Treatment of Ureaplasma in pregnancy - approaches to the choice of tactics
February 3, 2013
Pregnancy that occurs on a background of ureaplasmosis characterized by complicated variants of the course. Complications lead to adverse pregnancy outcomes and negatively affect the developing fetus. Treatment during pregnancy ureaplasmas
Ureaplasma in pregnancy: to treat or not to treat
carried out with the purpose of antibacterials, but only with strict indications for their destinations and given trimester.
The sensitivity of antibacterial drugs
In structure ureaplasmas differ from other microorganisms so that they do not have a cell wall. This explains the choice of certain antibacterial agents for therapeutic purposes. This pathogen has a sensitivity to the following groups of antibiotics
Antibiotics - whether they will help you in the foreseeable future?
:
- macrolides
- fluoroquinolones
- aminoglycosides
- tetracyclines
Antibiotics of cephalosporin, penicillin, sulfonamides should not be given, since the effect of these drugs is associated with the influence on the cell wall of the microorganism, which in this case is absent. The effectiveness of such treatment would be minimal, and its purpose is not justified.
When ureaplasmosis which complicates the course of pregnancy, shows the use of antibiotics. This therapy is usually prescribed in the second trimester, ie after 18-22 weeks of pregnancy. The question of the admission of this group of drugs should be resolved taking into account the individual approach, the clinical picture of the disease and presence of complications. The drugs of choice for pregnant women is erythromycin
Erythromycin - if you are allergic to penicillin
, Josamycin and spiramycin. Good therapeutic effect was observed at taking josamycin (dose of 1, 0 g per day) and spiramycin (9 million dose per day). Erythromycin should be taken up to four times a day at a daily dose of 2 g average duration of antibiotic therapy should be at least ten days. To the therapeutic effect was achieved by the therapy, it is necessary to combine antibiotics with enzyme preparations. For pregnant women the drug is safe, "Wobenzym" in a dose of 3-5 coated tablets three times a day. The drug has a systemic effect on the body and enhances the action of antibiotics, it should be taken within two weeks.
Correction of violations
Antibiotics are not the only tool in the treatment in pregnant ureaplasmosis
. The approach to the choice of treatment strategy must be comprehensive, taking into account the revealed violations at different levels of the woman's body
. Pregnancy in a large percentage of cases is complicated course, so it is necessary to carry out treatment, taking into account the revealed pathology
. The most characteristic ureaplasmosis complication during pregnancy is 24-26 weeks after the development of preeclampsia
. This is one of the most adverse complications, and the treatment should be carried out in a specialized hospital maternity
. The complex pharmacological activities include antispasmodic preparations, improving the metabolic processes and the processes of hemostasis (the state of coagulation)
. Not recommended for this therapy at home or outpatient basis, since only in a hospital can create a health-protective mode, which is one of the important healing factors and carry out the necessary treatment in full
.
Ureaplasmosis during pregnancy in 24% of cases the cause disturbances in the production of amniotic fluid (the development of polyhydramnios and oligohydramnios). Antibiotic therapy in combination with antioxidant drugs, metabolic and antiplatelet therapy helps to normalize the amount of amniotic fluid. Monitoring the effectiveness of this therapy in the form of complications should be conducted based on the results of objective examination (abdominal circumference and height of the uterus), on the conclusion of an ultrasound scan.
Particular attention should be paid to the treatment of placental insufficiency, which occurs in pregnant women at ureaplasmosis in 78% of cases. If ureaplasmosis
Ureaplasmosis - inflammation of the urogenital system
was diagnosed in women before pregnancy, and the pregnancy is at an unfavorable infectious background, it is necessary to carry out a course of therapy of placental insufficiency, since the first trimester. To this end, experts advise to normal human immunoglobulin administered intravenously 25 ml three times. You can repeat administration of the drug in pregnancy 20-24 and 35-36 weeks. It should also be carried out by indications Vaginal. It is often possible to observe a combination ureaplazmennoj infections with other types of bacterial pathogens. Timely detection and treatment of local infection in women helps to prevent the spread of infection.
Marina Solovyov
Pregnancy after ureaplasmas - features of the course
January 29, 2013
In women who have had mycoplasma or ureaplasma infection pregnancies has a high percentage of complications. Pregnancy after ureaplasmas exposed to interrupt more likely at the earliest timing. Especially at risk fetus in utero infection. Pregnant should be under medical supervision, to be able to timely prevent complications.
Chance of abortion
Since the early periods, pregnancy after ureaplasmosis exposed interruption in 45-70% of cases. The cause of the pathological course of pregnancy is an infection of the mucous of the uterus or endometrium, which takes place ovum implantation. Infection of the mucous naturally leads to infection of the ovum, so implants will not be complete. Attach another immunological factors, autoimmune antibodies are formed when aggravating pathological disorders. To a large extent the problem of miscarriage
Miscarriage - why you lose the most precious thing?
It refers to early maturity, when an interrupt occurs by detachment of the ovum. Clinically it is manifested signs of a miscarriage or abortion in the course.
Termination of pregnancy can occur at all stages of gestation:
- when threatened miscarriage
Miscarriage - can you protect yourself from it?
ureaplasma detected in 46-60%
- -threatening preterm labor at 33-30%
Another factor that contributes to the complications of pregnancy, a placental insufficiency. It is often formed of primary, leading to malfunction feto-placental complex, wherein the pathogen infection ureaplazmennoj found nearly 78% of cases.
Effect on the fetus
Infection of the fetus ureaplazmennoj infection can occur in utero. Most often develop malformations of the nervous system, respiratory pathology. In 30% of newborn infants during fetal infection can detect blood flow disorders, hydrocephalus, and choroid plexus cysts, which are diagnosed in one in three infected children. If we talk about the risk of the formation of fetal malformations with infection, they are found in 42-67% of cases.
Lung pathology has its own characteristics. Even in the absence of signs of infection in the amniotic fluid (chorioamnionitis signs), the fetus in the background, you can identify infection of the lung tissue damage, which manifested in the newborn child development of interstitial pneumonia. Pneumonia followed by circulatory disorders pronounced. Congenital pneumonia, the cause of which is ureaplasmosis
Ureaplasmosis - inflammation of the urogenital system
, Diagnosed in 35% of newborns. If proven ureaplazmennoj intrauterine infection in 30-40% of fetuses found the phenomenon of malnutrition or intrauterine growth lag, chronic fetal hypoxia. As a causal factor in favor placental insufficiency, which leads to the suffering of the fetus in utero.
Given the high incidence of complications during pregnancy, a woman should be evaluated immediately at the first comprehensive examination in order to exclude the presence of her ureaplasmosis. This is crucial especially for women with burdened anamnesis (previous complications of pregnancy - abortion or developing pregnancy and others). Pregnancy complications are the indication for a course of drug therapy, while it should be confirmed by the presence of ureaplasma infection as the sole cause of the pathological state. If the infection is in the form of carrier, it is not necessary to designate antimicrobials. In cases where the shows antibacterial therapy, pregnant women are allowed the appointment of certain drugs - josamycin, spiramycin and erythromycin
Erythromycin - if you are allergic to penicillin
. The course of therapy is performed in the second trimester, after 18-22 weeks. In the early stages it is important to conduct the course of prevention of placental insufficiency.
Marina Solovyov
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