Table of contents:
- The clinical picture of ureaplasma infection in women
- Ureaplasma: a part of microflora or a causative agent of the disease?
- Ureaplasma and associated diseases
- Causes of ureaplasmosis
- The main symptoms of ureaplasmosis
- Treatment of ureaplasmosis
- Transmission of infection
- Ureaplasma and pregnancy
Video: UREAPLASMA IN WOMEN - Signs, Symptoms And Treatment
The clinical picture of ureaplasma infection in women
- 1 Ureaplasma: part of the microflora or the causative agent of the disease?
- 2 Ureaplasma and concomitant diseases
- 3 Causes of ureaplasmosis
- 4 The main symptoms of ureaplasmosis
- 5 Diagnostics
- 6 Treatment of ureaplasmosis
- 7 Transmission of infection
- 8 Ureaplasma and pregnancy
- 9 Ureaplasmopositivity
Ureaplasma infection still causes numerous controversies among doctors and scientists. Some do not consider it a disease, others insist on being included in the International Classification of Diseases. The effect of bacteria on the course of pregnancy, the process of infection and methods of treatment is being actively studied. In one, experts agree that ureaplasma in women causes various urogenital complications, such as vaginitis, urethritis, cystitis, cervicitis and cervical neoplasia.
Ureaplasma: a part of microflora or a causative agent of the disease?
Ureaplasma: a part of microflora or a causative agent of the disease?
Ureaplasma is an intermediate form between viruses and unicellular organisms, it belongs to the genus of bacteria of the Mycoplasmataceae family. These microorganisms do not have their own cell membrane and DNA; they live in the urinary tract and mucous membranes.
As a representative of a transient microflora, ureaplasma is considered as an infection only in the presence of foci of inflammation. For a healthy woman, the bacterium is uncharacteristic, but it can be present in the body for a long time without causing harm. Normally, the microorganism is part of the microflora and does not manifest itself in any way. Various disorders of an immune or hormonal nature cause active division of the ureaplasma, its excessive multiplication in the urethra leads to the development of an inflammatory process.
Laboratory analysis is done for two clinically significant types of bacteria: Ureaplasma urealyticaum (ureaplasma urealyticum) and Ureaplasma parvum (ureaplasma parvum). They are pathogenic to humans. The incubation period for infection with ureaplasmosis lasts from 2 weeks to several months and even years.
Ureaplasma and associated diseases
In the question of whether it is necessary to treat ureaplasma, gynecologists have no doubts. An infection untimely detected in a woman can lead to infertility, being the cause of inflammatory processes in various organs. The following concomitant diseases are most often encountered with ureaplasmosis:
- Neoplasia of the cervix;
- Acute urethral syndrome;
Chronic inflammation of the pelvic organs leads to menstrual dysfunction. During pregnancy, ureaplasmosis increases the risk of miscarriage and complications. One of them is postpartum endometritis (inflammation of the uterus). Many cases of its occurrence have been described against the background of ureaplasma infection. The high-risk group includes patients after a caesarean section, as well as women with reduced immunity.
Experts note that colonization of the vagina with ureaplasma does not lead to problems with pregnancy, but intrauterine infection with bacteria poses a great danger. It is also associated with insufficient fetal weight (up to 2.5 kg), although reliable evidence of this assumption has not been obtained.
Causes of ureaplasmosis
Ureaplasmosis is called an inflammatory process in the genitourinary organs, if Ureaplasma urealyticaum or Ureaplasma parvum was identified as the causative agent. All the causes of the disease have not been fully identified, but scientists have a number of assumptions. Ureaplasma more often affects people with immunodeficiency, including those caused by HIV infection, with a decrease in the number of certain antibodies. However, there are many known cases of infection in people with normal immunity.
A huge role in the development of the disease is played by local antimicrobial factors that affect the genitourinary system and protect it from opportunistic microflora. Women with vaginal bacteriosis get sick more often than others. The lower the vaginal pH, the less likely it is to develop ureaplasmosis. Factors that increase the risk of ureaplasmosis in women:
- Long-term use of antibiotics;
- Weakened immunity;
- Nervous stress;
- Taking hormonal drugs;
- Lack of proper hygiene;
- Sexually transmitted diseases;
- Infectious vaginitis;
- Autoimmune and rheumatic diseases;
- Gynecological operations;
- Frequent change of sexual partners;
- Abortion and curettage of the uterus;
- Age under 30;
- Long-term use of an intrauterine device;
- The presence of other urogenital infections.
Often, ureaplasma infection occurs in patients suffering from a number of concomitant diseases, such as:
- Bacterial vaginosis.
The main symptoms of ureaplasmosis
The development of the infection may be asymptomatic, but even so, treatment is necessary, especially during pregnancy or planning to conceive. Ureaplasma urealiticum or parvum can be in a dormant state for a long time, but if the immune system malfunctions, it begins to actively multiply, provoking the following symptoms in women:
- Vaginal discharge
- Bleeding outside with the menstrual cycle;
- Redness and swelling of the tissues of the urethra;
- Discomfort in the groin and lower abdomen:
- Painful sensations during or after intercourse;
- Frequent and painful urination
- Sore throat (pharyngitis against the background of ureaplasmosis).
Vaginal discharge with ureaplasmosis is mucous and not abundant, colorless, bloody or with a yellowish-green tinge and an unpleasant odor. Cutting and burning in the urethra are signs of mucosal inflammation. Discomfort in the lower abdomen can be caused by pathological processes in the pelvic organs during the progress of the infection along the genital tract.
Any deviations in the urogenital sphere are considered indications for examination for ureaplasma. Patients at risk are also advised to be tested if an infection is suspected. Before conducting a laboratory study, the doctor determines the presence or absence of pathological changes, for this, the following is carried out:
- Inspection of the walls and vestibule of the vagina, examines the cervix;
- Bimanual examination of the uterus and appendages;
- General analysis of urine and blood;
- Samples from the vagina and urethra are examined under a microscope;
- Ultrasound examination of the uterus and appendages;
- Laparoscopy if indicated.
Before visiting a gynecologist, you must stop any douching and the use of vaginal tampons, suppositories, gels and solutions administered vaginally. Two days before visiting a doctor, you should refrain from sexual intercourse, even protected ones.
When examining a smear under a microscope, ureaplasma cannot be detected, microorganisms are too small. In most cases, ureaplasmosis is complemented by a number of other infections, as well as bacterial or fungal vaginosis. Microscopic examination is necessary for complex treatment in order to detect all existing diseases. At the second stage, the following types of surveys are carried out:
- Immunoassay analysis (ELISA);
- Polymerase chain reaction (PCR);
- Bacteriological culture of smear;
- Direct or indirect immunofluorescence reactions (RPIF or RNIF);
- Antibiotic susceptibility test.
The optimal time for the examination is the first half of the menstrual cycle (the first days after the end of menstruation). To carry out the polymerase chain reaction, samples are taken from the urethra, from the surface of the cervix and from the walls of the vagina.
PCR is the most accurate and reliable diagnostic method, but sometimes errors occur. Invalid results can be obtained when antibiotic treatment was given less than 3 weeks before the test. Incorrect collection of a sample or failure to comply with a number of conditions before sampling is often the cause of an error. In women, ureaplasmosis is very difficult to detect if the bacterial infection has already moved into the fallopian tubes.
One of the most modern and fastest diagnostic methods is direct and indirect immunofluorescence; they are used to detect acute or chronic ureaplasmosis. PIF and ELISA are serological tests that detect antibodies to the infectious agent. Only a gynecologist can correctly decipher the analysis and choose the treatment.
Treatment of ureaplasmosis
For the treatment of ureaplasma in women, antibiotics of the macrolide and fluoroquinolone groups are used. Preparations of the tetracycline series are not used, the bacteria have resistant strains to them. Antibacterial agents that are most often prescribed to eliminate ureaplasmosis:
In addition to the main drugs, in order to avoid dysbiosis, probiotics are used in the treatment: bifidobacteria, suppositories to restore the normal microflora of the vagina and antifungal agents. Apply Lactusan, Bifidumbacterin and Colibacterin. Immunomodulators increase the body's general resistance and help to cope with infection. For this, drugs such as Taktivin, Linex, Acipol, Atsilakt, Salvagin and Timalin are prescribed. The success of treatment largely depends on the state of the immune system.
Elimination of inflammatory processes is a necessary part of the treatment of ureaplasmosis. The most commonly used are Ibuprofen and Diclofenac. To enhance the effects of drugs, physiotherapy and bladder lavage are performed. Doctors also recommend following a diet during treatment, giving up alcohol, fatty and spicy foods, and abstaining from sexual activity.
The course of antibiotics should be taken not only by the woman, but also by all her sexual partners. If only one person is taking antibacterial drugs, therapy becomes ineffective. The medication regimen and dosage are prescribed by the doctor after a complete laboratory examination. Self-medication can be not only useless, but also dangerous. Folk and homeopathic remedies are not an alternative to antibiotics, but as an adjunct to the main therapy, they can speed up recovery and relieve a number of symptoms of ureaplasmosis.
On average, the treatment of ureaplasma lasts about 10-15 days, after which a control laboratory examination is required. Success is evidenced by negative tests for the presence of the pathogen after 3 complete menstrual cycles. Otherwise, the scheme is adjusted and the course is repeated until a positive result is achieved.
Transmission of infection
Infection with ureaplasma occurs sexually, including through oral-genital contact. Reliable information about the possible transmission of infection by contact-household method has not been obtained. A rare method of transmission, but still occurring, is organ transplantation. With a kiss, ureaplasmosis spreads only when the mucous membranes come into contact with the partner's saliva.
During pregnancy, a woman can infect her baby in utero - through the amniotic fluid and during the passage of the birth canal. This route of transmission is called vertical. Ureaplasma easily penetrates the placenta and umbilical cord vessels, and then spreads to the organs of the embryo.
In newborns, this microorganism causes inflammation of the respiratory system, up to acute congenital ureaplasma pneumonia and bronchopulmonary dysplasia. In rare cases, a child develops a systemic infection, leading to damage to the central nervous system: bacteremia, sepsis, and meningitis. In order to avoid infection, special protocols for the preventive treatment of pregnant women have been developed, they are applied in the second and third trimesters.
Ureaplasma and pregnancy
Ureaplasma and pregnancy
Pregnancy is a serious stress for a woman's body. Significant changes in hormonal levels occur, they also affect the immune system. On average, one in five pregnant women have ureaplasma, but some researchers believe that at least 60% of women are carriers. Most often, the bacterium does not affect the condition of the fetus and the health of the mother; only cases of its massive reproduction cause concern.
There is strong evidence that ureaplasma has a negative impact on the health of a pregnant woman and her unborn child. Although in Russia there are no mandatory tests for the presence of the bacteria in all women, in the case of premature birth or miscarriage, such tests are mandatory. In order to avoid possible problems in the future, when planning conception, it is recommended to pass tests for all major infections, including ureaplasma.
Scientists have established a link between infection with ureaplasma parvum and ectopic pregnancy. The bacterium affects the epithelium of the fallopian tubes, which leads to functional and morphological changes in them.
The main problem in the treatment of ureaplasma is the use of antibiotics. A number of drugs can cause abnormalities in the development of the fetus. Taking antibacterial drugs begins from the 22nd week of pregnancy, in the early stages, therapy is undesirable for the child, but it is much safer to cure the infection even before conception.
Ureaplasmopositivity is diagnosed when bacteria are detected by laboratory methods, but in the absence of associated diseases and pathologies. A number of experts believe that ureaplasma is present in the body up to 70% of women, other scientists call smaller numbers - 15-60%. The presence of a microorganism may not affect health in any way, but it is still a risk factor.
They share temporary, or transit, ureaplasmopositivity and persistent. In the first case, the microorganism is present in the microflora from one hour to several weeks, in the second, the bacterium is detected within months or even the patient's entire life. The absence of pathogenic danger is indicated by the amount of ureaplasma DNA in the studied biomaterial - 104 CFU (colony-forming units) per 1 ml. Exceeding this norm indicates the need for treatment and an increased risk of complications.
Sometimes, under the influence of a number of factors, the body's defense systems fail, then the bacterium begins to multiply actively and provokes numerous diseases of the genitourinary sphere. Women with a positive test for ureaplasma constantly infect their partners with an unprotected pilaf. Even if the patient herself does not have any threat to her health, this cannot be ruled out in relation to other people, whose immune system may be much weaker. The most dangerous circumstance with such a positivity is the infection of the child during pregnancy. With a high degree of probability, when infected, the newborn develops damage to the bronchi and lungs.
Treatment of ureaplasmosis is a difficult and lengthy process. It is better to prevent the development of the disease than to eliminate its consequences in the form of complications later. You should periodically undergo a routine examination by a gynecologist, strengthen the immune system and eliminate negative factors that increase the risk of infection. At the first symptoms of an inflammatory process in the pelvic organs, you should immediately consult a doctor. Pregnant women are advised to undergo a complete comprehensive examination for the presence of pathogenic microorganisms.
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