Gynecology And Obstetrics-

Chlamydial infection during childbirth

Chlamydia are bacteria that can be transmitted through unprotected sex. They are the most common pathogen causing sexually transmitted diseases in Germany. At birth, they can be passed on to the newborn and, if left untreated, cause serious complications. Therefore, a chlamydial infection must always be treated during pregnancy. Recognized in good time, however, it can be treated very easily in mother and child and the risk of consequential damage is low.

How dangerous is chlamydial infection for the child?

The bacteria are transmitted through the birth canal during birth. If this is infected with chlamydia, the infection is transmitted to the newborn in about two thirds of the cases.

Half of the infected children develop conjunctivitis (conjunctivitis) in the first two weeks of life. The inflammation usually occurs on one side at first and spreads to the other eye over the course of a week. It usually manifests itself in strongly reddened conjunctiva, purulent secretion from the eye and swelling of the eyelid. If left untreated, chlamydial conjunctivitis can lead to conjunctival or corneal scars and even blindness. Worldwide, infection with the pathogen is the most common cause of blindness in newborns.

Read more on the topic: Conjunctivitis in the baby

In addition, around a third of infected newborns develop pneumonia after 4 to 12 weeks. The children often had conjunctivitis before. This can be expressed by coughing attacks and loud breathing noises. Additional symptoms can include inflammation of the middle ear and mouth and throat area. In babies, however, pneumonia can only manifest itself through increased tiredness and reluctance to drink. In addition, premature babies may have pauses in breathing, which in rare cases can be life-threatening.

Read more about the topics: Pneumonia in the baby and what should I do if my baby stops breathing?

What impact does an untreated infection have on the course of pregnancy?

Untreated chlamydial infection can be associated with premature rupture of the bladder, premature birth, and reduced birth weight. In addition, chlamydial infections promote bacterial vaginosis (incorrect colonization of the vagina with other pathogenic bacteria), which in turn increases the risk of premature births.
Furthermore, if the bacteria rise out of the vagina, inflammation of the egg membrane and the fruit cavity can occur. In rare cases, chlamydial infection can also cause miscarriages.

Read more about the topics: Chlamydial infection in pregnancy and signs of miscarriage

What are the risks for the mother?

A chlamydial infection before or during pregnancy can cause inflammation of the fallopian tubes, which stick together and thus lead to infertility.

In addition, chlamydia can cause so-called ectopic (Greek: not in the physiological place) lead to pregnancies. The fertilized egg does not implant itself in the uterus, but remains in the fallopian tube or enters the abdominal cavity. These pregnancies must be terminated with medication or surgery, as there is a high risk of bleeding for the mother and the embryo cannot be adequately nourished.

Inflammation of the inner wall of the uterus can also occur during the puerperium or after an abortion.

Read more on the topic: How often does chlamydia cause sterility?

What must be considered after the birth?

Antibiotic therapy before the birth cures the disease and usually offers adequate protection for mother and child. Even so, the child should be carefully observed after birth. Symptoms such as conjunctivitis, pneumonia, or otitis media in the first month of life should suggest chlamydial infection.

In addition, an infection with chlamydia in the mother can pose a risk to the child even after birth, as the bacteria can be transmitted during breastfeeding. It is therefore important that a chlamydial infection that is diagnosed after birth is treated with antibiotics at an early stage. The pediatrician should also be notified so that the newborn can be treated immediately.

How do I notice a chlamydial infection?

A chlamydial infection of the urinary and genital tracts can cause the following symptoms in women:

purulent, bad-smelling discharge
Itching in the vaginal area
Burning when leaving the water
Intermenstrual bleeding
fever
stomach pain

However, an infection with chlamydia is often asymptomatic and therefore goes unnoticed. For this reason, an examination for chlamydia is an integral part of the preventive examinations during pregnancy (see prophylaxis).

For more information on possible symptoms, read: Main articles Chlamydia infection and How to test for chlamydia

therapy

Especially in the early stages, a chlamydial infection can be treated very well with antibiotics that are compatible with pregnancy. By taking it in good time, the complications and long-term effects listed above can be avoided very effectively.

Therapy for pregnant women

The antibiotics of choice during pregnancy are azithromycin as a single dose, alternatively erythromycin or amoxicillin for 7-14 days. One month before the birth, antibiotics can also be given as a precaution. The tolerability of these antibiotics is considered good. In rare cases, nausea, vomiting, diarrhea and mild discomfort can occur.

Of course, the partner must also be treated so that there is no mutual new infection. An examination of the partner is not necessary for this.

Therapy of the newborn

Newborns diagnosed with chlamydia are given the antibiotic erythromycin for 14 days.

prophylaxis

Since chlamydia is transmitted during unprotected sexual intercourse, condoms offer some protection. If there is a desire to have children, it is advisable to have a gynecologist test for chlamydia before the first unprotected sexual intercourse.

Due to the numerous symptom-free courses of chlamydial infections, screening for chlamydia is an integral part of the first preventive examination during pregnancy and is paid for by health insurance companies. This usually takes place in the 5th-7th Week of pregnancy. In the further course of pregnancy, routine screening for chlamydia is not planned, but is recommended for the 32nd week of pregnancy. If you notice the symptoms listed above or if you suspect an infection after unprotected sexual intercourse, you should definitely consult your gynecologist.

The rate of transmission of chlamydia from mother to child is highest during vaginal birth. However, even a caesarean section does not offer reliable protection, especially if the membranes and the amniotic cavity are affected or the amniotic sac has already burst.