, myocarditis, nephritis, pneumonia. In subacute course, signs of meningitis or encephalitis dominate. With chronic persistence, hydrocephalus with microcephaly, iridocyclitis, strabismus, and atrophy of the optic nerves develop. Sometimes there are monosymptomatic and latent forms of intrauterine infection.

Late complications of congenital toxoplasmosis include oligophrenia, epilepsy, and blindness.

congenital rubella

Intrauterine infection occurs due to the rubella infection during pregnancy. The likelihood and consequences of infection of the fetus depend on the gestational age: in the first 8 weeks, the risk reaches 80%; The consequences of intrauterine infection can be spontaneous abortion, embryo- and fetopathy. In the II trimester, the risk of intrauterine infection is 10-20%, in the III - 3-8%.

Babies with intrauterine infection are usually born prematurely or with low birth weight. The neonatal period is characterized by hemorrhagic rash, prolonged jaundice.

congenital herpes infection

Intrauterine herpes infection can occur in a generalized (50%), neurological (20%), mucocutaneous (20%) form.

Generalized intrauterine congenital herpes infection occurs with severe toxicosis, respiratory distress syndrome, hepatomegaly, jaundice, pneumonia, thrombocytopenia, hemorrhagic syndrome. The neurological form of congenital herpes is clinically manifested by encephalitis and meningoencephalitis. Intrauterine herpes infection with the development of skin syndrome is accompanied by the appearance of a vesicular rash on the skin and mucous membranes, including internal organs. With the layering of a bacterial infection, neonatal sepsis develops.

Intrauterine herpes infection in a child can lead to the formation of malformations - microcephaly, retinopathy, limb hypoplasia (cortical dwarfism). Among the late complications of congenital herpes are encephalopathy, deafness, blindness, psychomotor retardation.

Diagnostics

Currently, an urgent task is the prenatal diagnosis of intrauterine infections. For this purpose, in the early stages of pregnancy, smear microscopy, bacteriological culture from the vagina for flora, PCR examination of scrapings, and examination for the TORCH complex are performed. Pregnant women from the high-risk group for the development of intrauterine infection are indicated for invasive prenatal diagnosis (chorionic villus aspiration, amniocentesis with amniotic fluid examination, cordocentesis with cord blood examination). finds signs.

Treatment of intrauterine infections

General principles for the treatment of intrauterine infections involve immunotherapy, antiviral, antibacterial and post-syndromic therapy.

Immunotherapy includes the use of polyvalent and specific immunoglobulins, immunomodulators (interferons). Antiviral therapy of directed action is carried out mainly with acyclovir. For antimicrobial therapy of bacterial intrauterine infections, broad-spectrum antibiotics (cephalosporins, aminoglycosides, carbapenems) are used, and macrolides are used for mycoplasmal and chlamydial infections.

Posyndromic therapy of intrauterine infections is aimed at stopping individual manifestations of perinatal CNS damage, hemorrhagic syndrome, hepatitis, myocarditis, pneumonia, etc.

rubella vaccinations, must be vaccinated no later than 3 months before the expected pregnancy. In some cases, intrauterine infections may be the basis for artificial

Intrauterine infection in a newborn is a special group of diseases that a baby becomes infected with even before birth. Cases of infection are also recorded directly during labor. Infections of this nature can lead to fetal death, miscarriage, or abnormal development.

Cases were recorded when pathologies led to early childbirth, defects, and severe damage to the central nervous system. That is why it is advisable to carry out diagnostics in a timely manner. It involves the implementation of research at the microscopic level. Additionally, functioning, immunity, enzymes, interaction of molecules and correctness in the work of biological processes are analyzed.

Treatment of infections of this nature is carried out with the help of immunoglobulins, modulators. A woman is prescribed regular intake of antiviral drugs, the action of which is aimed at destroying bacteria.

Intrauterine infection in newborns is observed in the presence of pathologies in certain processes. The situation is observed against the background of infection of the fetus. To date, it has not been possible to fully determine the route of infection. Today, about 10% of all children are born with this disease. This problem is especially acute in pediatrics, because of this a large number of deaths and the development of diseases immediately after birth are recorded. Parents are advised to pay attention to the prevention of infection. In this case, it will be possible to reduce the risk of developing dangerous diseases.

Diagnosis of infection is prescribed during pregnancy

Causes of diseases

The process of infection with these diseases begins even at the time the fetus is in the womb. The risk of infection also remains during labor. In this case, the carrier of the infection is the mother. The disease can be transmitted vertically or ascending. It all depends on the location of viruses and bacteria.

Only in rare cases, infection of a pregnant woman has been observed during diagnosis, which involved a biopsy or other specific procedures. The risk increases with the introduction of drugs to the baby through the blood, plasma.

Viral agents can be transmitted by the antenatal route. In this case, the fetus can be infected with rubella, herpes, hepatitis, HIV. Due to intracellular pathogens, toxoplasmosis or mycoplasmosis is diagnosed.

An important role is played by the state of the birth canal and the process of the birth of the baby. At this stage, there is a risk of microbes entering the baby's body in various ways. Among bacteria, the possibility of infection with streptococci, Proteus, Klebsiella and others is increased. The placenta is initially used as an effective barrier. However, even a slight damage to it can lead to the development of insufficiency. Through small holes, harmful bacteria can enter without any special obstacles. Among them, the syphilis virus is of particular danger.

The history of the mother and the presence of previously unfavorable pregnancies are also taken into account. The risk of intrauterine infections also increases if the baby was born prematurely. Additionally, the period in which the woman was infected (before and after the onset of pregnancy) is analyzed.

During childbirth, the doctor analyzes the main properties of amniotic fluid

The child is directly affected by the period of infection, as well as the virus that caused the development of pathology. For example, if the pathogen got inside during the first ten weeks of pregnancy, then it will end in an independent miscarriage. If the infection occurred at the twelfth week, then most likely the child will be born dead or he will have serious malformations in the development of internal organs and systems. Infection of the fetus from the second trimester is fraught with abnormal development of individual internal organs or the presence of a pronounced generalized infection after birth.

It should be noted that the symptoms are radically different in mother and child. Even if no negative manifestations were found in a woman, serious lesions can subsequently be detected in the fetus.

The possibility of a stillbirth cannot be completely ruled out. Viruses and bacteria tend to penetrate deep into the tissue and disrupt the central nervous system, heart and other important organs.

Symptoms of infections

The consequences of infection of the baby are visible even in the process of labor. The doctor pays attention to the condition of the amniotic fluid - they become cloudy, they contain a lot of meconium. The patient may feel unwell. If a child has an intrauterine infection, then the risk of having a baby with asphyxia, a large liver and other defects in general development increases. As a rule, rubella, pyoderma and various profuse skin rashes are additionally diagnosed. Some babies have fever, convulsions, various respiratory and cardiac disorders.

Antenatal intrauterine infection can lead to pneumonia, myocarditis, anemia and other diseases that appear within a few days after the baby is born. Next, the child is examined using special medical equipment. With its help, it is possible to identify diseases of the organs of vision, defects in the work of the heart, the presence of cysts and improper functioning of the brain.

With IUI, a child may develop pathologies

The neonatologist pays attention to the baby in the postpartum period. In the presence of diseases, he often burps, there is muscle weakness, an incorrect reaction of the central nervous system. The skin is examined regularly. It is not allowed that it be a pronounced gray color. Intrauterine infections have a different incubation period. Each disease is analyzed separately depending on the nature and specification of manifestation.

Each individual TORCH infection has different methods of diagnosis and treatment. It is recommended to consult in detail with a specialist in this field.

The main types of infections

Intrauterine infection is a broad concept. Its division is carried out depending on the source of the formation of the disease:

In medical practice, it is customary to combine the most common diseases with a special abbreviation - TORCH.

This syndrome includes toxoplasmosis, rubella, herpes and other lesions.

Including the study is carried out for the presence of HIV, hepatitis, smallpox, mycoplasmosis, syphilis.

Toxoplasmosis: features of infection

The disease is diagnosed if the fetus in the womb was infected with Toxoplasma Gondii cells. Pathology can lead to abnormal development, the presence of malformations of the brain, heart and other internal organs.

Diagnosis is made immediately after the birth of the baby. The infection manifests itself in the form of severe fever, jaundice, swelling, stool disorders, and periodic convulsions. Additionally, the baby may have symptoms of meningitis and encephalitis. If the disease becomes chronic, then the situation is aggravated by strabismus or complete atrophy of the optic nerve. Unfortunately, the infection can be fatal before delivery.

At a late stage in the development of the disease, the baby develops epilepsy and complete blindness.

Features of rubella in utero infection

Infection is carried out in the case of the transfer of the disease during the period of gestation. In the first eight weeks, the probability reaches eighty percent. In the second trimester, it drops to twenty, and in the third - to eight percent.

If the child has a disease, he will be born prematurely and will not gain weight well. Additionally, a rash and obvious manifestations of jaundice can be seen on the skin.

Rubella of a congenital nature is dangerous by the manifestation of the following symptoms:

• partial or complete damage to the eye muscle;
• insufficient tone of the auditory nerve.

If the infection hit the baby in the second part of pregnancy, then he can be born with retinopathy or complete deafness.

Anomalies against the background of the transferred rubella are extensive. Defects can manifest themselves in the structure of the palate, hepatitis, abnormal structure of the skeleton or the genitourinary system. Infection is dangerous because the child may further lag behind in physical and mental development.

Diagnosis should be carried out during pregnancy and after the baby is born.

Cytomegaly: features of infection and the course of infection

This type of infection is dangerous because it leads to severe damage to the internal systems of a sick child. A complication can also lead to immunodeficiency or the appearance of purulent skin lesions. Defects can be either congenital or appear at a certain period of development. In the postpartum period, jaundice, hemorrhoids, pneumonia, anemia and other diseases may appear.

Subsequently, the organs of vision, liver, deafness and other diseases remain at risk.

Intrauterine infection with herpes

Herpes infection can manifest itself in several forms:

• the generalized form is characterized by toxicosis, the presence of respiratory diseases, jaundice, diseases of the upper respiratory tract and lungs, hemorrhoids;
• neurological;
• damage to the mucous membrane and skin.

If the bacterial infection becomes multiple, then the child is diagnosed with sepsis.

Herpes is a dangerous infection that can lead to a number of complications. Among the most dangerous are complete deafness, blindness, abnormal development or lag in it.

Features of the diagnosis

Today, the diagnosis of intrauterine infections is quite acute. It is necessary to find out about the presence of harmful bacteria, viruses and fungi as early as possible. To do this, a smear is taken in the gynecologist's office, sowing for the presence of bacteria and the state of the microflora. In some cases, PCR or a complex TORCH analysis is additionally prescribed. Invasive prenatal diagnosis should be performed only for those women who are at high risk.

The gynecologist will also be able to consider certain markers during an ultrasound examination. Attention should be paid to diagnosis in the event that low or polyhydramnios and other pathologies of pregnancy development were previously diagnosed. If there are deviations, the doctor additionally prescribes a study of the features of the functioning of the heart and blood flow.

The study must be additionally carried out even after the birth of the baby. For this, microbiological tests are carried out. DNA research should be done. For this, serological research methods are used. An important role is played by the result of the histology of the placenta, which can also be performed after childbirth.

If the baby is suspected of having any intrauterine infection, then during the first day of life he should be constantly under the supervision of a neurologist, cardiologist and other specialists in the field of childhood diseases. At their discretion, tests are prescribed to identify pathologies in the development of hearing, vision and other internal organs.

In order to prevent a woman should be regularly examined by a gynecologist

Basic principles of treatment of infections

At the first stage of eliminating pathologies, it is necessary to take drugs to increase immunity, against the development of viral, bacterial and other diseases.

To improve immunity, it is necessary to use special modulators and immunoglobulins. Acyclovir is most often used against viruses. Effective therapy against bacteria involves the use of broad-spectrum antibiotics.

Therapy must be carried out alternately to get rid of each individual symptom. Otherwise, the risk of pathologies in the work of the central nervous system increases. As a result, the child may experience problems in the work of the heart and lungs.

Infection prevention

If a patient is diagnosed with a generalized form of the infection, then the probability of passing it on to her child is eighty percent. With local manifestations, the risk of damage to only individual internal organs increases. Unfortunately, almost every infection can lead to problems in the central nervous system in the future.

The main methods of prevention involve a complete examination of the patient before pregnancy. During gestation, you should protect yourself from contact with sick people. If a woman has not previously had rubella and has not been vaccinated against it, then an injection must be made three months before the planned pregnancy. Additionally, it should be noted that some cases of infection involve termination of pregnancy at any time.

Intrauterine infections Localized and generalized purulent infection: causes and epidemiology Omphalitis, pyoderma, mastitis, conjunctivitis: clinical picture Treatment of localized purulent diseases Newborn sepsis: etiology, pathogenesis, clinical picture, diagnosis, treatment, prognosis

Intrauterine infections

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

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

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

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

Infection from mother to fetus is transmitted through the placenta only once in a lifetime, if she first became infected during this pregnancy. In a subsequent pregnancy or in the case of an illness before pregnancy, the fetus is not infected. This is due to the fact that a high immunological activity to this pathogen has already been formed in the mother's body.

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

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

V subacute phase(stage of active encephalitis) a child is born with symptoms of CNS damage - vomiting, convulsions, tremor, paralysis and paresis, progressive micro-, hydrocephalus are detected; there are changes in the eyes - clouding of the vitreous body, chorioretinitis, iridocyclitis, nystagmus, strabismus.

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

Treatment. V treatment with pyrimamine preparations (chloridin, daraprim, tindurin) in combination with sulfonamides ( bactrim, sulfadimezin). Use of combination drugs fansidar or metakelfin. Effective spiramycin (rovamycin), sumamed, rulid. With an active inflammatory process, corticosteroids are indicated. Multivitamins are required.

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

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

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

The source of infection is only a person (sick or virus carrier). From the infected organism, the virus is excreted with urine, saliva, secrets, blood, less often with feces. Isolation of the virus in the urine can take several years. The transmission mechanism is predominantly contact, less often airborne, enteral and sexual.

The source of infection of newborns are mothers-carriers of the cytomegalovirus. Viruses penetrate to the fetus through the placenta, ascending or during childbirth, to the newborn - with infected milk, with transfusion of infected blood. Infection during childbirth occurs by aspiration or ingestion of infected amniotic fluid, secrets of the mother's birth canal.

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

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

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

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

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

Treatment. When treating, you should make sure that there are no pathogens in the mother's milk. A specific anti-cytomegalovirus 10% solution of immunoglobulin is used - cytotect, sandoglobulin(IgG). Use pentaglobin - IgM, TRC, antivirals (cytosine arabinoside, adenine arabinoside, iododesoxyuridine, ganciclovir, foscarnet). Posindromic and symptomatic therapy is carried out.

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

Not much time has passed since death from infectious diseases in the first year of life was depressingly common, and in underdeveloped regions of the world the situation has not changed to this day. Fortunately, modern medicine has completely changed this picture in Western European society. Antibiotics, which came into widespread use in the 1940s, revolutionized the treatment of infectious diseases in infants; there has also been a significant increase in information on how to deal with infectious diseases in general.

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

Universal immunization, mandatory in the UK by law, has prevented terrible epidemics. After the introduction in 1950 of a vaccine against polio, a formerly terrifying disease that maimed and killed thousands of children every year, it became a disease of the past. Measles, which until a few years ago was practically recognizable at first sight, has become so rare that today's medical students are not able to make this diagnosis. Postnatal care, sterilization of artificial milk, infant formula, and technological advances in treatment have halted the spread and reduced the severity of infectious diseases in newborns.

But for certain groups of infants, infections are at particular risk. Some babies cannot make antibodies, others have chronic conditions such as cystic fibrosis, and premature babies are particularly susceptible to infections in the first weeks.

Soon after birth, microorganisms, natural flora, begin to accumulate in the baby's body, which form harmless colonies of bacteria on the baby's skin, in the mouth, in the throat and in the intestines. A healthy person is able to live with this horde of completely ordinary bacteria, as long as they do not multiply too rapidly and get into parts of the body where they are not supposed to be. We all have natural flora. Of course, these bacteria should be distinguished from the less common and much more dangerous ones, which we classify as pathogens, since they can cause illness, and we try to protect the child from them, strengthening his immunity.

Cystic fibrosis (cystic fibrosis) is an inherited disorder with no known cause; occurs in about one in two thousand cases. This is a general disorder in the glands of the body that produce abnormal cells, which manifests itself in excessive sweating, intestinal obstruction and respiratory complications. The pancreas, located next to the liver, is affected in 80% of cases, which makes normal digestion and absorption of fats impossible and leads to malnutrition of the body.
ma, why the child does not gain weight. Often ends fatally; average life expectancy - twelve to sixteen years; the risk of recurrence of the disease in a child of the same sex is 1:4.

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

The stock of antibodies in the newborn gradually decreases, and by the end of the fourth to sixth months there is only a very small amount left that will fight infection for the next four to five months. At the age of about three months, the child begins to produce the same antibodies that he received from the mother, and by the age of three or four years, the production of antibodies will reach normal levels. Thus, if a child comes into contact with familiar or unfamiliar bacteria in the environment, his body produces its own antibodies.

Some of these infections are very mild and therefore do not show any symptoms despite the fact that antibodies are produced. Against those dangerous bacteria from which the child is not protected, because he received little or no antibodies from the mother, immunization is required. A good example is whooping cough, or spasmodic cough. The whooping cough, diphtheria, and tetanus vaccine given to a child on one of the pediatrician's first visits stimulates the production of antibodies against these organisms. If a child is not immunized, he will be vulnerable to infectious diseases and will not be armed enough to fight them. Some antibodies, such as those against measles, remain in the body for nine to ten months and provide immunity during this period. For this reason, measles vaccination is often delayed until the time when maternal antibodies have dropped to a certain level.

When can a child become infected?

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

The classic example of this kind of mother-to-child transmission is, of course, syphilis. Despite the fact that this disease has become quite rare, there has been a slight increase in cases of infection. Another disease transmitted by a mother to her child during the prenatal period of life is typhoid fever. But most contagious bacterial diseases are well controlled.

Transmission of infectious diseases during fetal development came to the fore at the end of World War II, when it became clear that the rubella virus could damage the fetus in the first few weeks of pregnancy. A significant number of children whose mothers become infected with rubella in the first three months of pregnancy may become infected with the disease. Mothers themselves may not show symptoms.

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

After the baby is born, infection from the amniotic fluid and amniotic membranes can be passed directly to the baby. This can happen if the shells have burst, and labor has not begun. That's why it's so important that the hospital knows you've had a ruptured membrane and can tell you when to come to the hospital. In many departments, there are different opinions about how long to wait for the onset of labor after a rupture of the membranes. Usually, contractions and childbirth begin a few hours after the water breaks. But it still happens that nothing happens.

It is generally accepted that if six hours after the sudden rupture of the membranes, contractions do not begin, it is worthwhile to stimulate labor activity with an intravenous infusion of oxytocin. The reason for this is that the more time passes since the rupture of the membranes, the more opportunities for microorganisms to enter the uterus. A swab is usually taken and antibiotics are sometimes prescribed, but only if labor has not started twelve hours after the membranes have ruptured.

It is worth emphasizing once again that in every maternity hospital, in every clinic, and every gynecologist and obstetrician has their own scheme of action. However, today in every maternity hospital obstetricians make records of births in order to fix the sequence of actions in certain circumstances. Keeping these records should be continued, as they allow the decision-making process to rely on the highest standards recorded in them.

Infection during childbirth used to happen very often, but the precautions taken by modern obstetricians have significantly reduced the risk of infection. Most babies are born in sterile delivery rooms and then transported to a nursery where the motto is absolute cleanliness; here they are bathed in antiseptic solutions and the umbilical cord is treated with chemicals to reduce the growth of pathogenic bacteria.

After discharge from the hospital, the child finds himself in a completely different situation. All families are susceptible to infectious diseases that can be passed on to the child, but fortunately, most of these diseases do not cause serious concern. Virus-induced colds, sore throats, diarrhea, and so on are common, and a newborn baby is not immune from these ailments, but for reasons that are not well understood, these illnesses cause much milder symptoms in the first few months of life.

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

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

Bowel obstruction

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

Although bowel obstruction is rare, the symptoms need to be known. These are spasmodic pains in the abdomen that cause the infant to cry violently, vomit, flatulence (bloating due to flatulence), and gradual dehydration, manifested by the usual signs of fluid loss such as dry tongue, wrinkled skin, and sunken eyeballs. etc. Whatever the cause of the obstruction, surgical treatment is required.

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

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

Intussusception

This is a rare bowel disease that occurs predominantly in infants and young children. Requires medical supervision and surgical intervention. The child cries out in severe pain, and his stool resembles lumps of currant jelly. Mucus mixed with blood gives this unmistakable appearance to the stool. The section of the intestine is suddenly introduced into the neighboring one. Imagine holding a heavy flexible hose or hose with both hands and then bringing your hands together to force the hose to fold. This illustrates with sufficient accuracy what happens during invagination: a small section of the intestine is inserted inside, and with subsequent spasms, an increasing length of the intestine gets inside. The blood vessels are also ingested, the blood supply
is disturbed, swelling and necrosis of the area of ​​the intestine that has undergone invagination are formed.

Obviously, the pain is very strong. It can be intermittent, with lull intervals, and is usually a good reason for parents to contact a doctor. Gelatinous stools will confirm the diagnosis if needed. The treatment is either an enema, which can straighten the bowel, or, if this method does not work, surgery, which will be the only way out. During the operation, either straighten or remove a small section of the intestine. The prognosis is positive.

Jaundice

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

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

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

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

Hepatitis is a disease that most people associate with adult jaundice. At the same time, the liver becomes inflamed and cannot fully do its job of processing bilirubin, which was formed during the normal decay of old cells. Therefore, bilirubin accumulates in the blood, and the patient develops yellowing. Another cause is gallstones blocking the gallbladder or ducts; and some types of anemia, in which red blood cells are destroyed so quickly that the liver cannot handle all the bilirubin.

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

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

Another cause of neonatal jaundice, often a very serious one, is an incompatibility between mother and baby's blood types (Rhesus incompatibility).

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

Pulmonary collapse

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

The air present in the pleural cavity can also press on the lungs and thereby decrease the volume of the lungs when inhaled. As a result, rapid breathing and blue eyes may occur. A doctor may diagnose pneumothorax by listening to the chest and x-ray if the child is having difficulty breathing. Treatment depends on the cause: for example, antibiotics if there is an infection, or sometimes air can be expelled by inserting a small tube between the ribs and the air cavity.

Moniliasis (thrush)

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

Phenylketonuria

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

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

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

This disease is easily treatable, which consists in transferring to a special diet containing exactly as much of this amino acid as the body needs and no more. For example, vegetables and fruits are low in phenylalanine, and artificial milk has been developed to contain all the essential amino acids and a reduced amount of phenylalanine. But still, since treatment is necessary and observation is fraught with difficulties, it was considered necessary to establish treatment centers on the ground. Today, PKU treatment for most children can be fully completed by school time.

Pyloric stenosis (narrowing of the pylorus)

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

Usually vomiting prompt - a fountain. In this it differs from ordinary regurgitation, in which milk flows out in a weak trickle. If this gushing vomiting continues, signs of dehydration and starvation develop. Vomiting often begins a few weeks after the baby has left the hospital and is much more common in firstborns and boys. Diagnosis is made on examination and confirmed by x-ray. The treatment is quite simple, consisting of a minor surgical operation, well tolerated by infants, during which a small incision is made under general anesthesia in the stomach muscle in order to open the gastrointestinal tract. The child usually wakes up after a few hours.

And finally, there is no significant hereditary influence; therefore, if one child in the family has the condition, subsequent children are only marginally more likely to develop it than any other child.

Defects of the spinal column

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

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

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

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

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

In severe cases, when there is, for example, spina bifida and at the same time hydrocephalus and the prognosis for the child is very unfavorable, it is possible
but, it is worth going for an abortion. If not, antenatal diagnosis may be beneficial either by ensuring delivery is carried out in an intensive care unit that has all the facilities necessary for a surgical operation, or by having a variety of specialists present during delivery so that so that the situation can be assessed as early as possible.

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

Fistula of the trachea of ​​the esophagus

Some children have a congenital surgical condition in which the grachea and esophagus are connected. This is a rare birth defect that can take many forms, but always requires surgical treatment.

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

A child with this condition is in serious danger, and to make matters worse, stomach acid is expelled through the esophagus into the trachea and lungs, causing a violent reaction with pneumonia. Children with this disease cannot eat and are prone to lung infections; they regurgitate food back, choke and choke; rapidly developing serious condition. This disease, no doubt, requires surgical treatment in the first few days of life. The results are usually very satisfactory.

Undescended testicles

The testicles in a male child are formed early in fetal development, but first they are located high in the abdominal cavity and remain there until late in pregnancy. In most boys, the testicles descend into the scrotum at the time of delivery, but sometimes one or both testicles remain outside the scrotum, and when the doctor examines the newborn, the testicles in the scrotum are not groped.

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

Urinary system defects

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

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

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

How can a urinary tract obstruction be diagnosed?

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

There are many tests to determine whether and where the obstruction is located. Today, the fetal urinary tract can easily be seen on maternal abdominal ultrasound, and abnormalities are often found. Most of the abnormalities in question can be corrected with surgery in the first few years of life.

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