Chlamydia affects women during pregnancy Chlamydia trachomatis (CT): is a common sexually transmitted disease that can cause cervical mucositis, endometritis, salpingitis, pelvic inflammatory disease, and ultimately infertility or tubal pregnancy; CT infections can also cause immunologic infertility. CT infection during pregnancy can worsen the process of pregnancy, and is one of the causes of miscarriage, preterm labor, stillbirth, premature rupture of membranes and neonatal pneumonia. Route of transmission: direct transmission through sexual intercourse, indirect transmission is rare. Illness in pregnant women can lead to fetal or neonatal infection through intrauterine, birth canal and postnatal infections (breast milk, air, clothing, etc.). Infection through the birth canal is the most important route of infection, so cervical CT-positive pregnant women vaginal delivery is prone to vertical transmission of CT, but this does not indicate that cervical CT-positive pregnant women must have a cesarean section, because CT is a curable disease. Strengthening pre-pregnancy and pregnancy CT examination, early detection, early treatment, the effect is very good, as far as possible to avoid cesarean section. Yang Ping studied the mode of delivery for normal delivery and cesarean section and sick newborns, found that the incidence of normal delivery is higher than cesarean section, the reason, cesarean section may be due to the rupture of the maternal membranes of this type of newborns lead to intrauterine infection; and the newborns who have been sick in the normal delivery, mainly through the obstetric tract infection caused. Thus, different modes of delivery in CT-positive pregnant women can result in different routes of transmission of the disease to the fetus or the newborn. Impact: CT infection of the female reproductive tract first in the cervix, and under certain conditions further up the cervical columnar epithelium, resulting in endometritis, amniotic chorioamnionitis, etc. Most scholars believe that the infected chorioamnion, amniotic membrane due to inflammation of blood vessels in the cellular exudate, causing leukocyte infiltration, edema, fibrous tissue hyperplasia, elasticity decreased or disappeared, leading to an increase in brittleness, toughness decreases, causing premature rupture of the fetal membranes. Neonatal Chlamydia trachomatis infection mainly manifests conjunctivitis (mainly manifested by eyelid swelling, redness and edema of the lid conjunctiva, accompanied by secretions) and pneumonia (mainly manifested by mild respiratory symptoms, which may persist and gradually worsen, with elevated IgM, IgG and IgA in the blood). Serum chlamydia IgM positivity in newborns at birth indicates intrauterine infection. Conjunctivitis becomes symptomatic 1-3 weeks postpartum, and Chlamydia trachomatis pneumonia most often occurs between 6 weeks and 6 months after birth. Studies have shown that the incidence of neonatal pneumonia and neonatal jaundice is higher in CT-positive than negative individuals, which may be related to the progression of CT infection to intrauterine infection, which causes insufficient supply of blood oxygen to the fetus, and chronic hypoxia of the fetus in utero. Screening during pregnancy: Since 85-90% of CT infections are asymptomatic, screening in high-risk groups is particularly important. High-risk groups include: history of sexual intercourse <24 years of age, especially <20 years of age; other STD infections, especially with gonococcal infections; multiple sex partners, young age at first intercourse; sex partners with CT infections; low economic status and education; postcoital vaginal bleeding; and history of cervicitis, recurrent vaginitis, and pelvic inflammatory disease. The American College of Preventive Medicine, Centers for Disease Control and Prevention, the U.S. Preventive Services Task Force, and the Canadian Preventive Health Care Task Force guidelines all list ☆pregnant women☆ as candidates for CT screening, emphasizing that all women undergo CT screening in the first trimester of pregnancy or at their first prenatal visit, with some noting that high-risk populations should be retested in the last trimester of pregnancy. There is evidence that screening women for chlamydia during pregnancy reduces the incidence of adverse pregnancy outcomes. Two observational studies from abroad have shown that treatment of CT infections during pregnancy reduces the incidence of premature rupture of membranes, low birth weight babies, babies younger than gestational age, and neonatal death. After pregnancy, when screening for chlamydia infection, chlamydia trachomatis-negative people can continue pregnancy; chlamydia trachomatis-positive people who are afraid of fetal or infant infection during pregnancy and who are not urgently in need of childbearing should preferably undergo abortion. Those with middle or late stage infection can continue pregnancy, but must be treated. Treatment: due to the consideration of fetal factors, treatment is preferred to use macrocyclic lipids, hydroxybenzylpenicillin, etc., and tetracyclines and quinolones cannot be used. Commonly used drugs are erythromycin 500mg, orally, 4 times/day for 7d; amoxicillin 500mg, orally, 3 times/d for 7d; azithromycin 1g orally (single dose).Kacmar et al. conducted a randomized, single-blind study on women with gestation less than 33 weeks, which showed that: the above three kinds of medications have the same therapeutic efficacy, and treatment effect is good. Erythromycin is the first choice for treatment during pregnancy, this product can enter the fetal circulation through the placenta, but the concentration is not high, there is no literature on the effect on the fetus, but pregnant women are still advisable to weigh the pros and cons of the application; this product has a considerable amount of breast milk, lactating women should be suspended breastfeeding when the application. If gastrointestinal reactions are severe, amoxicillin may be used instead. Animal reproduction tests have shown that amoxicillin at doses 10 times higher than those in humans did not impair fertility or the fetus in rats and mice, but there are insufficient controlled studies in humans. In view of the fact that animal reproduction tests do not fully predict human response, pregnant women should apply this product when it is really necessary. Liu Zhiqin et al. used erythromycin and amoxicillin to treat 120 patients with CT infections, with a good cure rate of 89.17%. If the above drugs are ineffective, azithromycin 1g single dose orally can be used, the treatment efficiency and cure rate is almost 100%. Azithromycin animal experiments on the embryo no damage to humans have not yet seen reports of the effect on the fetus, its long-term effects to be further observed. To prevent neonatal conjunctivitis, 0.5% erythromycin ophthalmic ointment can be applied to the eyes once at birth or 1% silver nitrate solution can be applied to the eyes once. Effects of mycoplasma on pregnant women Mycoplasma is the smallest prokaryotic microorganism between bacteria and viruses, and mainly resides in the genitourinary tract of human beings, and is a common pathogen that causes infections in the genitourinary tract. Currently, there are 16 species found to inhabit the human body, of which Mycoplasma hominis (MH) and Mycoplasma urealyticum (UU) are the most common. There have been many reports about the pathogenicity of mycoplasma, and its positive rate reaches 50%-60%, and infection with mycoplasma can cause immune infertility. When pregnant women are infected with UU and MH, it is easy to invade the amniotic membrane and damage the placenta at 16-20 weeks of gestation, causing chorioamnionitis, leading to late miscarriage, preterm labor, or stillbirth, and congenital malformations may occur in the surviving fetus. Studies have shown that mycoplasma infection generally infects the fetus in the mid-pregnancy, and the detection rate of mycoplasma is significantly higher in second trimester abortions. Mycoplasma infection not only causes miscarriage in mid-pregnancy, but also one of the main causes of miscarriage and embryo abortion in early pregnancy. mycoplasma infection in MH causes vaginitis, cervicitis, and salpingitis, and in UU causes nongonococcal urethritis. Foreign reports 6%-75% of adults (up to 80% in pregnant women) have asymptomatic Mycoplasma hyopneumoniae infection. Transmission: mainly through sexual contact. It can be found in the female vagina, around the urethra, cervical orifice and urine, and can also cause vertical infection of mother and child. Mycoplasma urealyticum, can infect the fetus through the placenta and lead to preterm labor, stillbirth, or infect the newborn during delivery, causing respiratory tract infections. In early pregnancy, UU infection affects the fertilization and development of the egg and can lead to infertility or early miscarriage. UU infection during pregnancy is closely related to premature rupture of membranes. Zhang Fengyun et al. found that premature rupture of membranes was the most frequent adverse pregnancy outcome in UU-infected pregnant women, and the incidence of premature rupture of membranes in UU-infected women during pregnancy was as high as 31.4%, which was much higher than that in women without UU infection during pregnancy. Therefore, testing for the presence of mycoplasma infection in the genital tract before pregnancy and providing aggressive treatment are necessary to ensure a safe pregnancy. The presence of Mycoplasma deiureticum infection should be cured before pregnancy; secondly, testing early in pregnancy, if the test is positive, it should be treated in time so as not to pose damage to the fetus. It has also been reported that Mycoplasma hominis infection can also cause preterm labor and preterm infant infection. Treatment: Erythromycin 250mg is preferred for pregnant women, to be taken orally 4 times a day for 14 days. Erythromycin is used for neonatal mycoplasma infections.