Ureaplasma in pregnancy: to treat or not to treat

April 7, 2013

  • Ureaplasma in pregnancy: to treat or not to treat
  • Possible risk

 Ureaplasma in pregnancy
 Often during pregnancy revealed a ureaplasma This insidious ureaplasma - often too late  This insidious ureaplasma - often too late
 . What can we do to treat or not to treat? Undoubtedly, in the treatment of Ureaplasma in pregnancy prescribe antibiotics that adversely affect the fetus. But untreated ureaplasmosis threatening complications and adverse effects on the fetus. Therefore, positive for ureaplasma requires mandatory treatment for the disease.

Influence of various types of pathogens in the course of pregnancy is a serious problem. As the pathogenic agents may be bacteria, viruses, fungi or multiple pathogens which cause mixed infections. Ureaplasma in pregnancy causes a number of complications that affect fetal development and pregnancy.

 Ureaplasma in pregnancy: to treat or not to treat

Characteristic features of the pathogen

Mycoplasmas currently belong to a common pathology. A large number of diseases of the urinary tract caused by this organism. If it is proved that the cause of the disease is mycoplasma, it is possible to speak of urogenital mycoplasmosis. The term combined mycoplasma mycoplasma and ureaplasma. According to the modern classification ureaplasmas belong to the kingdom of prokaryotes, and combine more than 180 different species of this class of pathogens. If we talk about the importance of human, the pathogenic properties are about 14 species for which the human body is the master of them:

  • Ureapl.urealyticum
  • Myc.genitalium
  • Myc.salivarium
  • Myc.penetrans

Based on the results of numerous studies have established that ureaplasmas have sexual transmission, as previously anticipated. In certain concentrations and can be in a dynamic equilibrium with other vaginal flora, without causing any inflammatory change.

Allowable concentrations considered the content of the pathogen in the titer of 10 * 2 * 10 4 CFU / ml. If the concentration exceeds these values, it is naturally ends development of pathological changes. In this connection, it was decided to refer to the causative agents of urogenital mycoplasma group of opportunistic pathogens, which manifest its pathogenic properties only under certain favorable conditions.

There is also another point of view, which adheres to a number of researchers. They tend to refer to the absolute pathogen pathogens, ie those pathogens that initially have the ability to cause various inflammatory processes. Ureaplasmas characterized by certain features that allow you to combine a number of pathogens in a single class:

  • a class of free-living prokaryotes with minimum dimensions. Cell wall they lack
  • characterized by membrane type of parasitism
  • antigenically characterized by volatility, as it is subject to dynamic changes
  • are capable of causing immunopathological reactions in the body. In the process of adaptation of the pathogen to the host organism occurs genetic rearrangement of the pathogen. This confirms the presence of genetic heterogeneity ureaplasmas
  • the presence of the expressed enzyme activity, which is similar to the same activity of the representatives of the anaerobic flora. When combined ureaplazmennoj and bacterial infection is a cause of inflammation

This type of agent is detected for a qualitative determination of the PCR method (polymerase chain reaction, or) in healthy women 5-15% of cases. In pregnant women, and this percentage increases up to 45%. If we compare the number of complicated and uncomplicated options for pregnancy, the percentage identifying ureaplasmas will vary. If there is no incidence of complications Ureaplasma is not high, while at various complications of pregnancy reaches more than 60%. This factor highlights the importance of ureaplasma infection in terms of possible adverse effects and complications of pregnancy.

 Ureaplasma in pregnancy: to treat or not to treat

Ureaplasma and ureaplasmosis

Ureaplasma - a micro-organism, which occupies an intermediate position between viruses and bacteria. The structure ureaplasmas no DNA and no cell wall, so they penetrate the host cell, where they live and breed. Ureaplasmas name comes from their ability to break down urea (ureoliz). Mostly ureaplasmas live in the urogenital tract, where the presence of urea. The main route of transmission ureaplasmosis - is sexual, but does not exclude intrauterine infection during childbirth.

Ureaplasmosis - a disease which is caused by ureaplasma. Distribution ureaplasmosis wide enough and the disease is one of the most common sexually transmitted infections by. The risk for ureaplasmosis are girls who start early sex life, or are promiscuous and women who have had gynecological disease or sexually transmitted.

 Ureaplasma in pregnancy: to treat or not to treat


Ureaplasmosis relates to latent infection and often asymptomatic. But certain factors (alcohol consumption, decreased immunity) occur exacerbation. Very often ureaplasmosis manifested during pregnancy. This contributes to immunosuppression during pregnancy and action of large quantities of estrogens.

A characteristic symptom of ureaplasmosis are abundant mucous discharge from the vagina. Often, frequent and painful urination, itching and burning in the vulva. With long-term course of the disease, patients noted mild pulling pain in the abdomen and a slight increase in temperature. Especially dangerous is asymptomatic process in which it is possible purulent lesion of the fallopian tubes to the development of adhesions and expressed as a result of infertility. In addition, the ureaplasma is capable of hitting the urinary tract and kidneys and cause stone formation in them.

 Ureaplasma in pregnancy: to treat or not to treat


As noted above, ureaplasma during pregnancy, even in small amounts can be activated and cause irreparable harm both mother and fetus. According to some sources it is believed that the ureaplasma is not capable of causing congenital malformations of the fetus. Its main effect during pregnancy is an interruption. In early pregnancy ureaplasmosis Ureaplasmosis - inflammation of the urogenital system  Ureaplasmosis - inflammation of the urogenital system
   causing miscarriages and missed abortion, in the later stages leads to premature birth.

In addition, ureaplasmosis promotes the development of placental insufficiency Placental insufficiency - deviation from the norm  Placental insufficiency - deviation from the norm
 That manifest violation of utero-placental blood flow, hypoxia and intrauterine growth retardation. Infection of the child in the birth occurs in about fifty percent of cases. Ureaplasma affects the nasopharynx and genitals newborns. In the postpartum period ureaplasmosis is the cause of septic complications (endometritis).

In order to prevent premature birth and development of placental insufficiency, ureaplasmosis must necessarily be treated during pregnancy. Essential drugs for the treatment of ureaplasmosis are antibiotics. During pregnancy, prohibited the use of tetracyclines and fluoroquinolones. Appointed by macrolide antibiotics (Rovamycinum, vilprafen Vilprafen - modern highly effective and non-toxic antibiotic  Vilprafen - modern highly effective and non-toxic antibiotic
 Erythromycin). Antibiotic treatment is carried out not earlier than the twenty-second week of pregnancy. Also appointed adjuvants and vitamins.