Lto toxoplasmosis it is the one on which attention is most often focused, however when it comes to infections in pregnancythe issue should be seen in a broader perspective.
In fact, there are several infections that, if contracted by a woman at the time of conception or during pregnancy, can be transmitted to the fetus with sometimes very serious consequencesincluding fetal damage, preterm birth but also miscarriage.
That’s why for a future mother, but more generally for a couple who are planning a pregnancy, know what the rules to keep away the risk of infection is crucial. If for some infectious agents the best weapon of prevention remains the Vaccinefor others, such as Cytomegalovirus, you can do nothing but follow hygiene and behavioral rules adequate.
Infections in pregnancy: the acronym TORCH
So what are the most dangerous infections if contracted during pregnancy?
“They’re the agents who come back to the complex TORCH – explains the Dr. Maurizio Zavattoni, infectious disease specialist at Humanitas San Pio X – The acronym stands for T of ToxoplasmaC of CytomegalovirusR of RubellaH of Herpes Simplex and O which stands for Othersor other infectious agents that are the virus of the Varicella Zoster, that of Hepatitis B and C, that of HIV and the Treponema pallidum which is the causative agent of syphilis. These are agents that if acquired during pregnancy can be transmitted from mother to fetus. Not in all cases they involve fetal damage but if the mother contracts these infections in pregnancy there may be gods serious risks for the fetus and then for the newborn».
Infections in pregnancy: the first rule is prevention
Therefore, it is fundamental preventionwhich should start again before conception.
“It is possible and recommended do some tests before planning a pregnancy – explains the expert. – Enough simple blood tests to find out if a woman has antibodies and is therefore immune or is she receptive, i.e. not immune to those infectious agents. This is important because, for some of these agents, if the woman is not immune, there is a vaccination to prevent the risks pregnant”.
Vaccinations available
For some infectious agents, such as Rubella and Varicella Zoster in fact, there is a vaccine.
“These vaccines they are not mandatorybut highly recommended to prevent infectious complications and risks in pregnancy. If the woman is not immune, she can get vaccinated before planning the pregnancy, so as not to run risks after conception – underlines Dr. Zavattoni. – Pit was the virusHepatitis B, instead, the vaccine is obligatory».
Infections in pregnancy: toxoplasmosis
For the toxoplasmosis the vaccine is not available and the only means of prevention are the behavioral norms. The infection, caused by a parasite, the Toxoplasma gondiiif contracted during pregnancy, it can cause miscarriage, fetal death but also serious congenital defects in the baby.
“First, pregnant women have to do the screening test to see if they have the antibodies – explains the expert – if this is not the case, they must know the hygiene and behavioral measures suitable to avoid the risks ».
Toxoplasmosis: the rules of hygiene
As reported by the National Institute of Health, one study which involved several centers in Europe, including two Italian ones, published in the British Medical Journal in 2000, indicated consumption of undercooked meat is among the main sources of infection in pregnant women. The results showed that the main risk factors are related to diet.
«The patient who is not immune to Toxoplasma, throughout the pregnancy, must respect the rules of conduct, which can avoid infection – recommends Dr. Zavattoni. – Noor to minced, undercooked, raw meats and raw shellfish; not too to sausages and cured meats. Another important source of contamination is represented from the manipulation of the earth of the orchards and gardens, where infected animals may have defecated. It is therefore essential that, if gardening activities are carried out, wash your hands very well before touching your mouth or the mucous membrane of your eyes. The same goes for the consumption of fresh fruit and vegetables: if I’m to be eaten raw must be washed with extreme care with running water. In fact, bagged vegetables are not considered highly safe. It is necessary avoid strawberries, raspberries And blackberries or uncooked foods containing them.
And what about cats?
«Although it is a lot reduced attention to the cat as a carrier of the disease, if present in the house, it is important to feed it with safe foods, such as croquettes, canned food or well-cooked foods – underlines the expert – e have others change the litter box daily. In all cases, avoid contact with nose and mouth.
Cytomegalovirus: what it is
If you hear about Toxoplasmosis often, sul Cytomegalovirus (CMV) information provided to women of childbearing age and pregnant are less.
The virus, belonging to the Herpesvirus family, is actually extremely common in the population: after the first infection, it remains latent in the body for life, but can be reactivated in case of weakening of the immune system, as can happen in pregnancy. In Italy about 50-60% of the adult population is positive to anti-CMV antibodies. So, one about half of women of childbearing age are at risk of contracting the infection from CMV for the first time in pregnancy.
The most important aspect is represented from congenital infections. A‘infection contracted during pregnancy can involve the passage of the virus across the placenta and cause brain damage and other organs of the fetus by slowing their growth with possible microcephaly and psychomotor retardation, deafness and other consequences.
Cytomegalovirus: how to prevent the risks
“Even for this infectious agent there is no vaccine – explains Dr. Zavattoni. – For this a woman who is not immune early in pregnancymust know the measures to be taken to avoid contracting the infection. This especially applies to women who already have children. Cytomegalovirus is in fact eliminated through biological fluids, in particular urine and saliva. THE young children often become infected without symptoms and the mother, who is in contact with the baby’s urine and saliva, thus runs the risk of becoming infected during pregnancy ».
The risk of transmission to the fetus is higher for primary infection (i.e. if contracted for the first time during pregnancy) and varies between 30% and 40% in the first and second trimester and between 60% and 70% in the third quarter. For the fetus the risk of complications, of symptoms at birth and long-term outcomes, they are greater if an infection occurs during the first trimester of pregnancy. Instead, the non-primary infections (from reactivation of the virus in pregnancy) they are transmitted to the fetus in a much lower percentage (0.3-3% of cases).
Cytomegalovirus and prevention
So what are the rules to know to prevent the risk of contagion?
«Avoid close contact with pre-school or school-aged children where possible – underlines the expert – do not kiss their lips, cheeks or hands. Wash toys often and well that children put in their mouths, wash your hands often and thoroughlyabove all after coming into contact with saliva or dirty clothing of urine or feces. Do not share food and drinks or use the same dishes other people, especially children. But also wash hands immediately after using shared tablets and touch screens».
Genital herpes: what you need to know
Not to be underestimated is then also herpes simplex, particularly risky if the woman have a vaginal infection what can be transmitted to the newborn during vaginal delivery with serious consequences, includingherpetic encephalitis (a life-threatening brain infection), o generalized mucous and skin lesions.
“It’s important do a serological test – explains the expert. – Herpes Simplex can indeed be of Type 1 and Type 2: the latter is localized in 80% of cases in the genital area, often without giving obvious symptoms because perhaps localized at the level of the uterine cervix. If a woman has a positive Type 2 blood test, it means that she has had an infection and at the time of delivery it is advisable to swab to evaluate that it has not an ongoing recurrence. There is no indication to proceed with the cesarean section but it is advisable to know it in order to then carry out the checks on the newborn ».
Your partner’s health is also important
Finally, do not forget that, to prevent the risk of infections during pregnancy, it is also important know the state of health of the partner.
«In case the partner had genital herpes the woman must know – underlines the expert – so as to have safe sex and avoid oral-genital intercourse pregnant in order not to run the risk of contracting the infection.
Infections in pregnancy: drug therapies
Finally, it is important to know that effective pharmacological therapies exist today for some infectious agents able to prevent transmission from mother to fetus.
“For the toxoplasma there is a safe drug, which is the spiramycin – concludes Dr. Zavattoni. – It must be given to the expectant mother throughout the pregnancy from the moment the infection is found. As for the Cytomegaloviruswas recently approved, in 2020, a drug, the valacyclovirwhich makes it possible to prevent the transmission of the infection from the mother to the fetus”.
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