Pregnancy complicated by genital chlamydia trachomatis infection
Introduction
Introduction to Chlamydia trachomatis infection in pregnancy with genital tract Chlamydia trachomatis infection in the genitourinary tract is recognized as a sexually transmitted disease and is one of the sexually transmitted diseases that the Ministry of Health requires. Pregnant women with genital chlamydia infection have two forms: newly active infections and the latent infection of the original chlamydia are induced by pregnancy. The risk factors for cervical infection of chlamydia in pregnant women include: small age of sexual life, multiple sexual partners, low level of education, no obstructive contraception, trachoma and severe cervical erosion. If a pregnant woman is found to have one of the above risks, the Chlamydia trachomatis should be tested promptly. Pregnant women suffering from active infection of chlamydia have a risk of premature rupture of membranes. If it occurs early in pregnancy, it is prone to miscarriage. Once the chlamydia is detected in the pregnant woman's cervix, it should be taken promptly. Chlamydia trachomatis infection in the genitourinary tract is recognized as a sexually transmitted disease and is one of the sexually transmitted diseases that the Ministry of Health requires. Chlamydia trachomatis is not only the pathogen of trachoma, but also the most common pathogen causing female reproductive tract infections. basic knowledge The proportion of illness: 0.001% Susceptible population: pregnant women and newborns Mode of transmission: sexual transmission vertical transmission Complications: spontaneous abortion, premature rupture of membranes, neonatal pneumonia
Cause
Etiology of Chlamydia trachomatis infection in pregnancy with genital tract
Pregnant women with genital chlamydia infection have two forms: newly active infections and the latent infection of the original chlamydia are induced by pregnancy.
The risk factors for cervical infection of chlamydia in pregnant women include: small age of sexual life, multiple sexual partners, low level of education, no obstructive contraception, trachoma and severe cervical erosion.
Prevention
Pregnancy combined with genital chlamydia trachoma infection prevention
If a pregnant woman is found to have one of the above risks, the Chlamydia trachomatis should be tested promptly. Pregnant women suffering from active infection of chlamydia have a risk of premature rupture of membranes. If it occurs early in pregnancy, it is prone to miscarriage.
Complication
Complications of pregnancy with genital chlamydia trachomatis infection Complications spontaneous abortion premature rupture of neonatal pneumonia
1, pregnancy combined with genital chlamydia trachomatis infection can occur spontaneous abortion, stillbirth, premature rupture of membranes, premature delivery, low birth weight, neonatal conjunctivitis, neonatal pneumonia.
2, pregnant women with genital chlamydia infection can occur vertically, may have intrauterine infection, birth canal infection and puerperal sputum. Newborns are mainly infected through the soft birth canal. Neonatal chlamydial infection is a systemic disease. Chlamydia infection in neonates most often invades conjunctival conjunctivitis. It is characterized by mucopurulent secretions, conjunctival hyperemia and papillary hyperplasia, and the course of disease can be as long as 1-3 months. Newborn chlamydia pneumonia can also occur.
Symptom
Pregnancy with genital chlamydia trachomatis infection symptoms Common symptoms Vaginal secretions increased urinary frequency with urgency and dysuria urinary frequency cervical mucus purulent secretions vaginal purulent discharge
The clinical features are asymptomatic or mild symptoms, the patient is not easy to detect, and the course of disease is prolonged. The symptoms of pregnant women after infection are as follows:
1. Cervical mucositis Cervical canal is the most common infection site of chlamydia, 70%---90% of chlamydial cervical mucositis has no clinical symptoms, symptoms are increased vaginal secretions, mucus purulent, bleeding after intercourse or intercourse Period bleeding. Examination of the purulent discharge of the cervical canal, cervical redness, mucosal valgus, increased fragility.
2. urethritis such as urgency, frequent urination, dysuria, etc.
3. Endometritis 30% ~ 40% of cervical vasculitis caused by endometritis, manifested as lower abdominal pain, increased vaginal secretions, irregular vaginal bleeding.
4. Effects on the fetus and newborns Active infections can cause miscarriage, premature delivery, premature rupture of membranes, and low birth weight infants. Among the newborns born to untreated chlamydia-infected pregnant women, 20% to 50% of neonatal conjunctivitis and 10%--20% of chlamydial pneumonia.
Examine
Examination of pregnancy and genital chlamydia trachomatis infection
1 cytological examination: the inclusion bodies were found in epithelial cells under the microscope;
2 Chlamydia trachomatis culture: the most sensitive and specific method for diagnosing Chlamydia trachomatis infection;
3 Chlamydia trachomatis antigen detection: including direct immunofluorescence and enzyme-linked immunosorbent assay;
4 Chlamydia trachomatis nucleic acid detection: PCR technology is highly sensitive, can also detect chlamydial DNA when cell culture is negative, but should prevent false positives caused by pollution.
5 serum antibody detection: Chlamydia IgG, IgM.
Diagnosis
Diagnosis and diagnosis of Chlamydia trachomatis infection in pregnancy with genital tract
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Chlamydia trachomatis urethritis needs to be differentiated from urethritis caused by Neisseria gonorrhoeae and other pathogens.
2. Chlamydia trachomatis epididymitis needs to be differentiated from epididymitis and testicular torsion caused by Neisseria gonorrhoeae, Escherichia coli, Pseudomonas aeruginosa.
3. Chlamydia trachomatis proctitis requires gonococcal, intestinal bacteria (Shigella, Salmonella, etc.), protozoa (G. striata, E. histolytica, Cryptosporidium), virus (cytomegalovirus, Identification of proctitis caused by adenovirus or the like.
4. Chlamydia trachomatis cervicitis needs to be differentiated from gonococcal cervicitis.
5. Neonatal Chlamydia trachomatis need to be associated with Neisseria gonorrhoeae, large intestine
Identification of conjunctivitis caused by bacterium, Staphylococcus aureus, and Streptococcus pyogenes.
6. Neonatal Chlamydia trachomatis need to be associated with the virus (respiratory syncytium)
Identification of pneumonia caused by viruses, cytomegalovirus, adenovirus and influenza virus), bacteria (streptococcus, Staphylococcus aureus, Escherichia coli, influenza bacillus, pneumococci).
