What is the danger of measles vaccination in the first half of pregnancy. Mom-to-be, beware! The most dangerous diseases for pregnant women. Effect on the fetus

So, yesterday we started talking about childhood infections that can occur in expectant mothers at different stages of pregnancy. We touched on rubella and its manifestations during pregnancy, and also began a discussion of the consequences of rubella. Let's continue the discussion and also talk about other types of childhood infections in pregnant women.

What about rubella?

As we already found out yesterday, rubella during pregnancy is dangerous in terms of the formation of congenital malformations and miscarriages. On early dates in case of illness before the 10-12th week of pregnancy, doctors will offer the woman an abortion, since the risk of fetal lesions with severe deformities is very high. In terms of more than 14 weeks, if a woman who has not previously had rubella has become infected, the issue of pregnancy is resolved with her participation and a council of doctors in individually. Doctors take into account the opinion of the woman herself, signs of threats to the development of pregnancy, ultrasound data with the presence of problems in the development of the fetus, signs of placental insufficiency or infection, in combination with oligohydramnios or polyhydramnios.

Also, for the final decision on pregnancy, it is necessary to conduct laboratory examination methods with the detection of viruses in the blood or the level of specific anti-rubella antibodies in the serum. If a severe malformation is detected, there are signs of infection of the placenta, and a sufficiently strong delay in the development of the fetus in utero is detected, the question of terminating the pregnancy at any time is raised, if the pregnant woman herself agrees to this.

How to be safe?

How to protect yourself from rubella during pregnancy, if a woman did not have rubella in childhood, how to prevent the risk of infection during pregnancy to eliminate the negative consequences of a viral infection on health? Usually, in the context of pregnancy planning, women who have not had rubella or do not remember this fact are offered to undergo a blood test for rubella antibodies, and if there is no immunity, get vaccinated against rubella three months before pregnancy planning.

This is the period necessary to fully create immunity and fully guarantee the safety of vaccination. Many worry about the possibility of harm to the fetus by a vaccine virus that is weakened and "tamed", and the three months before planning are also dictated by the elimination of this fear. Although data on the safety of the vaccine even during pregnancy showed its complete safety for the woman and the fetus. If suddenly you are vaccinated and find out that you are pregnant, you do not need to terminate the pregnancy, since the fetus will not be affected by the vaccine.

Vaccination for women is not carried out when the child's card contains indications of the transferred rubella, according to the mother or simply from her own memories, the fact of rubella will be in doubt. In such doubtful cases, it is worthwhile to conduct a special blood test for the presence of antibodies to rubella - it is this that will put an end to the question - whether or not there was rubella. If there are no antibodies, you need to get vaccinated (if you don’t mind) or during pregnancy avoid children’s groups and crowded places where you can catch the virus. During pregnancy, rubella vaccination is not carried out, since the viruses are alive and the woman's immunity is physiologically changed.

Why is it dangerous to get rubella during pregnancy?

If a pregnancy with rubella persists or a woman carries the disease in late dates, this can cause an increased risk of complications during and after childbirth, mainly bleeding, purulent or septic complications, problems with labor, fetal asphyxia during childbirth. In addition, due to the characteristics of the immune system of the mother and fetus, the born baby will become a carrier of the rubella virus at birth and a source of danger to other children. He is placed in a separate boxed isolated room, in the observational department, and is examined very carefully and in detail, completely excluding all malformations and developmental problems. He is examined by a neonatologist, a neurologist, an ophthalmologist and an infectious disease specialist.

If the expectant mother has measles?

Pregnant women can develop not only rubella, but also other infections of the "children's" group. These include measles, an acute and highly contagious childhood infection that can spread rapidly to unvaccinated people. If a pregnant woman has not been vaccinated against measles, and she did not have measles in childhood, when in contact with a measles patient, the probability of acquiring her is almost 100%, since this is an extremely contagious disease. The measles virus is highly volatile, it can be carried by the wind, transmitted by airborne droplets, from sick to healthy people. On average, about ten days pass from the moment of contact with a measles patient to its first manifestations.

One of the initial manifestations is a sharp and strong increase in temperature - sometimes it reaches 39-40 degrees, a strong cough and runny nose appear, the mucous membranes of the eyes turn red and lacrimation occurs, appetite is severely disturbed. This malaise lasts for several days, and on the fourth day from the onset of manifestations, typical signs of enanthema (rashes in the mouth area) appear - these are small, similar to semolina spots that come out on the cheeks, the area of ​​\u200b\u200bthe palate - soft and hard.

A few hours later, or usually a day later, a typical rash appears, starting from the face and ear area, gradually sliding down to the whole body. The rash usually looks like red small spots of different sizes, with a tendency to merge. As the rash disappears from the body, areas of pigmentation change appear - dark spots that persist for several days. These spots gradually disappear in the same way as the rash itself disappeared.

How to confirm the diagnosis of measles?

Usually, the diagnosis is confirmed by detecting a typical measles clinic with rashes on the mucous membranes of the mouth and on the body, and also confirming it by detecting special anti-measles antibodies in the blood serum. However, based on the fact that measles seems to have been ill in childhood, one should not rely on it to be some other infection - the blood must be examined, since errors are possible both earlier in the diagnosis and now.

What to do with measles?

If the measles virus has got to a pregnant woman, she is very likely to get sick, since her susceptibility to infections increases, and the body's immune forces are physiologically reduced due to the bearing of the baby. Therefore, it is necessary to carry out active prevention of any infections. But if infection has occurred and measles has developed, there are no specific anti-measles drugs, only a complex of conventional antiviral therapies is used. You should not self-medicate, call a doctor immediately, and sometimes with severe measles during pregnancy, hospitalization in the infectious diseases department of a hospital is necessary. It is important to actively and quickly treat a viral infection, since in adulthood measles is quite difficult and for the most part complicated, and even more difficult during pregnancy.

Why is measles so dangerous for pregnant women?

If a woman becomes infected with the measles virus during pregnancy, the risk of spontaneous miscarriages can increase sharply, as well as in the later stages - by triggering the mechanism of premature birth, when the baby is completely unprepared for extrauterine life. Although scientists say that due to its size, the measles virus cannot cross the placenta, so far there is no clear and proven evidence of the absence negative impact virus on the fetus and on the membranes of the fetus. Today, the risk of congenital malformations of the fetus is quite likely, especially if measles occurs in its development in the first and second trimesters of pregnancy. Therefore, this disease is potentially dangerous at any stage of pregnancy and there is no absolute guarantee that it will not give consequences. And given the complications in the form of pneumonia and encephalitis, it can end in a very deplorable way. Therefore, remember to be safe, especially if you have children who have not been vaccinated against measles.

In cases where measles occurs in a pregnant woman in the later stages, almost already before childbirth, the baby can also be born with signs of congenital measles - he will have a characteristic rash in the mucous membranes of the mouth and on the skin. And all other complications of measles are also possible, especially pneumonia and encephalitis, since the baby's immunity is still extremely weak. In such extreme cases, the mother and child are placed in the observational department and the closed boxed ward of the maternity hospital, they are prescribed to stay together breast-feeding to baby with breast milk received part of maternal antibodies. If the baby is born without signs of infection, he is isolated from the sick mother for the entire duration of her illness, and fed with expressed milk or formula.

Any pregnant woman who has been in contact with children or adults with measles, and if she herself has not been ill with measles and has not been vaccinated against it in time, is shown to administer anti-measles immunoglobulins into the muscle for prophylactic purposes during the first three days of contact. If a woman is just planning a pregnancy, and she did not have measles in childhood, it is recommended that she be immunized against measles together with rubella at least three months before the planned pregnancy. But it is impossible to vaccinate a pregnant woman against measles, since her vaccine is live, although weakened.

Like most "childhood" viral infections, measles dangerous for pregnant women. When a pregnant woman is infected with measles in the early stages pregnancy, in 20% of cases, spontaneous abortion occurs or fetal malformations occur.

The saddest thing in this situation is that the most common complications from the fetus are oligophrenia (dementia) and lesions nervous system are worst diagnosed at this stage of pregnancy. Therefore, it is impossible to say for sure whether a particular pregnant woman is in those same 20%.

Most likely, the doctor will offer a woman who has had measles in the early stages of pregnancy, artificial termination of pregnancy. But, of course, in each case, the examination will be thorough and individual.

And it should be noted that the absolute indication for abortion is measles, in contrast to rubella, is not.

The most dangerous from the point of view of possible damage to the fetus are complications of measles, especially bacterial pneumonia, which can lead to fetal death, and especially severe cases- and the most pregnant woman.

It should be said that infection in general is extremely rare. Even at a time when it was not known vaccination against measles, the number of pregnant women with measles was 0.4-0.6/10000.

And yet before pregnancy planning a woman should be tested for antibodies to measles and, if necessary, get a measles vaccine in order to think about possible infection did not prevent her from calmly and joyfully expecting the birth of a child.

After the first weeks of pregnancy, measles most often occurs without causing damage to the fetus. However, in the last weeks of pregnancy, the risk of giving birth to a child with congenital measles infection increases, the mortality rate in which, before the use of antibiotics, was 20-30% in full-term newborns and 56% in preterm ones.

Currently, when using antibiotics and modern methods resuscitation, the death rate of newborns from congenital measles infection has decreased significantly.

Measles can be considered a congenital infection, symptoms which manifested in the newborn during the first ten days of life. If the clinical signs of measles appear on the 14th day of birth or later, then the measles infection is considered acquired after childbirth. Such an infection is generally associated with a lower risk of complications.

In order to avoid complications of congenital or acquired measles infection, a pregnant woman who has come into contact with a patient with measles undergoes passive immunization, in which immune serum globulin is administered at a dose of 0.25 ml / kg of body weight within 6 days from contact. For newborns whose mothers became ill with measles 1 week before or after birth, immunization at the same dose is recommended.

Unlike prophylactic immunization, measles vaccine is not given during pregnancy, as there is a theoretical risk of harmful effects on the fetus of a live virus, on the basis of which the measles vaccine is made. At the same time, it is necessary to recall that a child vaccinated against measles with post-vaccination symptoms of measles infection is completely safe for others, including pregnant women. Therefore, routine measles vaccinations for older children during the mother's pregnancy do not need to be canceled.

When planning a pregnancy medical center "Euromedprestige" an obstetrician-gynecologist will definitely ask the expectant mother if she had measles in childhood, and will advise on prevention, treatment and vaccination against infection.

IN Lately measles infection during pregnancy a rare event And all thanks to mass vaccination. Recently, however, a measles epidemic has stirred up Romania, cases of the disease have also been identified in Ukraine. In 2015, measles outbreaks were observed in the US and some other Western countries.

Measles is a highly contagious disease, which means that contact with a sick person is very likely to cause infection. The onset of measles resembles a common viral infection: fever, runny nose, cough, often conjunctivitis, lacrimation. A few days after the onset of the first symptoms, a rash occurs, first on the head and face, then spreading throughout the body.

The World Health Organization notes that measles is a severe disease that can cause complications such as blindness, encephalitis, pneumonia, and ear infections.

Of course, unvaccinated children are most at risk of contracting measles. early age. However, pregnant women who have not previously had measles and have not been vaccinated are also at risk if this disease occurs.

Measles vaccination and pregnancy.

Fortunately, most young women were vaccinated against measles as children. It is known that a two-time vaccination with a live vaccine reliably protects against the disease.

If a woman is planning a pregnancy and does not have immunity to the measles virus, then vaccination is highly desirable, but you need to be vaccinated at least a month before conception. Measles vaccination during pregnancy is contraindicated because it contains a live virus that can adversely affect the unborn baby.

If you are pregnant and your older child is to be vaccinated against measles, then this is quite safe, since after vaccination a person is not contagious even if symptoms of infection develop.

Measles during pregnancy: consequences.

Due to recent events, as well as the fact that anti-vaccination propaganda is actively being carried out today, especially suspicious expectant mothers are seriously concerned about the consequences of measles during pregnancy.

Moreover, most Internet resources, as well as many old textbooks, contain information that measles in the first trimester can lead to miscarriage or fetal malformations, and later to premature birth and growth retardation of the child.

In articles on sites for pregnant women, you can even find evidence that measles can be an indication for abortion. However, recent statistics show that the measles virus is not dangerous to the fetus and does not affect the incidence of malformations in the child.

Of course, if a mother gets measles during pregnancy, there is a possibility of transmitting the virus to the fetus, but it is impossible to accurately determine its percentage due to the fact that cases of measles infection in pregnant women are rare. However, the danger negative consequences measles during pregnancy still exists.

First of all, measles is dangerous for the woman herself, as it can lead to eye damage, pneumonia and other complications. In addition, if measles is severe, the woman's body may be too weak to bear the child and the pregnancy will be interrupted (miscarriage or premature birth).

To avoid the consequences of measles during pregnancy, you need to consult a doctor for any alarming symptoms. Also urgent appeal for medical care necessary if someone in your environment has measles.

In order to prevent complications, a pregnant woman is recommended to administer antibodies within 6-7 days after contact with the sick person. Such a measure in most cases helps to prevent the disease.

If a pregnant woman does become ill, timely contact with a doctor and treatment will reduce the risk of complications.

There is no specific treatment for the measles virus. Good nutrition, drinking enough fluids, including oral dehydration solutions, are essential.

Prescribing vitamin A can prevent complications from measles, but pregnant women should not take large doses of this vitamin. The decision to prescribe vitamin A or other medications is made by the doctor.

It is important to know that measles causes a significant decrease in immunity, so against its background it is easy to get sick with other infections. In this regard, during the illness and a few weeks after recovery, it is recommended to sharply limit contact with other people.

If a woman falls ill with measles when planning a pregnancy, then it is advisable not to become pregnant within a month after complete recovery.

Testing for measles during pregnancy.

The measles virus can be found in nasal discharge laboratory methods. However, testing for measles during pregnancy is not always prescribed, as the diagnosis is usually made by clinical symptoms, which are quite pronounced.

In doubtful cases or if there was contact with a sick person, and the woman does not know if she has immunity, it is recommended to be tested for antibodies to the measles virus IgM and IgG. During the initial infection, both groups of antibodies will be positive.

If only IgG is positive, then the woman had measles or was vaccinated. In this case, you can not be afraid of re-infection with measles, antibodies reliably protect the woman and the child during pregnancy.

In the first trimester of pregnancy often causes malformations and may be grounds for referral for abortion.
The only way to prevent measles is to get vaccinated, but this must be done before pregnancy.
Unfortunately, there are no drugs that would destroy the measles virus, so it remains only to create optimal conditions for the body to fight the infection.

How does measles manifest during pregnancy?

The incubation period for measles (from infection to the onset of symptoms) is usually one to two weeks. A pregnant woman's temperature rises sharply, coughing, runny nose, photophobia, headaches begin, and reddish spots appear in the sky.

The next day, small whitish rashes appear on the mucous membrane of the cheeks. After a few more days, the measles rash spreads over the face, neck, behind the ears, and then all over the body.

Unlike rubella, individual rashes merge with each other and have their own characteristics. Once upon a time, if the doctor was not sure of the diagnosis, he could use the term "rubella measles", but now it is known that these are two different diseases, and now they can always be accurately diagnosed.

How can you get measles?

Measles is transmitted by airborne droplets from a sick person when coughing, sneezing, talking. measles virus in external environment it is unstable and easily dies, that is, the likelihood of infection is especially high with frequent contact with the patient.

Especially dangerous is the fact that a person can spread the virus already during incubation period. A person with measles ceases to be contagious about the fifth day after the onset of the disease.

What threatens measles during pregnancy?

By itself, the disease proceeds quite easily and passes without treatment, however, measles during pregnancy threatens with serious complications for both the expectant mother and her child. born child. In some cases, it can lead to measles pneumonia, an inflammation of the lungs.

In early pregnancy, the baby can become infected with measles, which leads to the appearance of various malformations, including damage to the nervous system. According to the results of ultrasound before childbirth, it is impossible to know how affected the baby's brain is.

The likelihood of malformations with measles is less than with rubella, when experts always recommend termination of pregnancy to women who fall ill with it in the first trimester. Therefore, if the expectant mother suffered measles at the very beginning of pregnancy, the issue of its preservation is decided in each case separately.

Infection during the last weeks of pregnancy increases the risk of having a baby with congenital measles infection, which modern conditions treated, but the newborn may not be able to tolerate it.

Measles sometimes causes miscarriage, premature birth, and in individual cases- the death of a child.

Diagnosis of measles in expectant mothers

If a woman is planning a pregnancy, she is recommended to take a blood test to determine antibodies to infection - their presence indicates that she has had measles and is protected from it. Diagnosis of the disease in pregnant women is usually carried out on the basis of symptoms.

The symptoms of this disease are so characteristic that additional tests may not be required. In doubtful cases, when the picture is atypical (and this happens in vaccinated people), the doctor may prescribe a blood test to determine antibodies.

It is almost impossible to determine whether a child has become infected before he is born. Usually, children with congenital measles infection are born with a characteristic skin rash.

How to prevent measles during pregnancy?

Measles gets sick once in a lifetime, so a person who had it in childhood can no longer be afraid. If a woman planning a pregnancy has not previously encountered this infection, you can advise her to get vaccinated.

However, you need to take care of this even before conception, since there is a certain risk that the vaccine will have a bad effect on the child, because it is based on a live virus.

What is the treatment for measles in expectant mothers?

As with most viral illnesses, all you can do is "wait" for the body to get over the infection. There are no remedies that would speed up recovery, it remains only to alleviate the symptoms of the disease.

Expectant mothers are usually prescribed bed rest, heavy drinking and antipyretics. Bacterial complications of measles (such as pneumonia) are dangerous, and if they develop, women are prescribed antibiotics.