Gebelikte Enfeksiyöz Hastalıklar
Özet
Gebelik döneminde karşılaşılan viral, bakteriyel ve protozoal enfeksiyöz hastalıklar, klinik özellikleri, fetal etkileri, tanı ve tedavi yöntemleri açısından bu metinde kapsamlı bir şekilde ele alınmaktadır. Viral enfeksiyonlar bölümünde Varisella-Zoster (VZV), İnfluenza, Kabakulak, Kızamık, Kızamıkçık, Sitomegalovirüs (CMV) ve Parvovirüs B19 incelenmiştir. VZV gebelikte pnömoni riski yaratırken bağışıklığı olmayanlara Varizig ve IVIG önerilir. İnfluenza ve CMV enfeksiyonlarında antiviral tedaviler ve serolojik takipler uygulanabilir. Özellikle kızamıkçık ve CMV, ilk trimesterde yüksek teratojenik etkiye ve ciddi konjenital anomalilere yol açmaktadır. Parvovirüs B19 ise fetal anemi ve hidrops fetalise neden olabilmektedir. Bakteriyel enfeksiyonlarda, yenidoğan sepsisine yol açabilen Grup B Streptokok (GBS) kolonizasyonuna karşı 35-37. haftalarda rektovajinal kültür takibi ve intrapartum penisilin profilaksisi vurgulanmaktadır. Protozoal enfeksiyonlarda Toxoplasma gondii'nin gebelik haftasına göre değişen bulaş ve şiddet riskleri ile spiramisin tedavisi açıklanmaktadır. Canlı virüs aşılarının gebelikte kontrendike olduğu, postpartum ve emzirme döneminde ise güvenle uygulanabileceği belirtilmektedir.
Infectious diseases encountered during pregnancy, classified as viral, bacterial, and protozoal, are comprehensively evaluated in this text regarding their clinical features, fetal impacts, diagnosis, and treatment methods. In the viral infections section, Varicella-Zoster (VZV), Influenza, Mumps, Measles, Rubella, Cytomegalovirus (CMV), and Parvovirus B19 are examined. While VZV poses a risk of pneumonia during pregnancy, Varizig and IVIG are recommended for non-immune pregnant women. Antiviral treatments and serological follow-ups can be administered in Influenza and CMV infections. Especially Rubella and CMV cause high teratogenic effects and serious congenital anomalies during the first trimester. Parvovirus B19 can lead to fetal anemia and hydrops fetalis. Regarding bacterial infections, screening via rectovaginal culture between 35-37 weeks and intrapartum penicillin prophylaxis are emphasized against Group B Streptococcus (GBS) colonization, which can cause neonatal sepsis. In protozoal infections, the transmission and severity risks of Toxoplasma gondii varying by gestational week, along with spiramycin treatment, are explained. It is noted that live virus vaccines are contraindicated during pregnancy but can be safely administered during the postpartum and breastfeeding periods.
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