It is extremely important to conduct sanitary and educational work among the population, discuss issues of care in a family where there is a child.
A special place is taken by the care of premature babies, children with developmental defects and in the pathological course of childbirth in the mother. In this risk group, dispensary observation is carried out.
A significant number of postoperative complications are associated with nosocomial infection. The hospital properly isolates infected patients from non-communicable patients. A large number of visitors are not allowed in their rooms.
Infectious processes in newborns can both develop independently and pass in utero from the mother.
When clarifying the causes and mechanisms of the development of the disease, the following main tasks are solved:
– determination of the developmental period at which intrauterine infection could occur (the disease was detected after birth):
– having determined this period, assess the possible harmful effects to which the mother and the fetus could be exposed. Determining the time of the onset of infection is not such a difficult task when it comes to individual diseases, the defeat of which occurs at certain intervals of development of the embryo, fetus and newborn. In the early stages of embryogenesis (embryo development), an inflammatory response is impossible due to the absence of inflammatory cells and immune response in the body of the embryo. However, during this period, harmful factors, acting on the embryo, can cause the formation of defects of organs and systems (the so-called teratogenic effect, from the Greek. “Freak”), And acting on the mother and fetus, when the organs are already formed, most often these factors cannot cause vice. Infections during this period cause organ dystrophy, which, if not leading to fetal death, then affects the child after birth. In dystrophic organs, inflammatory reactions are prolonged more and more progressively, the sensitivity to other infections is high, which sooner or later affects the functions of the organ, leading to its failure and cell death. The factors acting on the fetus in the last months of pregnancy lead to structural changes in the fetus. During childbirth, mechanical damage occurs more often, infection of the mucous membranes and skin.
Thus, on the basis of the characteristic manifestations in most cases, it is possible to establish the period in which the harmful factor acted. Many factors can even terminate a pregnancy.
There are three stages in the development of the embryo, fetus, newborn:
a) antenatal (early and late);
The embryonic period – from conception to 8 weeks, is characterized by the formation of the head, trunk, limbs, all internal organs. When exposed to teratogenic factors during this period (ionizing radiation, thermal factors, mechanical damage, hypoxia, hormonal disruptions, chemical toxins, hypovitaminosis or hapervitaminosis, anemia, viral, bacterial, fungal and other influences) the state of the embryo is directly disturbed, malformations occur with subsequent defects or fetal death. Diseases during this period are called embryopathies. These include most of the developmental defects confirmed by infectious embryopathies. For the first time, infectious embryopathy was discovered by N. Greg (Sgedd) with measles rubella. In the cells of the embryo, conditions for the development of the rubella virus are favorable, and the mother’s disease with measles rubella in the first 3 months of pregnancy leads to congenital cataract (clouding of the lens), more often bilateral paralysis; in second place are the occurrence of heart defects and microcephaly (a decrease in the total volume of the brain), abnormal development of teeth – their late eruption, the absence of tooth rudiments, insufficient development, violation of enamel formation. The defeat of the lens most often occurs when the mother is sick with rubella in the 5th week of pregnancy; at 6-7 weeks, the disease leads to heart defects; deafness develops at 8-9 weeks. Rubella in a mother during pregnancy for more than four months does not lead to embryopathies, however, damage before conception will lead to malformations.
The fetal period is divided into antenatal and intrapartum. The early antenatal period (from 9 to 28 weeks) is characterized by rare, but possible occurrence of malformations, the formation of the ability to inflammatory reactions. Thus, an infection affecting the fetus can cause organ dystrophy or miscarriage. Late antenatal period (from the 29th week before childbirth) – manifestations of infectious pathology in this period are usually called late fetopathies.
The intrapartum period (the period of childbirth) is characterized by possible mechanical effects on the child. Compression of the umbilical cord leads to circulatory disorders, oxygen starvation. Long-term compression of the skull also leads to impaired blood circulation in the brain. A long anhydrous interval (from the discharge of amniotic fluid to the birth of the child) leads to an ascending infection from the vagina into the uterus and fetal damage. During this period, the diseases are called intranatal fetopathies. Here, aspiration pneumonia (inhalation of infected amniotic fluid into the child’s respiratory tract), gonorrheal conjunctivitis, most of the pustular skin lesions, herpes simplex with damage to the mother’s birth canal, and fungal infections can occur.
The neonatal period lasts up to 28 days of a child’s life (early) and from 28 days – late. In the first week, the flora colonizes the mucous membranes of the skin, the baby’s digestive tract. Infectious neonatopathy occurs relatively often as a result of imperfect defense reactions. Premature babies are especially often affected by infections.
Infectious diseases of a newborn that arise in utero are classified by different authors as fetopathies, and not as neonatopathies. True neonatopathies include diseases that become infected after the birth of a child. These are diseases such as anphalitis (inflammation of the umbilical residue), which can be complicated by umbilical sepsis, intrauterine staphylococcosis, colibacelosis, candidiasis, pneumonia, erysipelas, etc.