Data 11 Aug ● Comments 0 ● Views

Doctor Maria Nikolaeva

Pregnancy is the most pleasant and beautiful period in the life of every woman. However, not all of the fair sex, it flows in one breath. The body of a pregnant woman is exposed to serious disturbances from the hormonal and immune systems, which makes her vulnerable to all kinds of infectious diseases. One of the most common and dangerous infections for the expectant mother and baby is cytomegalovirus.

Cytomegalovirus belongs to the herpesvirus family. Pathology is very common and for some it poses a serious danger. The harm lies in the fact that many do not suspect the presence of a virus in the body due to the absence of specific symptoms.

For a healthy person with a strong immune system, the disease does not pose a danger. A truly harmful disease is only for those who suffer from a violation in the work of the protective functions of the body. And since the immunity of a pregnant woman is almost always weakened, they are among the first to be at risk of transmitting the virus.

After the penetration of infectious agents - cytomegalia - into the body, they will never leave it again. If the immune system is strong, then the virus is in a dormant state. When the protective functions are weakened, it begins to multiply, destroying the structure of normal cells and leading to their swelling.

Cytomegalovirus spreads with the help of human biological fluids, that is, through saliva, urine, feces, semen, blood, breast milk, sputum.

It should be noted that the disease proceeds in two forms - latent carriage of infection and subclinical manifestation. The disease can also be acquired and congenital.

It is transmitted in the following ways:

• to the child through mother's milk;
• after sexual contact (orally, anally, genitally);
• after using personal items of a sick person;
• in the process of blood transfusion or transplantation of donor organs, tissues;
• in a transplacental way;
• endogenous, that is, by droplet-air way.

Cytomegalovirus: causative agent, transmission routes, carriage, re-infection

Are there any symptoms

If infection has occurred, and the person's immunity is strong, then in most cases there will be no symptoms. Only occasionally in people with a strong protective function can manifest the so-called mononucleosis-like syndrome. This is when, 20-60 days after infection, a high fever, headache, and general malaise appear. This condition can last from 2 to 6 weeks.

The virus manifests itself in the body of a pregnant woman quickly. Symptoms resemble SARS - fever, body aches, muscles, joints, headache, weakness. Therefore, often a woman believes that this is a common cold and is treated with completely different medicines. The condition of the pregnant woman worsens.

The main difference between ordinary ARVI and cytomegalovirus is that the latter takes much longer - up to 4-6 weeks.

With immunodeficiency, the infection can cause the development of dangerous diseases in a pregnant woman - pneumonia, encephalitis, pleurisy, myocarditis. In addition, there is a high probability of damage to internal organs and vegetovascular disorders.

If cytomegalovirus occurs in a generalized form (which is very rare), then the infection spreads to almost all organs.

Symptoms of cytomegalovirus

Analysis for cytomegalovirus

It is not possible to find out on your own about the presence of pathology in the body. Even the acute form is difficult to recognize because of its similarity with other diseases. To find out about the presence of cytomegalovirus during pregnancy, you should be tested. The essence of the study is to detect antibodies to CMV - IgG. For this, saliva, blood or any other biological fluid of a pregnant woman is taken.

To be clearer, IgG is an antigen, a protective protein that is formed by the immune system in response to the entry of foreign organisms. "G" means here one of the subtypes of immunoglobulins. In addition to this letter, the letter “M” can also be seen in the abbreviation. It indicates the presence of completely different antibodies. IgM is faster than its counterparts. They are much larger and are produced almost instantly in response to the penetration of the herpes virus into the body of a pregnant woman.

However, these antibodies do not possess immunological memory. This means that the activity of antibodies after 4-5 months is on the decline. What can not be said about IgG. These antibodies to cytomegalovirus are produced, cloned throughout life. They are produced much later than IgM (they are often called late). Therefore, if CMV igM is negative in the tests for antibodies, and CMV IgG is positive, this means that the inflammatory process in the body of the pregnant woman has been stopped.

Cytomegalovirus during pregnancy: consequences for the fetus, diagnosis (tests)

Deciphering the analysis

Unfortunately, cytomegalovirus in a smear during pregnancy is often detected. But this does not always mean that you need to worry.

Here are all the norms and values ​​\u200b\u200bof antibodies to cytomegalovirus that are found in the test results:

1. If the indicators are “0” or the “-” sign is indicated in the decoding, then the pregnant woman has nothing to worry about. Cytomegalovirus is absent in the body.
2. If the avidity index (characteristic of the strength of the bond between antibodies and antigens) is 50-60%, regardless of the presence of antibodies, then a second study is required.
3. If avidity is high, IgG positive during pregnancy, and IgM negative, then the cytomegalovirus is inactive, that is, the virus is dormant. The risk to the fetus is minimal.
4. If avidity is low - less than 40%, IgMm and IgG are positive, then this means primary infection and a high risk of infection of the fetus.
5. If antibodies to cytomegalovirus IgG in the analysis are positive, avidity is average, and IgM are marked in this way “+/-”, then the infection is in a subsiding stage. This period is also quite dangerous for the fetus.
6. If avidity is low, IgG values ​​are positive, IgM is marked as “+/-”, then CMV during pregnancy is in the stage of reactivation and is dangerous to the fetus.

Deciphering the analysis for cytomegalovirus, taking into account the risk to the fetus

Risk to fetus and pregnant woman

If the levels of antibodies to cytomegalovirus IgG are increased in pregnant women, then this indicates an exacerbation of the pathology. That is, the infection recurs. This situation, both for the unborn child and for his mother, is more favorable than in the case of primary infection.

If the pregnant woman caught the virus for the first time, then the level of IgM will increase in the analysis. There is a high risk of transmission of cytomegalovirus to the child. It is especially dangerous when the infection is detected in the first weeks of pregnancy. This threatens the development of serious developmental anomalies in the child, intrauterine death and miscarriage.

If infection occurs in the second and third trimesters, then this threatens congenital, damage to the internal organs of the fetus and other dangerous pathologies. The infection is transmitted during the passage of the child through the birth canal during childbirth.

Treatment and prevention

Unfortunately, it is completely impossible to remove cytomegalovirus from the body. The goal of treatment is to eliminate symptoms and prolong the remission of the infection. Pregnant women are prescribed special antiviral drugs based on acyclovir and immunomodulatory drugs.

Good herbal teas consumed to strengthen the immune system. Herbal preparations for pregnant women are sold in pharmacies. They cannot be taken on their own, as they have contraindications.

As a prevention of cytomegalovirus, it is important to pass all the tests and carry out treatment even at the stage of pregnancy planning. In addition, proper nutrition, being outdoors, rest, avoiding stressful situations, and observing the rules of personal hygiene are mandatory.

To prevent primary infection, intimate relationships, any contact with a sick person should be avoided. It is important to follow the rules of personal hygiene, wash your hands more often with soap, avoid public places, etc.

Prevention and treatment of cytomegalovirus during pregnancy

The presence in the blood of antibodies to cytomegalovirus in a pregnant woman does not mean that she and the unborn child are in serious danger. If the disease recurred, then this is the most favorable option for the woman and for the unborn baby. Worse, when infection occurred during gestation. To avoid this, you should take preventive measures.

Also read with this

Is it necessary to sound the alarm if antibodies to cytomegalovirus are found in the blood of the expectant mother? After reading the article, you can learn about the features of the infection, the possible risks for the expectant mother and child.

All infections caused by viruses from the HERPESVIRIDAE family (herpesviruses) have a similar pathogenesis: the disease persists, proceeds in a latent or chronic form. So is cytomegalovirus: it can “sleep” in the body for many years, not at all making itself felt or waking up (reactivating) from time to time.

Causes and symptoms of cytomegalovirus

Cytomegalovirus hominis (Human Cytomegalovirus) is a DNA-containing pathogen that belongs to the HERPESVIRIDAE (Herpesviruses) family. The name of the virus, "giant cell", is due to the fact that the cells it affects can be multinucleated and have a huge size.

Cytomegalovirus is also different in that it can persist in the environment for a long time. This partly explains its high contagiousness.

IMPORTANT: According to the WHO (World Health Organization), 2 out of 10 adolescents and 4 out of 10 adults are carriers of a particular strain of Cytomegalovirus hominis.

The source of CMV infection is an infected person. Cytomegalovirus hominis is found in its saliva, tears, nasal secretions, semen, female genital secretions, urine and feces.

Ways of transmission of CMV and forms of CMV infection.

Transmitted by Cytomegalovirus hominis, regardless of strain:

• contact (including through objects)
• airborne
• through the placenta from mother to child
• organ transplant or blood transfusion

Infection with cytomegalovirus infection occurs very often, its gateway is the mucous membrane lining the genitals, upper respiratory tract and gastrointestinal tract. Nevertheless, the body of a healthy person copes with it, so the disease in the vast majority of people proceeds in a latent form.

IMPORTANT: The incubation period of CMV infection is 30-60 days. If a person's immunity is strong, it suppresses the disease in 1-2 months. Suppresses, but does not cure: in an inactive form, Cytomegalovirus hominis can live in the host's body for years and reactivate under favorable circumstances, that is, in the case of a decrease in immunity. It is difficult and not always possible to distinguish between primary infection and reactivation of the virus.

Symptoms of the same infection appear in those who are in a state of immunodeficiency. Acquired cytomegalovirus disease is often referred to as mononucleosis-like syndrome and presents as follows:

• weakness
• subfebrile condition or fever
• myalgia (muscle pain)
• swollen lymph nodes

Since Cytomegalovirus hominis can infect the respiratory system and liver, some patients with acute CMV infection may present as influenza or viral hepatitis.

If the human immune system is strong, after 30-60 days anti-CMV immunoglobulin is produced, the symptoms of the disease subside.

IMPORTANT: A carrier of Cytomegalovirus hominis remains contagious for weeks and months after symptoms of CMV infection disappear.

In people with weak immunity, as well as in pregnant women and young children, cytomegalovirus can cause:

• retinitis (inflammation of the retina)
• pneumonia
• hepatitis
• enterocolitis
• ulcers of the esophagus, stomach, intestines
• inflammation of the genitals
• encephalitis

Symptoms of cytomegalovirus during pregnancy. What is cytomegalovirus reactivation during pregnancy?

The development of CMV in pregnant women is possible in two cases:

• with primary infection (the risk of transplacental infection is higher)
• in case of reactivation of a dormant virus in the body (the risk of transplacental infection is lower)

If the expectant mother is a carrier of the virus, but she does not have symptoms of the disease, infection of the child through the placenta may not occur.

Weakness, fever and swollen lymph nodes are signs of CMV infection in an acute form.

Clinical forms of infection caused by Cytomegalovirus hominis are also different in expectant mothers.

If the disease is acute, the lungs, liver, eyes, genitals, and brain may be affected. A pregnant woman may have complaints about:

• weakness and fatigue
• specific discharge from the nose or genital tract
• swollen and sore lymph nodes

CMV infection affects the normal course of pregnancy. If the disease is acute, the expectant mother is often diagnosed with:

• vaginitis
• colpitis
• uterine hypertonicity
• premature aging of the placenta
• oligohydramnios

CMV infection can also come back to haunt a pregnant woman:

• premature detachment of the placenta
• weakening of labor activity
• blood loss during childbirth
• postpartum endometritis

VIDEO: Cytomegalovirus infection and pregnancy

Cytomegalovirus during pregnancy: consequences for the fetus

Cytomegalovirus hominis can also affect a baby in the womb.

If intrauterine infection with CMV infection occurs in the early stages, the pregnancy may fail.

IMPORTANT: Doctors consider the most dangerous situation to be the one when intranatal infection of a child with cytomegalovirus occurs in the first trimester of pregnancy. There is a risk of fetal death or the occurrence of various severe malformations in it.

Perinatal pathologies caused by CMV infection are:

1. Regardless of the gestational age at which the infection occurred: stillbirth, prematurity, fetal malnutrition
2. Infection occurred at an early stage: malformations of the nervous system (microcephaly, hydrocephalus), respiratory organs (lung hypoplasia), digestive organs, urination, heart disease
3. Infection occurred at a later date: the birth of a child with pneumonia, jaundice of various origins, hemolytic anemia, nephritis, meningocephalitis, etc.

Unfortunately, congenital CMV infection can result in developmental defects and health problems in the child in the future.

A child with congenital CMV infection may appear completely healthy at first. But over time, they may appear:

• hearing impairment up to deafness
• visual impairment up to blindness
• decline in intelligence
• speech problems

Cytomegalovirus in pregnancy planning. Analysis for cytomegalovirus during pregnancy

A woman who is serious about planning a pregnancy consults with a gynecologist, and already at this stage she is tested for TORCH infection, which allows her to identify a number of serious diseases that can disrupt the course of pregnancy and affect the health of the child, or antibodies to them .

IMPORTANT: The "C" in TORCH stands for Cytomegalovirus hominis.

Analysis for cytomegalovirus is included in the TORCH complex.

A serological blood test reveals the presence of anti-CMV immunoglobulins of class M and G and its titer in a woman.

Antibodies to cytomegalovirus - what does it mean? Deciphering the analysis for cytomegalovirus in pregnant women

The results of a test for Cytomegalovirus hominis in a pregnant woman will allow the doctor to answer three important questions:

• Is the mother-to-be infected with cytomegalovirus?
• if so, when did the infection occur?
• if yes, is the virus active

Deciphering the analysis

Indicators of cytomegalovirus during pregnancy, normal. What do cytomegalovirus titers mean during pregnancy?

An analysis that did not reveal IgM and IgG antibodies to Cytomegalovirus hominis is considered normal. This means that the woman is not infected. But there is absolutely no guarantee that infection will not occur in the pre-delivery period of time.

1. A high IgM titer in the absence of IgG indicates an acute period of CMV infection and, accordingly, a high risk of infection of the fetus
2. A high titer of IgG in the absence of IgM indicates the presence of a virus and the possibility of reactivation.
3. Low titer of IgM and IgG - infection at the stage of attenuation
4. High titer of IgM and IgG - reactivation of Cytomegalovirus hominis

Change in the titer of antibodies to CMV.

Treatment of cytomegalovirus. How to treat cytomegalovirus during pregnancy?

Unfortunately, it is impossible to completely eliminate Cytomegalovirus hominis once it enters the body. But medicine knows ways to mobilize a person's own immunity to fight it.
Pregnant women are usually prescribed antiviral and restorative drugs. These are drugs based on interferon or herbal preparations. Effective, for example, is the drug Proteflazid.

CMV cannot be cured, but it can be controlled.

If there are no antibodies to cytomegalovirus in the blood of the expectant mother, she should take preventive measures:

• do not change sexual partner
• use condoms
• follow the rules of personal hygiene
• do not eat from someone else's dishes
• regularly clean the apartment
• take care of your own health

What to do if cytomegalovirus is found during pregnancy: tips and reviews

If Cytomegalovirus hominis is found in a pregnant woman, she should not consider this the end of the world. The key to a normal pregnancy is constant interaction with the doctor and strict adherence to his prescriptions.
In the acute form of the infection, the expectant mother should be tested to control the antibody titer every two weeks, and also regularly examined to monitor the development of the fetus.

VIDEO: Cytomegalovirus during pregnancy

Cytomegalovirus is a worldwide virus related to chicken pox and Epstein-Barr disease. Asymptomatic or as a mild malaise in healthy people, cytomegalovirus infection is dangerous for immunocompromised patients and the developing fetus.

You can become infected with cytomegalovirus through blood transfusion, organ transplantation. The infectious agent is also transmitted sexually and by airborne droplets. The virus passes from mother to child in utero through the placenta, during childbirth and during breastfeeding.

Cytomegalovirus infection is widespread. In different regions of the globe, the number of carriers ranges from 40 to 100%. Routes of infection, the severity of symptoms can vary greatly, but only a few people do not get this infection during their lives.

A person with normal immunity can easily cope with an acute infection caused by cytomegalovirus. In the future, the infectious agent is in the body, but does not affect the vital activity of the systems and organs of the carrier. The disease is dangerous only when it occurs against the background of reduced immunity. A separate problem is its combination with pregnancy.

In developing countries, the peak incidence occurs in childhood. In economically developed countries, people are more likely to become infected in their mature years. In the US and Western Europe, 50% of young people of the age of creation of a family are not yet infected with this virus.

The incubation period of the disease is 9-60 days.

Statistical data

Cytomegalovirus is the most common causative agent of intrauterine infections. Moreover, it is the most common viral cause of mental retardation.

The following fact must be clearly understood: while a healthy adult suffers a cytomegalovirus infection without any consequences, infection of the fetus inside the mother's womb often leads to serious developmental disorders.

Cytomegalovirus during pregnancy is most dangerous if the infection occurs in the mother for the first time. In this case, it is transmitted to the fetus through the placenta with a probability of 30-40%.

In women with a positive analysis for the presence of antibodies of class G to cytomegalovirus (in other words, in previously ill women), the probability of transmitting the virus to a child is 1%.

From the point of view of possible consequences, the development of an infectious process is most dangerous in the first trimester of pregnancy.

In rare cases, women who previously had this infection may become ill again during pregnancy due to the reactivation of the virus against the background of reduced immune forces. Like other herpesviruses, cytomegalovirus, once having caused a disease, remains in the body in a “dormant” form and is activated when immunity drops below normal.

The risk of infection to the fetus

In 85-90% of children who become infected with cytomegalovirus in utero, immediately after birth there are no symptoms of the disease. Most of them will not experience the consequences of the defeat in the future.

In 5-15% of children infected in utero, but without signs of illness at birth, there will be symptoms associated with cytomegalovirus in the future, most often deafness. Also, the consequences of the disease include a decrease in intelligence, impaired vision and speech.

In 10-15% of children infected in the womb, serious disorders are detected immediately after birth: neurological disorders, small head, enlarged spleen and liver, jaundice, anomalies in the development of the heart, kidneys, and gastrointestinal tract.

The influence of the virus in early pregnancy can lead to intrauterine death of the fetus.

If the virus enters the child's body through breast milk, then a healthy infant carries the infection in the same way as healthy adults - almost asymptomatically.

Clinical picture

Usually, in people with normal immunity, an infection caused by cytomegalovirus goes unnoticed or causes mild symptoms similar to SARS.

During the acute phase, the lymph nodes and spleen may be enlarged. Sometimes cytomegalovirus causes a picture similar to mononucleosis (Epstein-Barr infection): a person develops tonsillitis against the background of swollen lymph nodes and fever up to 38-39 degrees.

In patients with reduced immunity, for example, with HIV infection, cytomegalovirus can cause pneumonia, myocarditis, meningitis and other diseases of any organs and systems.

Diagnostics

For diagnosis, serological methods are used (determination of antibodies to an infectious agent), polymerase chain reaction (detection of pathogen DNA fragments in biological fluids) and cytopathological studies (identification of changes in cells characteristic of cytomegalovirus when analyzing a smear under a microscope).

Deciphering these studies is often difficult for patients. Typical is the initially wrong question - what is cytomegalovirus during pregnancy and what is its norm. Therefore, the story about diagnostic methods must be preceded by an explanation of why it is necessary to determine class G and M immunoglobulins (IgG and IgM).

What is IgG and IgM

In response to any infection, antibodies are produced in the blood of a person - special proteins involved in the neutralization of the infectious agent. There are 5 classes of antibodies (or immunoglobulins) with different functions.

For the diagnosis of cytomegalovirus in pregnant women, immunoglobulins of the G and M classes (IgG and IgM) are most important.

The decoding of analyzes is based on the following patterns. IgM appear in the blood during an acute infection or reactivation of a chronic process.

IgG, in addition to participating in the immune response to "invasion", are related to immunological memory. This means that if a person has previously had an infectious disease, then his blood will always have a certain amount of class G immunoglobulins (IgG) that carry information about this disease.

Now we can return to the issue of cytomegalovirus M during pregnancy. Such a laboratory indicator, of course, does not exist. We can only talk about the determination of class M immunoglobulin to cytomegalovirus.

Serological studies

The serological diagnosis of cytomegalovirus in pregnant women is based on the rules described above: if the patient’s blood contains only G (IgG) antibodies, and there are no M (IgM) antibodies, this means that she once had an infection, but is currently not sick.

If a pregnant woman is positive (available) for both class G (IgG) and class M (IgM) antibodies, then she is currently experiencing an acute infection or reactivation of a chronic form of the disease.

If a person does not have either immunoglobulins G or M in the blood, this is the norm.

In some cases, a false positive increase in IgM to cytomegalovirus can be recorded, for example, in mononucleosis or rheumatoid arthritis.

polymerase chain reaction

This type of diagnosis is accurate, easy to decipher, and therefore doctors widely use it. Using the polymerase chain reaction (PCR), it is possible to detect the presence of the virus both in the blood and in other tissues of the body (a smear is made).

There are qualitative and quantitative PCR methods. The quantitative method is the most informative in case of cytomegalovirus infection. Performing only high-quality PCR is not enough, since it can be positive in the absence of an active infectious process.

A few words about the interpretation of the results: the norm of high-quality PCR in case of suspected infection is the absence of the virus in the test material.

Cytopathological studies

Cytomegalovirus infection in pregnant women can be determined by examining a biological preparation. A tissue sample from any organ is viewed under a microscope. In a smear stained in one of the most common ways, one can see a symptom of cell damage characteristic of cytomegalovirus - the so-called "owl's eye". Normally, it is not defined.

Diagnosis of cytomegalovirus lesions in the fetus

Cytomegalovirus in the fetus before delivery can be detected by examining the amniotic fluid using PCR. If the PCR response is positive, intrauterine infection is suspected, but its effect on the fetus cannot be established in this analysis.

Ultrasound is used to detect developmental anomalies that have arisen under the influence of the virus.

The detection of class M immunoglobulins to cytomegalovirus in a newborn child in the first 2 weeks of life indicates intrauterine infection.

Treatment and prevention

Treatment of cytomegalovirus infection in pregnant women is not an easy task. Many antiviral agents can lead to malformations. Therefore, in most cases, antiviral therapy is not carried out.

The need to treat a pregnant patient may arise if she has an immunodeficiency, and the developed cytomegalovirus infection is life threatening. But the prognosis for the fetus with such treatment is unfavorable.

Given the difficulties with treatment during pregnancy, prevention plays a major role in the fight against cytomegalovirus.

A common question that women ask when planning a family is whether it is possible to get pregnant if you have previously had a cytomegalovirus disease. You can get pregnant, the probability of infection of the fetus in such a situation does not exceed 1% percent. At the same time, it is far from a fact that this percentage of children will have complications in the future.

The primary infection of the mother during pregnancy is much more dangerous. In this regard, the education of women is important. Pregnant women who do not have antibodies to cytomegalovirus should avoid large crowds and be aware of the dangers of unprotected sexual contact.

An important role is played by infectious screening in the early stages of gestation.

Cytomegalovirus during pregnancy: consequences for the fetus, treatment of CMV infection, decoding of the analysis

For non-pregnant women, cytomegalovirus infection does not matter. In some cases, the presence of cytomegalovirus in the body can be considered as an aggravating factor that worsens the general symptoms and prognosis in other diseases.

Plays a huge role cytomegalovirus during pregnancy and when planning a pregnancy. 70% of premature babies are infected with cytomegalovirus. CMV is a universal factor that leads to prematurity of the fetus, fetoplacental insufficiency, placental abruption, intrauterine growth retardation.

• What is CMV infection during pregnancy
• Features of cytomegalovirus infection
• Consequences for the fetus
• Symptoms
• Treatment of cytomegalovirus during pregnancy
• Pregnancy planning and prevention

What is cytomegalovirus infection (CMVI)?

CMVI or is a widespread infection caused by human cytomegalovirus. This virus belongs to the herpevirus family and is opportunistic pathogen.

For a pregnant woman, the source of CMV infection is:

• virus carrier (asymptomatic stay of the pathogen in humans);
• a patient with an acute form (infection has just happened);
• a sick person in the acute stage (he has been sick for a long time, but an exacerbation occurred with the onset of symptoms).

By transmitting cytomegalovirus to a pregnant woman and a woman planning a pregnancy, it can be:

• airborne (coughing, sneezing);
• sexual;
• contact (through unwashed hands, household items);
• oral (the entry of the virus into the body of the expectant mother through the mouth);
• parenteral (through the blood);
• enteral (ingestion through the digestive tract, for example with food).

Features of cytomegalovirus

This virus is able to persist in the body for a long time with irregular production of viral particles, which leads to episodic exacerbation of the disease. The causative agent has a large DNA genome, relatively low virulence (infectiousness). Cytomegalovirus sharply suppresses the immune system and the interferon system, replicates slowly, and when reproducing viral particles, the human cell in which it multiplies may not be damaged. All this leads to chronic cytomegalovirus infection.

Cytomegalovirus during pregnancy and consequences for the fetus

The consequences in newborns with cytomegalovirus are:

• deafness;
• decrease in intelligence;
• pathology of internal organs (liver, kidneys, pulmonary tract);
• hemorrhagic vasculitis - small-point hemorrhages due to the pathology of blood vessels and the coagulation system.

These are quite serious complications for the fetus, but you need to be afraid of their appearance only if there was a primary infection with cytomegalovirus during pregnancy, or shortly before conception. The majority of the world's population is infected with cytomegalovirus, the symptoms of the disease are nonspecific and manifest as symptoms of a cold or flu.

Symptoms of cytomegalovirus during pregnancy

Cytomegalovirus infection manifests itself as ARVI or flu, that is, a pregnant woman has symptoms:

• runny nose;
• weakness and weakness;
• pain when swallowing;
• temperature increase;
• feeling unwell for several days.

With the simplest therapeutic measures - bed rest, plentiful alkaline drinking - the woman is back in line, recovering.

In a non-pregnant organism, the period of primary infection lasts 2-. The outcome depends on . In its absence, the disease becomes generalized. With a sufficient immune response, self-healing occurs, with insufficient, a localized form develops. The infection can also go into an inactive phase - the virus carrier. As a rule, cytomegalovirus infection develops against the background of a decrease in immunity.

Why is cytomegalovirus dangerous during pregnancy

It is quite dangerous when the primary infection for some reason is delayed and cytomegalovirus develops during pregnancy. In this case, 40% of pregnant women transmit the virus to the fetus, and in 10-12% of cases pathologies develop in the child. This means that cytomegalovirus should be feared during pregnancy in the context and pathology of the fetus.

Pregnancy is a physiological state with a sharp decrease in the activity of the immune system.

Cytomegalovirus during pregnancy is dangerous in two cases:

• at the initial meeting of the body with an infection;
• with reactivation of cytomegalovirus in the body of a pregnant woman.

The risk to the fetus in the primary disease is more severe than in the exacerbation of chronic infection.

If cytomegalovirus enters the fetus in the first half of pregnancy, then clinical manifestations develop in 2-8% of children born to mothers with a primary infection. They have very severe symptoms:

• hepatosplenomegaly (enlargement of the liver, pancreas), hepatitis;
• thrombocytopenia (decrease in the number of platelets with impaired blood coagulation);
• microcephaly - a pathology of brain development;
• bilirubinemia (increased levels of bilirubin in the blood);
• CNS disorders.

Mortality in children or fetuses is up to 10-12%.

If cytomegalovirus damage occurs in the second half of pregnancy, chronic congenital CMVI develops, in severe cases there may be damage to the central nervous system, liver, visual impairment, and hearing.

Diagnosis of cytomegalovirus during pregnancy: IgM and IgG antibodies

All pregnant women, when registering, ask a blood test for TORCH infection. This is one of the tests that cannot be abandoned under any circumstances. This is a complex of infections, the disease of which during pregnancy poses a direct threat to the child. CMVI belongs to this complex.

If IgM and IgG (positive) are found in the blood test, this is normal, which means that there will be no initial meeting with cytomegalovirus during pregnancy - it has already happened. If antibodies are not detected (IgM and IgG are negative), then such a pregnant woman needs close attention. The study is carried out after 2 weeks.

Repeated tests are given even before and in the second half of pregnancy. If the first analysis was negative, and the second analysis detected IgM and IgG, this indicates a recent infection with cytomegalovirus. In this case, a re-analysis is given again after 2 weeks. A fourfold increase in IgG indicates an active CMVI.

Detection of cytomegalovirus DNA is the most reliable diagnostic method during pregnancy.

In pregnant women, PCR diagnostics and the determination (in extreme cases) of the virus itself in the blood are very important. The most dangerous condition when the virus is found in the blood is viremia. The virus circulates with the bloodstream and penetrates the feto-placental barrier, enters the fetal circulation and affects its development.

Detection of cytomegalovirus DNA in saliva indicates the presence of the virus in the body, but does not mean the presence of a high viral load. If the DNA of the virus is found in smears from the vagina, in urine and blood, it confirms not only the presence of the pathogen, but also a high viral load.

Interpretation and interpretation of test results in pregnant women

Positive tests for the presence of the virus or the presence of antibodies do not always indicate the presence of the disease. Two research methods are recommended - direct and indirect, for example, serological (determination of specific antibodies to cytomegalovirus antigens) and PCR.

Presence of IgM antibodies- indicates a primary infection or exacerbation of CMVI.

Antibodies of the IgG class- indicates that the pregnant woman had previously met with an infection.

More than 4-fold increase in IgG titers- exacerbation of chronic infection.

Cytomegalovirus during pregnancy: treatment

For the treatment of cytomegalovirus infection, there are no specific etiotropic (acting on the pathogen) drugs. Most antiviral drugs are contraindicated during pregnancy. During pregnancy, treatment with immunoglobulin at a dose of 25-50 mg intravenously 3 times a day in saline is indicated.

Intensive detoxification therapy with saline solutions is carried out to reduce the viral load and remove toxic substances. Fetoplacental insufficiency, circulatory disorders are being prevented.

An important aspect in the prevention of cytomegalovirus during pregnancy is timely preparation for conception. This means that even at the stage of pregnancy planning, you need to donate blood for the TORCH infection complex. If a woman is seronegative - there are no antibodies to cytomegalovirus, then measures must be taken to prevent contact with this virus.

A potential group that can infect a pregnant woman is children, especially preschool children. The prevalence of CMVI in children attending kindergarten is 25-80%. If you work with kids, for example, a kindergarten teacher, an elementary school teacher, it is highly advisable to change jobs. It is necessary to limit contact with children and stay in places where children are located - playrooms, developing activities, not to contact the mothers of other children.

Actual video

The most dangerous infections during pregnancy

This disease is called cytomegaly.

A characteristic feature of the disease is that infected cells lose their ability to divide and there is a rapid increase in their size. Near the infected cell structures, the development of the inflammatory process is observed.

Cytomegalovirus infection can affect any internal organ:

• Rhinitis- nasal sinuses.
• Bronchitis- bronchi.
• Cystitis- urinary bladder.
• Urethra or vagina- urethritis or vaginitis.

Almost always, CMV is localized in the genitourinary system, despite the fact that the presence of infection is observed in almost all body fluids (sweat, blood, saliva, vaginal discharge, etc.).

Causes of infection and carriage

Cytomegalovirus infection, like others, is chronic. It penetrates the blood once and remains forever.

There are no drugs yet that could get rid of the carriage. Those people who do not have symptoms of the disease, despite the fact that they are called CMV carriers.

Many may not even suspect that they are sick and are a danger to others until they fail, and the primary signs of the disease begin to appear.

Among the most common causes of a decrease in the immune status of the body in a healthy person, the following factors can be distinguished:

• Taking medications after organ transplantation, the action of which is aimed at reducing the immune response in order to eliminate the likelihood of rejection.
• Irradiation and chemotherapeutic effects in oncological diseases.
• Long-term treatment with hormonal drugs.
• Alcoholism and smoking over a long period of time.

This is due to the fact that their immune system is not fully formed, so there are practically no obstacles in the way of viral infections.

Cytomegalovirus manifests itself in childhood only when the child catches a cold or beriberi develops in his body. Serious immune problems can also be the cause.

If the immune system in children is not lowered, they become carriers and the disease does not manifest itself: there is no runny nose, etc.

Immune cells cope with foreign microorganisms, so the temperature does not rise, but the formation of antibodies occurs, followed by memorization of the program for their production.

Symptoms of the disease

Cytomegalovirus IgG manifests as acute respiratory infections (ARI):

• Body temperature rises.
• There is acute rhinitis.
• My throat starts to hurt.

As a rule, there is an increase in lymph nodes. The listed symptoms in the complex are called mononucleosis syndrome, which accompanies infectious diseases.

The main difference between cytomegalovirus infection is the time during which the acute period of the disease lasts.

Colds usually go away in 5-7 days. Cytomegaly can last for one and a half months or more.

Among the characteristic signs of cytomegalovirus can be identified:

• Inflammation of the salivary gland.
• Inflammation of the genital organs (testicles in men and ovaries in women).
• Symptoms may be absent if the localization area is the genitourinary system.

Laboratory tests and their interpretation

The causative agent of a viral infection is contained in all biological fluids (saliva, blood, mucus, urine, etc.).

That is why you can take urine, blood, saliva, etc. for analysis. Women take or pharynx.

Under a microscope, the biomaterial is studied in order to identify cells affected by the virus. They are large and are called "huge".

An additional diagnostic method is a blood test for antibodies. If there are specific immunoglobulins in the biological fluid, which are formed as a result of the fight against a viral disease, it indicates that the infection was and the patient is a carrier.

According to the type of immunoglobulins, experts distinguish between the type of infection - primary or secondary. For diagnosis, you need to pass an analysis - enzyme immunoassay (ELISA).

As an additional examination, PCR is performed. This analysis allows you to determine if there is an infection.

Amniotic fluid or vaginal discharge is used as the test material. If there is a positive answer, we are talking about an acute form of the disease. If the virus is not detected during PCR, but antibodies are detected during ELISA, then we are talking about carriage.

Getting tested is half the battle. The results can only be deciphered by an experienced specialist who knows a lot about the difference in immune bodies.

Only with the help of correctly decoded results, it is possible to prescribe the correct treatment, which is very important during pregnancy, as it allows you to avoid the use of unnecessary drugs.

In the human body, only two groups of antibodies can be formed:

1. Primary IgM. Formed when the causative agent of an infectious disease first enters the bloodstream. In this case, their appearance has no connection with the strength of the onset of signs of the disease. Primary infection does not manifest itself, despite the fact that antibodies are present in the body.
2. Secondary IgGs. If we are not talking about primary infection, but about relapses, then type G antibodies are formed. In this case, the infection gets out of control of the protective functions of the body and actively multiplies. The formation of secondary antibodies occurs when the dormant form of the virus, which is stored in the spinal ganglion, gets out of control.

?

An indicator of the stage of formation of an infectious disease is. This factor indicates the maturity of antibodies and the fact that the infection entered the human body for the first time.

With avidity up to 30%, we are talking about a low level of maturity, that is, in this case, infection is primary.

If, when examining a biological fluid for cytomegalovirus infection, the result of the analysis is more than 60%, then this symptom indicates a chronic carriage, that is, a latent stage of the disease.

If the indicator is between 30 and 60%, then we are talking about a recurrence of the infection, that is, the activation of the "sleeping" form of the disease.

When deciphering the analysis for CMV, not only the amount, but also the type of antibodies is taken into account.

The information obtained allows us to draw conclusions about the time when the infection occurred. The analysis makes it possible to establish the level of the patient's immune response.

A smart approach to treatment

If the result of the analysis is positive, then many patients panic, and they begin to take extreme measures.

Do not start treatment on your own. Despite the fact that the causative agent of cytomegalovirus is found in the blood serum, medications must not be taken in all cases.

It is necessary only when the primary symptoms of the disease appear. That is, before the activation of the virus in the body, there is no need to take therapeutic measures.

During pregnancy, if a blood test shows, then there is no need for treatment. This type of antibody indicates carriage.

It is necessary to take medicines only when the primary symptoms of the disease appear.

It should be understood that a complete cure for the virus is still not possible. A person still remains a carrier and carries a danger to others.

Over time, the G titer decreases. If immediately after infection, the indicator varies within 250, then after a few months it is almost halved.

From the point of view of leading experts from the field of the pharmaceutical industry, all infected people, without exception, should be treated in order to prevent the spread of an infectious disease.

CMV treatment is carried out in the following areas:

• The appointment of drugs whose action is aimed at strengthening immunity (modulators, immunostimulants) and drugs containing interferon (ginferon and).
• Use of specific antiviral agents (ganciclovir, foscarnet).
• Reception of vitamin and mineral complexes (vitamin of group B).

Treatment is carried out with the help of similar drugs. The dosage is calculated on an individual basis, depending on the characteristics of the body and the presence of concomitant diseases.

Conclusion

You should not trust your health to people who are trying to get rich at the expense of a gullible buyer. First of all, after detecting cytomegalovirus, you should consult a doctor.

Only a doctor can prescribe an effective treatment rationally. Strengthen the protective functions of the body and do not neglect the recommendations of specialists.