Ureaplasmosis during pregnancy can occur against the background of a decrease in the protective functions of the body. The infectious disease is predominantly sexually transmitted. The causative agent of the violation inhabits the woman's vagina, it can be in the body for years, but only manifest itself when the symptoms favorable for this are created.

What is ureaplasmosis in women during pregnancy

Pregnancy can become a provoking factor for the exacerbation of chronic diseases and the activation of opportunistic microflora. Due to this, new diseases occur, they negatively affect the fetus and affect the condition of the pregnant woman.

Ureaplasmosis during pregnancy is diagnosed in at least 40% of cases.

The causative agent of the disorder belongs to the mycoplasma family, it is an opportunistic pathogen. This means that the pathogen can stay in the body for a long time and not cause discomfort to the carrier. Ureaplasmas do not belong to bacteria or viruses, they are recognized as an intermediate form. A characteristic feature of these organisms is the ability to synthesize urease, this enzyme instantly breaks down urea and forms ammonia.

The causative agent of ureaplasmosis is able to adapt to the stimulus, therefore it rapidly multiplies in the cells of the genital organs. Scientists have identified 7 types of ureaplasmas, but only 2 are dangerous to humans. The disease is included in the list of sexually transmitted infections, but this method of infection is not the only one.

Ureaplasma exists in the body of every woman, but in the presence of inflammation in the body, it begins to actively multiply and have a negative impact on the patient's condition. Basically, infection occurs during unprotected intercourse or during the prenatal period. Also, the cause of the development of ureaplasmosis can be the use of someone else's underwear and other personal hygiene products. Household mode of infection is unlikely, but it cannot be ruled out.

During pregnancy, serious hormonal changes occur, they can affect overall well-being and cause the development of ureaplasmosis. Also, a decrease in immunity occurs with:

• the presence of chronic diseases;
• abuse of alcohol or smoking;
• completed infectious diseases;
• malnutrition;
• disruption of the endocrine system or the use of hormonal agents;
• leading a sedentary lifestyle.

In the external environment, ureaplasma is not able to multiply, therefore, infection by airborne droplets is excluded.

Is it possible to get pregnant with ureaplasmosis

During ureaplasmosis, a woman's reproductive functions worsen, but there is a chance of successful conception. You should not postpone a visit to the doctor if a pathology is detected, since there is a risk of intrauterine infection of the child, the development of a chronic form of the disorder and infertility.

If you want to give birth to a healthy baby, you will need to undergo treatment and then resume trying to have a baby.

Problems with pregnancy in the event of ureaplasmosis occur in 60% of cases, since the bacterium affects the genitourinary system, the uterine mucosa and the vaginal microflora. Experts advise to complete therapy before pregnancy, otherwise a miscarriage may occur. If a woman could not influence this process and pregnancy occurred during an exacerbation of ureaplasmosis, then she will be prescribed antibiotics and other auxiliary drugs to normalize her health.

Is it dangerous during pregnancy

With the active reproduction of ureaplasma, exposure to opportunistic microflora causes serious harm to health. The most common negative consequence is the transition of the disorder to a chronic form. This means that a woman will regularly suffer from exacerbations of ureaplasmosis.

The female reproductive system is also affected. Ureaplasmas provoke an inflammatory process in the vagina and uterus, and therefore the fertilized egg cannot be fertilized. Therefore, infertility can become a complication of ureaplasmosis. Attempts to conceive a child can result in an ectopic pregnancy. The danger of such a consequence increases with the defeat of the fallopian tubes.

The effect of ureaplasmosis on the fetus

In the early stages of pregnancy, ureaplasma penetrates through the anatomical membrane into the amniotic fluid and affects the child. In early pregnancy, there is a high risk of embryo freezing. In this case, the infection affects the formation of the child and leads to a halt in its development, which leads to death. The disorder can affect the baby's lungs. In this case, after childbirth, broncho-pulmonary dysplasia or respiratory failure is diagnosed.

In some cases, pregnant women with ureaplasmosis experience premature birth or miscarriage. This occurs with the active spread of the inflammatory process. Concomitant diseases also have an impact. Among them are endometritis, salpingitis, oophoritis. The child experiences a lack of oxygen and nutrients, so it lags behind in development and does not gain weight.

Symptoms in a pregnant woman

Late diagnosis is the main problem of ureplasmosis during pregnancy. When carrying a child, significant changes occur in the body. A woman perceives all the symptoms as part of the gestation process, so she does not report them to the doctor. It is possible to recognize ureaplasmosis by the following manifestations:

1. Abundant discharge from the vagina appears, they acquire a cloudy color and an unpleasant odor.
2. Discomfort appears in the genital area. The woman will experience itching and burning. Unpleasant symptoms are aggravated during urination, bathing or showering.
3. Pain during intercourse. Having sex will not bring pleasure due to disturbances in the body.
4. Spasms and aching pain. These signs appear in the lower abdomen. They may resemble the sensations during the onset of menstruation, if the woman had a pronounced PMS.

A favorable place for the reproduction of ureaplasma are the mucous membranes. In most patients, the disorder is located in the genital area. But when infected during oral sex or when infected through personal hygiene products, ureaplasmas can affect the larynx. In this case, the same symptoms appear as during a sore throat.

During the progression of ureaplasmosis, microorganisms spread to other internal organs.

First of all, the bladder is affected. During this, the woman is faced with painful urination and regular false urges to go to the toilet.

How is it treated during pregnancy

Therapy to eliminate ureaplasmosis is prescribed by a doctor based on the patient's condition and the results of laboratory tests. To eliminate the pathology, it is necessary to use antibiotics and other medicines that can harm the child. Therefore, the treatment uses an individual approach.

Usually, doctors prescribe medications only when there are signs of an inflammatory process and microorganisms are detected in a titer that exceeds the norm. In the absence of complaints, the disease is simply observed. Both partners must be treated, otherwise taking medication will not give the desired results. Sexual contact is prohibited while taking medication.

The course of therapy is divided into 3 stages. First, drugs are selected to normalize the microflora of the body, then the doctor stops the provoking factors that influenced the development of the disorder and, at the final stage, increases the immunity of the pregnant woman.

During the treatment of ureaplasmosis, antibacterial drugs are used. Therapy is prescribed from the 22nd week of pregnancy, so as not to harm the baby. By this time, the internal organs are already forming in the fetus, so antibiotics have a minimal effect. For this purpose, it is most often prescribed:

• erythromycin;
• azithromycin;
• tetracycline.

The medicine is selected by the attending physician, the duration of therapy does not exceed 2 weeks.

Decreased immunity is the main factor contributing to the development of ureaplasmosis, so the patient is prescribed immunomodulators during treatment. The medicine is selected depending on the goal. To increase the body's resistance, immunoglobulin is prescribed. It consists of purified blood plasma and helps quickly. To stimulate cellular immunity, thymalin or myelopid is prescribed. In order to enhance the action of antibiotics, interferon is used.

Local preparations are also used to normalize the vaginal microflora.

Vaginal probiotics, tablet preparations and suppositories for dysbacteriosis are used. After completion of therapy, a control laboratory test is prescribed, it allows you to verify the effectiveness of the medication.

Precautions and Prevention

To prevent ureaplasmosis during pregnancy, you should take a responsible approach to this process and plan conception. Sexual partners are encouraged to regularly take tests and check their health. Also, doctors recommend carefully monitoring compliance with personal hygiene standards and using contraceptives during intimacy.

For genital tract infections. However, it is not always possible to do this, so some diseases may appear already directly during pregnancy.

The microflora of the vagina has more than 30 types of microorganisms. The vast majority of them are lactobacilli. Other pathogenic microorganisms make up only 5-10%. If the body functions normally, then even pathogenic microflora may not cause any diseases. But when immunity is lowered or under any stress, these conditionally pathogenic microbes lead to illness.

Analysis for ureaplasma during pregnancy

Ureaplasmas also belong to conditionally pathogenic microorganisms. This means that a small amount of ureaplasmas can be present in the body without causing damage.

But during pregnancy, ureaplasma can worsen. This is a threat to the fetus and pregnancy. In recent years, more and more women hear a disappointing diagnosis - ureaplasmosis. However, you should be aware of how this disease can interfere with the birth of a healthy child.

Symptoms of ureaplasmosis appear 4 weeks after ingestion. However, if in men it looks like urethritis: the same pain when urinating, the appearance of mucous secretions, then only small ones can be observed in women. These symptoms pass very quickly and, it would seem, there should be no problems. But, you need to remember: the virus settles in the vagina and just waits for its time when the body weakens a little. During pregnancy, immunity decreases, and as a result, the virus progresses.

For the diagnosis of ureaplasmosis, modern medicine provides a whole combination of methods, the choice of which lies with the doctor. So, an analysis for ureplasma during pregnancy can be carried out by the bacteriological method, as well as by the polymerase chain reaction (PCR).

The bacteriological method involves taking a smear from a pregnant woman from the mucous membrane of the urethra, vaginal vaults and from the church canal. A study of morning urine is also provided - all this in combination will determine the number of ureaplasmas, as well as the resistance and sensitivity of the pathogen to certain drugs before prescribing them.

PCR (polymerase chain reaction) is a reliable confirmation of the presence of ureaplasmas, because it detects particles of pathogen DNA. An analysis for ureaplasma during pregnancy by PCR also involves taking samples from the vagina, cervix and urethra. And, although it is possible to establish the presence of ureaplasma in a smear by means of PCR already within five hours, however, this analysis is not capable of determining in what quantities they are present.

How does ureaplasma affect pregnancy?

It should be remembered that ureaplasmosis can cause abortion, moreover, in its early stages. Especially if the disease first arose during pregnancy: the formation of fetal developmental deficiencies leads to miscarriage.

If the disease arose for the first time in the second or third trimester of pregnancy, then ureaplasma can lead to placental insufficiency - a condition when the baby lacks oxygen and nutrients. In turn, this can also lead to the threat of termination of pregnancy. The danger of ureaplasmas for pregnancy also lies in the fact that it is mandatory to treat the disease with the use of antibiotics. As doctors always warn, taking medications while carrying a child is highly undesirable - antibiotics are very likely to adversely affect the fetus and cause a miscarriage.

Ureaplasma during pregnancy: consequences

The consequences of ureaplasmosis during pregnancy can be very unpredictable and even very, very serious. There are, for example, cases when ureaplasmas cause inflammation of the uterus and which are quite severe postpartum complications.

Dangerous consequences of ureaplasma and for the baby. First, there is a risk of intrauterine infection of the fetus. However, even if infection was avoided during pregnancy (the fetus is relatively protected from ureaplasmas by the placenta), then at the time of passage through the birth canal, infection of the child occurs in almost half of the cases. And this, in turn, entails damage to various organs and systems of the newborn, most often inflammation of the respiratory tract.

Miscarriages in the presence of ureaplasmosis during pregnancy occur due to the "friability" of the cervix and softening of the external pharynx under the influence of ureaplasmas. But at the same time, there is another serious risk for the mother associated with ureaplasmas: ureaplasmosis can lead to infection of the uterus and the development of endometritis in the postpartum period - a complex and severe purulent complication.

Can ureaplasma be treated during pregnancy?

But do not terminate the pregnancy if ureaplasmosis is detected. Correct and timely treatment will help a woman bear a child.

It is necessary to treat ureaplasmas in any case, even during pregnancy. Start doing this depending on the duration and characteristics of the course of pregnancy. If there are complications or a threat of miscarriage, then treatment should begin immediately. However, when everything is normal, then doctors recommend treating ureaplasmosis after the 30th week. This will ensure that at the time of the birth of the baby, he will not become infected with ureaplasmas during passage through the birth canal. Otherwise, in newborns, ureaplasma can be found in the nasopharynx, and in girls, also on the genitals. Some gynecologists insist that it is better to treat the disease from the 20-22nd week of pregnancy, then the baby will already have all the organs formed. Each organism is unique, so the doctor selects drugs individually, guided by the course of a particular pregnancy.

Be sure to treat both sexual partners and during treatment to limit sexual contact.

At the end I would like to add only one thing. Ureaplasma during pregnancy is not a sentence for the life of your child. Contact an experienced doctor, and it will still be possible to cure ureaplasma without harm to the body.

Specially for- Maryana Surma

From Guest

There was a miscarriage 8 weeks began to look for the cause of ureoplasma 10 * 4, probably still need to be treated and on time, it's a pity

From Guest

I had ureaplasma before pregnancy, during pregnancy I passed the test, showed 10 to the 6th degree, they said it was necessary to treat, I drank antibiotics from the 24th week and inserted suppositories rectally, the baby was born healthy, everything is fine, it didn’t affect him, although I I was very worried, I went to consult 3 doctors, they said to treat and that by the 24th week the main development of the child’s organs ends and you can start treatment, then I re-analyzed, showed 10 to 4 degrees, and the 4th is just considered not high

From Guest

I had ureaplasma before pregnancy, and I even treated it, but it still remained. Then she got pregnant unplanned and was very worried about this, she was treated with approved antibiotics after 22 weeks - the analysis remained the same, with the same amount. But after giving birth, it is not found in me ... Like this.

Ureaplasma, like any infection, has a negative effect on the body. Very often, women ask themselves the question - does ureaplasma affect conception? Why is this disease dangerous during pregnancy? Let's try to figure it out.

How to detect ureaplasma in pregnant women?

First of all, you should know what ureaplasma is, what are its symptoms, as well as diagnostic methods in pregnant women. Ureaplasmosis is a disease caused by a specific opportunistic bacterium ureaplasma. It may be present in the microflora of the vagina, but be inactive.

But under certain conditions (decreased immunity), it is activated and causes a pathogenic process. Infection occurs in several ways:

• during sexual intercourse;
• during oral sex;
• from mother to child during pregnancy or childbirth.

Such an infection is not transmitted in a domestic way, that is, the possibility of catching ureaplasmosis in public places (baths, saunas, pools, toilets) is zero.

The bacterium lives predominantly in a woman's vagina, but it can occasionally infect the uterus, urinary tract, and bladder.

It can be quite difficult to detect ureaplasma, since the symptoms are not specific. Ureaplasmosis is often confused with other diseases. Signs of infection during pregnancy are:

• white discharge (sometimes their color changes, there is an unpleasant odor);
• pain in the abdomen (lower part);
• symptoms of cystitis (frequent and painful urination);
• symptoms of angina (with oral infection).

The disease proceeds in several stages:

How to distinguish ureaplasmosis from other diseases? There are several methods for diagnosing it:

1. The polymer chain reaction method is used to detect ureaplasma DNA in a woman's body. To do this, take a smear from the vagina, cervix and urethra for examination. The method is fast (the result is known a few hours after the analysis), but not accurate, since it does not provide information about the number of bacteria in the microflora.
2. Analysis for the presence of antibodies.
3. Examination of morning urine.
4. The method of bacteriological seeding reveals the rate of development of bacteria. It allows you to determine whether the disease is dangerous for pregnant women and the fetus.

Diagnosis of ureaplasma should be carried out even before conception. Since during pregnancy it is much more difficult to identify and treat it.

What are the consequences of ureaplasmosis for the mother and her child?

Often ureaplasma is in the human body in a dormant state. However, the risk is not significant. But sometimes the number of pathogenic bacteria increases dramatically, which can provoke the rapid development of the disease.

During pregnancy, this condition can occur due to various reasons:

• decrease in the protective mechanisms of the expectant mother due to weakened immunity;
• nervous and physical overstrain;
• stressful situations;
• penetration into the body of a woman of pathogenic microorganisms of a viral, bacterial, fungal nature.

What are the threats to a pregnant woman? There are several of them:

1. Primarily, the negative impact of ureaplasma on conception. It causes gynecological complications (inflammation of the vagina and uterine mucosa), which interfere with the attachment of the embryo. This leads to spontaneous miscarriage.
2. Ectopic pregnancy. This condition is associated with damage to the fallopian tubes by bacteria, as a result of which the egg is not able to enter the uterus. An ectopic pregnancy is always terminated surgically.
3. Infection of the uterus. Ureaplasma in the vagina does not cause danger to pregnant women. Only when the genital organ itself, its neck and tubes are infected, complications arise.
4. Early dilatation of the cervix can provoke a spontaneous miscarriage of the embryo at a short gestation period, and at a long gestation period - premature birth.
5. Postpartum inflammation of the uterus(especially after a caesarean section).
6. The saddest complication for all women is infertility, inability to become pregnant and carry a baby.

A child with aggression of a bacterium can also suffer. It all depends on the period in which the infection was made. How can children get an infection? There are only 2 ways:

1. The first is during the period of intrauterine development. This can happen at different stages of pregnancy when the infection is activated for one reason or another.
2. The second is directly at birth through the birth canal.

If infection has occurred, then negative consequences will not keep you waiting. It can affect many processes that occur during the growth and development of the fetus. Ureaplasma during pregnancy - the consequences for the child are as follows:

1. If infection occurs early, spontaneous miscarriage often occurs.
2. Inflammation of the membranes of the fetus - chorioamnionitis. It also extends to the fetus, which is an indication for artificial termination of pregnancy.
3. Lack of oxygen or nutrients.
4. Various pathologies of the fetus. There may be various lesions of organs and systems, mainly the respiratory tract.
5. Delayed normal development and growth.
6. Small weight newborn.

Ureaplasma can affect the occurrence of such a dangerous complication as pneumonia.

But in some cases, despite the threats of doctors, the presence of an infection in the mother does not affect the child in any way - he is born absolutely healthy.

The influence of ureaplasma on the possibility of conception and the course of pregnancy

Does ureaplasma affect the possibility of conception? This question worries many women. Infection can affect the process of conceiving a child in the following ways:

It is important to know that a disease such as ureaplasmosis during pregnancy (consequences) negatively affects the condition of a woman. It can provoke a number of complications that affect the normal course of pregnancy. Among them are:

• inflammation of the external and internal genital organs;
• abundant vaginal discharge, which causes discomfort to expectant mothers;
• pain in the abdomen;
• frequent urge to urinate;
• painful urination;
• sometimes the throat can hurt (as with a sore throat).

To these complications, you need to add constant nervous strain due to the mother's feelings for her child. No need to be afraid. Ureaplasmosis is not a sentence. It does not always give complications. With such a diagnosis, many women carry and safely give birth to healthy full-fledged children.

Recently, the question has been increasingly asked about the danger of developing ureaplasma during pregnancy, the consequences for the child.

What is ureaplasma

Ureaplasma is a microorganism that in its structure occupies an intermediate position between bacteria and viruses.

This microorganism is currently considered to be opportunistic, which means that a certain amount of ureaplasma bacteria is present in the microflora of the mucous membranes of a healthy person, peacefully "getting along" with other bacteria and without bringing a person absolutely no discomfort.

However, in the case when the concentration of ureaplasma in the mucous membranes exceeds a certain threshold, an inflammatory process begins in the body, and this pathological condition is called ureaplasmosis.

To date, the maximum allowable non-pathological concentration of ureaplasma is considered to be a value of 10 to the power of 4 CFU / ml. Anything below this value is considered normal.

According to the latest data, about 70% of the world's population are carriers of ureaplasma.

This type of bacteria is mainly found on the mucous membranes of the genitourinary system, much less often on the mucous membranes of the respiratory tract and digestive tract.

It is believed that ureaplasma is transmitted sexually or vertically, that is, from mother to child during childbirth when they pass through the birth canal. Infection with ureaplasma in the domestic way (through public baths, swimming pools, bathrooms, etc.) is completely excluded by medicine today.

Detection of ureaplasma in pregnant women

As you know, the disease is easier to prevent than to treat, and given that it is extremely undesirable to get sick during pregnancy, it is necessary to undergo a medical examination and be tested for pathogenic microflora even at the stage of pregnancy planning. If any diseases are detected, they must be carefully cured, which is much easier and safer to do at the stage of pregnancy planning, especially since the doctor will have a wider range of medicines at his disposal.

However, in the case of ureaplasma, certain difficulties may arise. When examined at the stage of pregnancy planning, the concentration of these microorganisms can be normal, not pathogenic, and the onset of pregnancy can sometimes provoke their rapid growth due to the general decrease in immunity and hormonal changes characteristic of this time.

It is also important that it is not easy to detect ureaplasmosis during pregnancy, since it is often asymptomatic, and if any symptoms appear, they are difficult to distinguish from normal physiological phenomena during pregnancy (for example, clear or whitish discharge) or from symptoms of other infectious diseases, including banal thrush.

The main symptoms of ureaplasmosis are:

• a slight increase in temperature;
• itching or burning in the urethra;
• itching or burning in the vagina;
• pain in the lower abdomen;
• clear or whitish mucous discharge from the vagina.

The diagnosis of ureaplasmosis is made if there is an inflammatory process, the concentration of ureaplasma exceeds the value of 10 to the power of 4 CFU / ml and there is no positive test result for other pathogenic microorganisms.

To date, about 14 varieties of ureaplasma are known, but medical examinations are aimed at identifying only two pathogenic species:

• ureaplasma urealyticum (ureaplasma urealyticum);
• ureaplasma parvum (ureaplasma parvum).

Other known types of ureaplasma bacteria do not pose a danger to the body.

Ureaplasma parvum is considered the most aggressive during rapid reproduction in the mucous membranes, however, ureaplasma urealyticum is the most dangerous during pregnancy, since it is this species that is able to penetrate the placental barrier, which can pose a serious danger to the fetus.

The effect of ureaplasma on the body of a pregnant woman and possible consequences for the fetus

It is important to note that, unfortunately, at present, ureaplasma is a rather poorly studied microorganism, information about its effect on the body of a pregnant woman, possible consequences for the fetus does not have conclusive evidence and is rather hypothetical and conditional.

Previously, the detection of ureaplasmosis in a pregnant woman was an indication for termination of pregnancy, it was believed that this infection causes serious pathologies in an unborn child.

However, modern medicine no longer makes such categorical conclusions and does not consider the effect of ureaplasma on the fetus extremely dangerous. There are frequent cases of the birth of absolutely healthy children in mothers who suffered from ureaplasmosis during pregnancy.

It is known that ureaplasmosis contributes to the deterioration of the structure of the genital tract, loosening and thinning of the mucous membranes and muscles of the genitourinary system, which can lead to ruptures and various injuries during delivery. The development of the disease in the cervical region contributes to the weakening of its muscles, which can cause it to open prematurely and provoke a miscarriage or premature birth.

There may be various adhesive processes, which in the future will lead to infertility or ectopic pregnancy.

Endometriosis is common.

As already mentioned, the effect of ureaplasmosis on the fetus cannot be unequivocally proven, but, according to available observations, it can lead to such consequences for the child as:

• fetal hypoxia;
• small fruit;
• congenital or neonatal pneumonia;
• meningitis;
• sepsis;
• pyelonephritis;
• conjunctivitis, etc.

Treatment of ureaplasmosis during pregnancy

Ureaplasmosis is treated exclusively with antibiotics, usually erythromycin and vilprafen are prescribed. But taking antibiotics during pregnancy is highly undesirable, in connection with this, today the question of whether to treat ureaplasmosis during pregnancy remains open.

Some doctors attach great importance to the possible consequences of the influence of ureaplasma on the body of the unborn child and consider treatment in this case to be extremely necessary. Others, on the contrary, see a great danger in taking medicines and consider the possible consequences of treatment to be much more dangerous than the possible consequences of the disease itself.

Often, the treatment of ureaplasmosis is carried out as part of the general preparation for childbirth in the last stages of pregnancy.

The question of whether or not to treat this disease during pregnancy, in each case, is decided by the doctor, without fail warning the patient about the possible consequences of the disease and treatment.

The fact remains unequivocal that when deciding on treatment, it can be started no earlier than 20-22 weeks of pregnancy, when all organs in the fetus have been laid. Any treatment before this period is considered highly undesirable.

We note for general information that in Western European countries they do not attach much importance to the effect of ureaplasma on the fetus and the treatment of ureaplasmosis during pregnancy, as a rule, is not carried out.

Treatment of ureaplasmosis during pregnancy is carried out in combination with other measures, and, in addition to antibiotics, the following drugs are also prescribed:

• probiotics (to restore healthy microflora);
• hepatoprotectors (to protect the liver from the negative effects of antibiotics);
• immunostimulating drugs;
• complex vitamin preparations.

During treatment, it is necessary to follow a diet, completely excluding spicy, salty, smoked, sweet foods, as well as the use of alcoholic beverages from the diet.

Ureaplasma is a special microorganism that occupies an intermediate position between viruses and bacteria. In the medical environment, attitudes towards him are constantly changing. At this stage, ureaplasma belongs to the group of opportunistic pathogens. This means that with good immunity, its activity is suppressed, the disease does not occur. But under favorable conditions, the microorganism can cause inflammation. Ureaplasma during pregnancy may carry special risks for a woman. When is treatment needed and when is it not needed?

In women, two types of microorganisms can be detected in smears: ureaplasma urealyticum (Ureaplasma urealyticum) and ureaplasma parvum (Ureaplasma parvum). They do not have a cell wall, their cytoplasm is surrounded by a thin membrane.

Ureaplasma lives in the epithelium of the urinary tract and vagina. It is located on cell membranes and multiplies by division. It can repeatedly change its antigenic structure and elude the immune response.

How infection occurs

Ureaplasma is found in 20% of people who do not have clinical symptoms of the disease. But they are able to infect others without knowing it. The following mechanisms of spread of the pathogen are distinguished:

• sexual - during sexual contacts;
• ascending - from the vagina, the infection spreads to the appendages;
• hematogenous - with blood flow, rarely implemented;
• translocation- from one organ to another;
• transplacental from sick mother to child.

A child can become infected not only during the period of gestation, but also during childbirth. Moreover, the method of delivery does not matter - it can be both natural childbirth and caesarean section.

The mechanism of the development of the disease

Normally, a whole system of protective factors works in the female vagina.

• Beli. Approximately 20 ml of physiological whites are released per day, which moisturize the environment, making it favorable for the reproduction of beneficial microflora.
• Epithelium. It is constantly sloughed off and, as part of the whites, is brought out. If microorganisms attach to it, they also come out.
• Microflora. Normal biocenosis is represented by lacto- and bifidobacilli. The percentage of other microorganisms is insignificant. Lactobacilli occupy all nutritional niches, so pathogens do not have a substrate for growth and reproduction.
• Sosav Wednesday. The acidic environment is provided by the processing of glycogen by lactobacilli. They also emit hydrogen peroxide, which is an antiseptic.
• Immunoglobulins. The mucosa contains cells of the leukocyte series. They synthesize immunoglobulins capable of activating phagocytes to engulf bacteria, viruses and fungi.

But ureaplasma is able to change cellular metabolism and cause:

• metabolic disorders of amino acids and peptides;
• chromosomal mutations in cells;
• autoimmune reactions;
• increase in prostaglandin synthesis;
• increased blood coagulation.

Treatment of ureaplasmosis with antibiotics does not always lead to recovery. Carrier infection without clinical signs is very common.

What causes ureaplasma during pregnancy

Before pregnancy, the detection of insignificant concentrations of ureaplasma in smears in the absence of a clinical picture of inflammation does not cause danger. But if a woman often has exacerbations of the infection, then this can have negative consequences for reproductive health and the fetus. The danger of ureaplasma during pregnancy is as follows:

• miscarriage;
• primary and secondary placental insufficiency;
• delayed fetal development;
• intrauterine infection;
• pneumonia in a newborn.

In a woman, ureaplasma can cause chronic endometritis. Against the background of recurrent inflammation of the uterus, its ability to accept a fertilized egg changes. This can manifest itself in the form of habitual miscarriage - two or more miscarriages in a row in the early term. For some women, infertility becomes a serious consequence.

In conditions of placental insufficiency, the intrauterine development of the child is disturbed. Such children suffer from hypoxia, do not receive the necessary amount of nutrients. Therefore, they are born hypotrophic - with low weight and small size for their term.

Even if the baby does not become infected in utero, the presence of infection in the mother's body leads to immune shifts. Consequences: after birth, the child is more susceptible to various diseases.

Ureaplasma can be combined with similar mycoplasma. But it is much more dangerous that ureaplasma infection often occurs simultaneously with other STIs: gonorrhea, chlamydia, trichomoniasis.

What makes a microbe

Most often, ureaplasma is present in the genital tract or urethra without symptoms. In the normal state of the microflora, it does not cause an inflammatory reaction. The causes for the onset of the disease appear with a decrease in local and general immunity. It happens:

• during pregnancy;
• during hormonal changes;
• after serious illnesses;
• after hypothermia;
• against the background of microflora disturbance.

But even with the inflammatory process, ureaplasma is not always possible to detect. Detectability increases to 65-75% with:

• urethritis;
• vaginitis;
• bacterial vaginosis;
• pathology of the cervix;
• miscarriage.

From the moment of infection to the appearance of the first signs in a woman, it can take several months. In the acute course of infection, the following symptoms appear.

• Allocations. Usually transparent, but their number increases significantly. When combined with another infection, they can become cloudy, yellowish, with an unpleasant odor.
• Itching. A burning sensation, a desire to scratch occurs due to irritation by secretions and inflammation products.
• Pain. A pulling pain may appear in the lower abdomen. Sometimes it has a connection with sexual intercourse.

Clinical manifestations during pregnancy usually have the form of colpitis, vaginitis, urethritis. In rare cases, it may be salpingitis. Non-pregnant women also have endometritis.

Ways to identify the pathogen

For pregnant women, a mandatory study is a smear on the flora, which is taken at registration, in the middle of the term and shortly before childbirth. In other cases, the study is carried out when there are complaints of discharge or itching in the genital tract. A feature of ureaplasma is that it is almost impossible to detect it in a conventional smear. Special studies are needed for ureaplasmosis. But they are not carried out by all without exception. It is recommended to examine the following women:

• with obscure infertility;
• in case of miscarriage;
• with a frozen pregnancy;
• with a history of stillbirth.

Men are necessarily examined for ureaplasmosis only if they are going to become sperm donors.

Research methods

Research is carried out in a variety of ways. The material for it can be:

• scraping from the urethra;
• smear from the cervix or posterior vaginal fornix;
• morning urine.

Analysis based on morning urine is carried out by a molecular biological method, which is very rarely used in Russia. The main diagnostic methods are as follows.

• Cultural. Sowing on nutrient media discharge from the vagina allows you to get clean colonies of microorganisms. The norm is on the border below 104 CFU. If there are no signs of inflammation, then the woman is considered healthy.
• PCR. At the moment, a technique is used not only to detect the DNA of the pathogen, but also to determine its amount. Vaginal scraping is used as material. The norm is considered to be 104 copies of DNA or less. Deciphering the analysis also allows you to establish a specific type of ureaplasma - urealiticum or parvum.
• Serological. The technique is based on the detection of antibodies to ureaplasma. Depending on the combination and titers of immunoglobulins, it is possible to determine the stage of the course of inflammation: this is a primary infection, a chronic disease, or remission. This technique helps in diagnosing miscarriage, causes of miscarriage, and for examining newborns with congenital infection. But this method is not used to establish the fact of infection.

A swab from a woman can only be taken two weeks after antibiotic treatment if culture is planned. And after 30 days, if PCR diagnostics are needed.

Manifestations of ureaplasmosis are nonspecific, so it is necessary to differentiate the disease from other sexually transmitted infections and vaginal dysbiosis. To do this, make a smear for the degree of purity, as well as PCR diagnostics of other infections.

Treat or leave

Many microorganisms are opportunistic pathogens. But during pregnancy, the question of whether or not to treat ureaplasma is associated with a possible risk to the child. The clinical guidelines table defines the following approach.

• No signs of inflammation. If at the same time less than 104 CFU of ureaplasmas are detected, the woman is considered healthy, treatment is not carried out.
• No inflammation, but a lot of ureaplasmas. Non-pregnant women do not require treatment. Ureaplasma during pregnancy is treated in women with a history of complications, with habitual miscarriage. Infertile couples are also treated.
• There is both inflammation and ureaplasma. Treatment is for everyone.