Trichomoniasis during pregnancy
Trichomoniasis during pregnancy has its own specifics. In this case, the doctor should pay special attention to the examination and treatment of the patient.
The cause of inflammation of the genitals in pregnant women is often Trichomonas (the simplest parasitic unicellular organism from the flagellate class), the disease is called Trichomoniasis or Trichomoniasis. According to the WHO, the most common sexually transmitted infection is trichomoniasis. In pregnant women, this disease often appears against the background of a general weakening of the immune system, and in 2/3 of cases, infection occurs with unprotected intimate relationships. Trichomonas often provoke urethritis, cystitis, cervicitis, proctitis and other diseases. Erosion of the cervix may occur.
Trichomonas remain active on bedding, for example, up to five hours. Therefore, the causes of trichomoniasis in pregnant women are not limited only to lowered immunity (as discussed above), but also depend on the personal hygiene of the woman herself and her partner. It is important to remember that these protozoa die instantly at temperatures above 40 ° C, which means that ironing linen with a hot iron is by no means an idle business. In a weak soapy solution, these microorganisms live for only a few minutes.
Often Trichomonas "peacefully coexist" with other causative agents of diseases associated with the genitourinary system, for example, with gonococci and ureaplasmas.
Screening for trichomoniasis is a mandatory component of screening the health status of pregnant women. This disease is classified as an STD (Sexually Transmitted Disease). Its causative agent is a bacterium from the genus of protozoa, the class of flagellates. Vaginal Trichomonas (Trichomonas vaginalis) parasitizes in the human genitals, on the mucous membrane of the vagina and urethra (urethra). This unicellular organism can make it difficult to diagnose the disease in the laboratory by sometimes mimicking the structure of human blood cells (lymphocytes and platelets).
Trichomoniasis is sexually transmitted; the disease affects at least 10% of the world's inhabitants. This number increases by 200 million annually. Due to the structural features of the genitourinary system, women suffer from this infection 4 times more often than men. A temporary decrease in immunity in pregnant women makes them a frequent target of Trichomonas.
Content:
- Causes of trichomoniasis during pregnancy
- Effect on the fetus of trichomoniasis during pregnancy
- Symptoms of trichomoniasis during pregnancy
- Treatment of trichomoniasis during pregnancy
- Features of the treatment of trichomoniasis during pregnancy
- Is it possible for a child to become infected with trichomoniasis from the mother during childbirth?
Causes of trichomoniasis during pregnancy
The main reason for contracting trichomoniasis during pregnancy is unprotected genital intercourse with a carrier of the infection. The main method is traditional sex, since you cannot get this STD through the anal and oral routes. It has been proven that the household route of infection with trichomoniasis is possible, although it is very rare. The use of the same hygiene items: a towel, a washcloth, as well as common linen together with a Trichomonas carrier can become a transmission pathway.
The parasite dies at 40 degrees, and in a natural environment, for example, on bedding, it can live for only 5 hours. Ironing is a guarantee of health
A person suffering from trichomoniasis sometimes is unaware of his illness. Inflammation of the genitourinary tract (urethritis, proctitis, prostatitis), he usually does not associate with infection with bacteria. A family may be planning a pregnancy and not know that both partners are infected until the woman undergoes mandatory laboratory diagnostics.
Until the final sanitation of the genitourinary system from Trichomonas, it is better not to conceive a child. It is advisable to make sure that the infection is completely cured in both spouses. When diagnosing chronic trichomoniasis during pregnancy, it is very difficult to get rid of the Trichomonas vaginalis bacteria completely. Often, the disease manifests itself with a weakening of immunity, provoked by an increased load on the body of the expectant mother.
Effect on the fetus of trichomoniasis during pregnancy
The bacterium is unable to cross the placental barrier, so during pregnancy it does not pose a great danger to the growing fetus. If the infection is mixed, that is, gonococci, chlamydia and other pathogens of sexually transmitted diseases join Trichomonas, then the risk of infection of the baby during childbirth increases many times. Therefore, trichomoniasis is potentially dangerous for the health of the expectant mother.
Trichomoniasis by itself during pregnancy does not lead to miscarriage or stillbirth. But this can happen in the advanced stages of mixed genital infections.
Some gynecologists associate trichomoniasis during pregnancy with the risk of a premature baby, early discharge of amniotic fluid. Chorioamnionitis (inflammation of the amniotic membrane) can theoretically result from infection of the body with Trichomonas and the penetration of the pathogen into the uterine cavity.
A decrease in general and local immunity provokes the onset of dangerous diseases of the female genital area:
- Inflammation of the appendages;
- Endometritis;
- Pelvioperitonitis (inflammation of the pelvic peritoneum) due to infection.
They are accompanied by fever, purulent discharge, pain in the lower abdomen, and can cause premature birth or miscarriage. In the early stages, with such symptoms, there is a question of artificial termination of pregnancy. That is why it is important to timely diagnose and treat trichomoniasis.
Symptoms of trichomoniasis during pregnancy
In the acute stage of trichomoniasis, a woman is worried about itching, burning, heaviness and pain in the lower abdomen, cramps during urination. When examined by a gynecologist, there is a hyperemia of the vaginal mucosa, abundant foamy discharge, possibly with an unpleasant odor. In the chronic course of the disease, hyperemia disappears.
Trichomoniasis has a great impact on a woman's reproductive function and often leads to infertility. In pregnant women, the disease is diagnosed more often than in non-pregnant women. Often, trichomoniasis during pregnancy causes condylomatous growths and bartholinitis, premature birth or spontaneous abortion is also possible due to inflammation of the membranes. Infection with trichomoniasis in a child, according to the researchers, can occur when the fetus passes through the birth canal. If this happens, the child's treatment is started as early as possible and is usually successful. Interestingly, trichomoniasis is exacerbated not only during pregnancy, but also with frequent alcohol intake or in case of excessive sexual activity.
The incubation (latent) period of the development of the disease lasts from several days to 2 months. The disease can manifest itself with intense symptoms, or it can immediately go into the stage of a chronic process.
Symptoms of acute trichomoniasis during pregnancy:
- Severe itching in the vagina and external genitals;
- Pain and cramps when urinating;
- Foamy vaginal discharge with an unpleasant odor, having a yellow-green color;
- Frequent bowel movements
- Hyperthermia;
- Heaviness felt in the lower abdomen;
- During a gynecological examination - hyperemia of the vaginal mucosa, punctate hemorrhages on its walls;
- Increased fatigue, weakness, deterioration in performance.
Symptoms of latent trichomoniasis during pregnancy:
- Pain during sexual intercourse;
- Mucopurulent discharge;
- Anaphrodisia;
- Frequent urination
- Itching in the external genital area;
- Recurrent pain in the lower abdomen;
- Exacerbation of chronic diseases.
Latent trichomoniasis can turn into an acute form with a decrease in immunity, hormonal disorders, metabolic disorders, pathological changes in the vaginal microflora.
The consequences of this disease for pregnant women are much worse than the disease itself. Although the acute form of trichomoniasis is characterized by very painful symptoms
To diagnose trichomoniasis during pregnancy, a smear is taken from the posterior fornix of the vagina. Bacterioscopic examination allows you to determine the intensity of inflammation and the concentration of microorganisms. To confirm the diagnosis, sowing is carried out on the flora, placing the vaginal discharge in a nutrient medium. Additional diagnostic methods are the study of vaginal secretions using PCR (accuracy 95%), as well as the detection of antibodies to Trichomonas in the patient's blood by the PIF method (direct immunofluorescence).
Treatment of trichomoniasis during pregnancy
Examination and treatment of trichomoniasis during pregnancy is carried out at once in both sexual partners, otherwise the therapy will be ineffective. In the 1st trimester of pregnancy, it is undesirable to influence the fetus with drugs because of the possible teratogenic effect, the appearance of developmental defects. During this period, treatment is carried out with agents for topical use - douching with medicinal solutions and setting suppositories.
Suppositories for the treatment of trichomoniasis during pregnancy:
- Clotrimazole;
- Ginesol;
- Terzhinan;
- Polygynax;
- Betadine.
In the 2nd and 3rd trimester, treatment with imidazole derivatives is possible:
- Tinidazole;
- Atrikan;
- Metronidazole;
- Naxojin;
- Ornidazole.
Treatment of trichomoniasis during pregnancy is carried out under the supervision and on the recommendation of a doctor. In most cases, he prescribes the lowest possible dosage of the drug, a short course of treatment. Although with this treatment regimen relapses of trichomoniasis are possible, the drug load on the body of a pregnant woman and a baby remains minimal.
Monitoring the effectiveness of therapy is carried out within 3 months. The woman and her sexual partner pass swabs three times. Treatment does not form local immunity and does not guarantee protection against re-infection by contact with an infected sexual partner.
Video about the treatment of trichomoniasis during pregnancy:
Features of the treatment of trichomoniasis during pregnancy
In no case should you self-medicate. Only a doctor, based on the result of the analysis, can prescribe effective drugs. Moreover, the treatment of trichomoniasis during pregnancy should be carried out with great care so as not to harm the unborn child. Antibiotics, which are effective for this disease, are prescribed only in the 2nd and 3rd trimester, and at the very beginning of pregnancy, preference is given to drugs for topical use. Douching is carried out with disinfectant solutions or vaginal suppositories are introduced at night. It is imperative to strengthen a woman's immunity so that the body can independently resist the disease, multivitamins or vitamin complexes with minerals are prescribed.
Folk remedies used in the treatment of trichomoniasis include aloe, garlic, chamomile, bird cherry, calendula, lilac, celandine. For example, aloe juice should be taken 3 times a day, a teaspoon for 15 minutes. before meals, and the greatest amount of active substances in aloe accumulates on the second or third day after cutting the leaf (the cut leaf is placed in the refrigerator for a day or two). A decoction of calendula, like chamomile, is used for sitz baths and douching.
Simultaneously with the woman, her partner should also be treated.
If there is a relapse of the disease, then the previously used drug in this case will already be ineffective, and the doctor, on the basis of the newly passed tests, will select another antibiotic. After the end of the course of treatment, for about another three months, you need to be monitored by a doctor and take new tests at his request. It is also imperative to follow the rules of hygiene at home.
Is it possible for a child to become infected with trichomoniasis from the mother during childbirth?
Pregnancy management in antenatal clinics excludes the active course of the disease and infection of the newborn. In isolated cases, with a low culture and an irresponsible attitude of a woman to her health, infection of children during childbirth is recorded. Babies become infected while passing through the genital tract of a woman in labor. The course of infection during pregnancy reduces the development of protective mechanisms in the child.
The defeat of the newborn with Trichomonas leads to pathologies of such organs as:
- Cornea and conjunctiva of the eye;
- Tonsils;
- Perineal skin;
- Anal passage;
- The mucous membrane of the vagina and labia in girls;
- Lungs.
Trichomoniasis in newborns is always acute, 2-4 days after infection. The disease is manifested by redness of the affected mucous membrane, in girls - foamy discharge from the genital tract. Purulent tonsillitis, pneumonia, death is not excluded. To prevent complications and negative symptoms, newborns are treated immediately after birth.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
