Cytomegalovirus during pregnancy: treatment, consequences for the fetus, reviews

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Not everyone knows about the existence of such an infection as cytomegalovirus. And that it poses the greatest danger to the body of a pregnant woman. But why is it dangerous for a child, and how to escape from the negative consequences associated with it? Below we consider what to do if the virus test turned out to be positive, and what does this mean: cytomegalovirus during pregnancy?

About the virus

Cytomegalovirus belongs to the group of herpesviruses. Often, many people who become infected with it are unaware of it. It does not manifest itself in any way until a certain point, as a rule, until the immune system fails. This is what cytomegalovirus is dangerous during pregnancy. Indeed, at this moment, the woman's immunity decreases.

The cells of the body increase under the influence of infection. Penetrating into them, the cytomegalovirus violates the structure of the cell, as a result of which it is filled with liquid and swells. Hence the name of the disease -"cytomegaly", which literally translates as "giant cells".

The disease manifests itself as a common cold. Or maybe not manifest for a long time, in which case the person becomes a carrier of cimegalovirus. During pregnancy, it is especially dangerous in the first trimester, during this period, infection leads to sad consequences: miscarriage, fetal death and congenital pathologies.

Features

The incubation period of the virus is 30-60 days. At this time, the infection spreads through the blood throughout the body and begins to actively multiply. There are several types of the course of the disease:

• The disease passes without symptoms. This type of course is typical for people with a good immune system, in which case the virus can be in the body for a long time in the latent phase and appear only when the protective properties of the body are reduced. That is why cytomegalovirus can become active during pregnancy.
• Mononucleosis-like type. It is typical for people with weak immune defenses, during the active phase it resembles a cold. Usually it is not dangerous, and the immune system successfully copes with the virus, but it does not disappear from the body anywhere, but simply passes into an inactive form.
• Cytomegalovirus hepatitis is very rare. Symptoms resemble ordinary hepatitis: jaundice, fever, discoloration of secretions (urine and feces), feeling unwell. As a rule, within a week the symptoms cease to appear, and the disease becomes chronic.
• Generalized typecharacterized by a severe course of the disease. In such a situation, the virus infects most human organs. As a rule, it occurs in babies under 3 months of age or when infected in utero, as well as in people with immunodeficiency when infected during blood transfusions and organ transplants.

Symptoms

Cytomegalovirus during pregnancy is similar in symptoms to a common cold, so the expectant mother and the doctor may simply not pay attention to it. If the body of a pregnant woman is strong, then the immune system will make the infection go into an inactive form. Or mild symptoms of ARI may appear:

• temperature increase;
• runny nose;
• sore throat;
• headaches;
• feeling aching in the body;
• weakness;
• enlarged lymph nodes.

The difference with ARI is that with a common cold, the symptoms disappear within a couple of weeks, and with cytomegalovirus during pregnancy, signs may be present for two months.

How can you get infected?

There are several distribution methods:

• Airborne: you can become infected when talking with the sick, sneezing and coughing.
• Sexual way - is considered the most common. The infection enters the body during sex. If conception occurs in this case, the disease is transmitted to the fetus.
• The household method is considered not the most common, since the infection may not exist in the external environment for a long time, but forentering the body, it must be active. But still, you can catch the disease when kissing, and also if you use personal belongings and utensils together with the carrier.
• Blood transfusion can rarely lead to infection, as can organ transplants.
• Placental way: infection occurs during pregnancy.
• Breastfeeding: when infected in this way, the virus rarely causes complications in the baby.

Infection and fetus

The danger to the fetus during placental spread is the possibility of developing a congenital disease and further severe consequences.

Depending on the period at which the infection of the baby occurred, the further course of the disease depends. Often such children are born prematurely, and the consequences of the infection may appear only after six months of life.

The main manifestations of congenital cytomegalovirus include:

• puffiness and yellowish skin tone at birth, the presence of bluish spots and rashes;
• signs of jaundice;
• often these children are inactive and sleepy;
• involuntary muscle contraction of the limbs;
• poor motor development;
• small skull and brain;
• sucking and swallowing disorders;
• anemia;
• lower than normal platelet count resulting in frequent bleeding and difficulty stopping blood;
• inflammation of the retina, decreased visual acuity;
• impaired hearing;
• may be presentcongenital malformations of the kidneys, liver, heart and brain.

If a child becomes infected during childbirth or shortly before them, you can not worry about severe complications associated with organ damage. But in the first month after birth, the baby's condition will resemble acute respiratory infections. Thanks to the intake of antibodies through mother's milk, the baby quickly returns to a he althy state, and the infection becomes latent. With artificial feeding, due to a lack of immunity, an acute course of the disease is possible, with a transition to a generalized form.

If the infection entered the body before pregnancy

If a girl caught cytomegalovirus long before pregnancy, then the probability of infection of the fetus through the placenta is small and amounts to only 1-2%. The infection can re-activate only with a serious decrease in immunity, which is extremely rare.

In this case, if the result of testing for cytomegalovirus during pregnancy is positive, antibodies to the infection immediately begin to fight the virus that penetrates the cells, since the future mother who has been ill once has developed immunity. In this regard, with exacerbations of pathology during pregnancy, the likelihood of serious consequences is low. The mother's immunity will not allow the virus to enter the child's body.

Cytomegalovirus detected during pregnancy

Primary infection in the first three months after conception is especially dangerous. It is during this period that important organs begin to develop in the child. And if the viruscan overcome the placental barrier, there are various options for the development of consequences for the fetus from cytomegalovirus during pregnancy:

• In most cases, the baby will have mother's immunity, the infection will not have a detrimental effect on the body, and after birth it will become a carrier. Such an outcome of events is possible only with good immunity of the pregnant woman.
• About twenty percent end up with negative consequences from cytomegalovirus during pregnancy. It attacks the fetus, and due to the insufficiently strong protective system of the mother, further death of the child, miscarriage, the occurrence of pathologies of vital organs in the baby, and the birth of a child with external deformities are possible.

At the time of pregnancy, the woman did not have time to get immunity

It happens that a pregnant woman does not have antibodies to cytomegalovirus during pregnancy, and she is not considered a carrier of the infection, in which case she is at risk for possible placental infection of the baby.

In the first three months, it is especially important to follow the doctor's recommendations, maintain immunity and regularly undergo examinations. After all, it is during this period that the baby forms all the vital organs and systems of the body.

Cytomegalovirus when planning pregnancy

Six months before conception, a young couple should undergo a diagnostic examination for infection. This will help to avoid problems in the future and carry out planned treatment on time.

During preparation for pregnancy treatmentcytomegalovirus will help to avoid infection of the unborn baby. In accordance with the clinical picture, the doctor will prescribe a therapeutic course for both partners. And only after the onset of remission for 2-6 months, conception is recommended.

For the prevention of cytomegalovirus, expectant mothers can be prescribed drugs and procedures to increase immunity, which in any case will have a positive effect on future pregnancy.

Diagnosis

Since the virus does not pose a particular danger to the population, examinations for its presence in the body are carried out on request. But there are groups of people who are required to be sent for tests:

• women with miscarriage;
• couples preparing for IVF;
• persons suffering from inflammation of the genitourinary system;
• women who gave birth to children with obvious signs of intrauterine infections;
• future donors;
• immunocompromised people.

When planning a pregnancy, it is advisable to take an analysis for all women. According to medical reviews, cytomegalovirus during pregnancy brings much less problems if the expectant mother makes an early diagnosis even before conception.

The clinical picture of the virus is very similar to other diseases, so the disease can only be detected by laboratory testing. There are several diagnostic methods:

• Method of culturing a virus obtained from biological fluids in a special environment.
• PCR diagnostics: with it you can even determinea small amount of infection DNA in the biological material taken for research.
• Cytological method: a small piece of biological material obtained by biopsy is examined under a microscope to detect cell pathology.
• ELISA is the most common way to detect positive cytomegalovirus during pregnancy. Its main feature is the detection of antibodies in the blood.

In practice, the ELISA method is mainly used, since this study is inexpensive and technically simple. There are no restrictions for its implementation, and you can perform it the required number of times, for a more accurate assessment of the course of the disease.

Deciphering diagnostic results

IgM and IgG are negative. This result suggests that there was no infection with cytomegalovirus, and the woman does not have immunity to the disease. In order to reduce the risks of the disease, preventive measures are prescribed:

• an additional examination for cytomegalovirus is carried out once a month;
• only personal hygiene products are allowed;
• it is undesirable to visit places where there are a lot of people;
• undesirable contact with small children;
• it is forbidden to communicate with people suffering from colds.

As a prophylaxis, injections of human immunoglobulin are prescribed once a month throughout pregnancy.

IgM negative, IgG positive. This result suggests that the woman had previously had a cytomegalovirus, and in herthe body has antibodies. To avoid a recurrence of the disease, it is necessary to monitor nutrition and try not to catch a cold.

IgM positive, IgG negative. This indicates the primary infection and the acute phase of the course of the disease. A very dangerous situation for the fetus, in this case, gynecologists monitor the development of the child in order to detect deviations as early as possible.

IgM positive, IgG positive. This indicates a recurrence of the disease, or a primary infection during the recovery period. In this case, you need to find out exactly when the woman fell ill and whether the fetus is infected. For this, another analysis for IgG avidity is prescribed.

If the avidity is more than 60%, we can say that the infection occurred more than 4 months ago, and the risk of the child getting CMV in the first trimester is minimal.

At medium and low rates, there is a high probability of infection of the fetus. In this case, after studying the results of ultrasound and amniotic fluid analysis, the attending physician will decide on further actions.

Treatment

Treatment of cytomegalovirus during pregnancy is to eliminate the symptoms of the disease and further keep the virus in an inactive state. At the moment, there are no drugs that completely destroy the infection.

The decision on what kind of treatment will be carried out with a positive cytomegalovirus during pregnancy depends on several factors: how long ago the infection occurred, how actively the process develops, whether there isimmunodeficiency.

During the diagnosis, it may turn out that the infection occurred before conception or during the first trimester, in which case the doctors will observe the development of the fetus for some time and, if they suddenly notice abnormalities in the embryo, the issue of terminating the pregnancy will be decided. This is only done if the woman agrees. It is also possible to conduct a study of amniotic fluid to clarify the infection of the baby.

If the disease is acute or the existing virus in the body is reactivated, antiviral and immunomodulating drugs, as well as vitamin complexes are prescribed.

In the presence of antibodies to cytomegalovirus, drugs are prescribed that support and strengthen the immune system, because in this case it is important that the virus remains in an inactive phase.

Prevention

It is much easier to follow certain rules for the prevention of a disease than to treat a disease for a long and painful time. In order to stay he althy herself and keep the baby he althy, a pregnant woman must observe:

1. Hygiene rules: wash your hands as often as possible, especially after a walk, do not use other people's personal products, towels and razors.
2. Any food, especially vegetables and fruits, must be washed with hot water before use. Doctors say that you need to wash the product packaging itself (for example, milk in a bag).
3. For pregnant women, a great solution would be to buy a separate set of dishes for yourself.
4. It is necessary to exclude contact with people whowith cold sores or cold symptoms.
5. If you have any symptoms of a cold, seek medical attention immediately.
6. Strengthen your immunity.
7. Stay outside every day.
8. If there are no contraindications, you can do a special set of exercises for pregnant women.
9. The nutrition of the expectant mother plays an important role. It is necessary to make a balanced diet, which will include all the substances that are useful for the body. After all, with a lack of vitamins, the immune system noticeably weakens. And also experts advise replacing regular tea and coffee with herbal teas during pregnancy. But before buying any collection at the pharmacy, you should consult a gynecologist.

It is not uncommon for women to become infected with cytomegalovirus during pregnancy. But most of them are not even aware of this and are not able to assess the risks themselves. In the modern world, every woman at any time can be tested for cytomegalovirus during pregnancy. A positive result does not mean a sentence for mother and baby. And although this virus is officially listed in the TORCH group, you should not worry about it. Timely treatment will help the baby be born he althy.