The danger of cytomegalovirus: nature, diagnosis and treatment in women. Cytological examination of the cervix Features of pregnancy and childbirth

In order to detect the onset of a pathological process, monitor its progress, and evaluate the effectiveness of therapy, it is necessary to understand what changes the cell undergoes during the development of pathology.

This became possible with the advent of such diagnostics as cytological examination.

Currently, there is a tendency to increase the incidence of cancer, especially in the female genital area. Every year, cancer is registered in 12 million people, of which a million are women who have been diagnosed with cancer of the reproductive organs, 45 thousand are Russian women. Cervical cancer occurs annually in approximately 2,250 women in Russia. Cytological examination of the cervix allows identifying the disease and making an accurate diagnosis.

The essence of the method

The basis of a cytological examination of a cervical smear is the microscopic examination of cells. Under a microscope, the vital activity, composition, structure of the cell, and its compliance with normal development are assessed.

Diagnostics allows you to evaluate cellular structures, the state of which can be used to judge health or the development of a disease:

• The cell nucleus is the basis containing DNA molecules with hereditary information.
• Cytoplasm or sarcoplasm in muscle cells– cytosol (liquid) containing organelles (vital components of the cell); the nucleus is located in the cytoplasm.
• Mitochondria are components responsible for energy processes.
• Enzymes are catalysts for chemical reactions of protein nature.
• Lysosomes are an enzyme shell whose function is to break down various substances.
• Ribosomes - participate in the formation of amino acids and protein molecules, which is determined by genetic information.
• The membrane is a membrane that preserves the cell, ensures its integrity, regulates intracellular balance, transports various substances, blocks the entry of others, thus ensuring the stability of the intracellular environment.

Thanks to cytological examination of the cervix, early detection of cancer of the cervix and appendages at the preclinical stage has increased 10 times.

Detection of cancer in the first stages and precancerous conditions is the main goal of cystoscopy. This is the most informative diagnostic method, allowing you to assess the condition of the organ and adjacent tissues.

Cytological examination is similar to histological examination in terms of goals (recognition of pathology), diagnostic object (cells of pathologically altered tissues), principle (morphological analysis), and methods of staining cellular structures.

However, cystoscopy requires a smaller amount of biopsy material, much less time to obtain results, and often does not require pre-processing of the material or special equipment.

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Indications

An examination can be prescribed not only by a gynecologist, but by another specialist (oncologist, surgeon, reproductive specialist), as well as a therapist.

With the help of cytological examination of the cervix, the following tasks are solved:

• Preliminary examination to select a further set of diagnostics, including with the aim of preventing diagnostic procedures that are risky for the patient.
• Preventive screening, especially for a group of patients with an increased risk of cervical cancer.
• Assessing the body's response to cytotoxic drugs, radiation, and a combination of chemotherapy and radiation therapy.
• Clarification or establishment of a diagnosis for damage to cervical tissue.
• Rationale for the feasibility of surgical intervention.
• Suspicion of cervical cancer.
• Suspicion of an inflammatory process or STD.
• Suspicion of a precancerous disease.
• Using a cytological examination of the cervix, the therapeutic effect of the medications used is assessed, the possibility of changing the drug to a more effective one or adjusting the dosage.
• Suspicion of HPV.
• Monitoring the progression of cancer or inflammation.
• Comparison with the results of pathohistological examination.
• Selection of the optimal set of treatment procedures.
• Thanks to cystoscopy performed during surgery, you can quickly clarify the diagnosis and, based on the results, change the tactics of the operation.
• Early detection of relapses and changes to which the cervix has undergone.
• For the purposes of scientific experiments and research.
• Complaints of itching in the genital area, burning, atypical discharge, unpleasant odor, cycle disorder.
• Pregnancy.
• Preparation for the in vitro fertilization program.

In some difficult cases, for example, when it is impossible to perform a biopsy, cytological examination of the cervix is ​​the only option for an accurate diagnosis.

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Benefits and features

Using a cytological examination of the cervix, you can identify:

The advantages of cytological examination of the cervix include efficiency, painlessness, and safety. This is a non-invasive technique that does not leave wounds, scars, scars when obtaining biomaterial, and does not cause bleeding or discomfort.

Psychologically, the patient tolerates it better and it is easier for her to tune in to cystoscopy than to histological examination.

Material for analysis, preparation

The cervix is ​​short (3-4 cm), located between the vagina and the body of the uterus, consists of the vaginal part and the cervical canal. Parts of the cervix have different surfaces: the canal is lined with columnar epithelium (endocervix), the vaginal section is lined with flat epithelium (exocervix). At the border of these two surfaces, inflammatory processes develop, and areas of epithelial degeneration from one type to another appear. From this area, from the vaginal area, from the affected areas, material is taken for cytological examination of the cervix.

A superficial light scraping from the designated area is done with a special brush, probe, spatula or cotton swab, placed on glass that has previously been degreased and dried. Glass thickness – 2 mm. Apply the smear in a thin layer with a wide strip in one direction. If the cervix is ​​healthy, you will need one glass, in other cases - several glasses. In case of pathological changes, the first smear taken from healthy tissue is applied to one slide, the second smear-imprint is taken from the affected area and applied to another slide. Room temperature is sufficient to dry the material. After drying, the glass and a referral with the patient’s data and preliminary diagnosis are sent to the laboratory no later than four days from the moment the biomaterial is collected.

You can deliver a smear to the laboratory for cytological examination of the cervix not only on glass, but also using a transport liquid. The scraping is taken with a cytobrush, turning it clockwise 5 times. The tip is removed from the brush and placed in a container with a multilayer preservative preparation. The container is closed, shaken, labeled, and sent to the laboratory.

This method allows you to completely preserve the material using a liquid fixative, which increases the clarity of cell structures and also eliminates the appearance of foreign microparticles in the biomaterial, which cannot be excluded when drying the smear in air.

Liquid cytology is of higher quality; the biopsy sample is stored in a preservative for 10 days.

You need to prepare for a smear test for cytological examination of the cervix:

• Two days without sex before the analysis.
• Lack of menstruation.
• Colposcopy is excluded two days before.
• The use of vaginal suppositories, medications, tampons, lubricants, vaginal contraceptives, and douching is prohibited.
• A smear is not taken during treatment for STDs and inflammation of the genital organs.

Collection of material takes several minutes.

Research options

The cervix is ​​examined using the cytological method, which is part of the mandatory set of diagnostic procedures for gynecological diseases.

Different laboratories use different options for cytological examination of the cervix:

• Light microscopy– a nanoscope (optical microscope) is used for diagnosis. The transparency (translucency) of the sample under study is important so that the beam passes through the material. The advantages of light microscopes: cell magnification up to 3000 times, this allows you to analyze cells 200 nanometers in size or more, the ability to study in detail the life of a cell (division, movement, movement, general structure, and so on). The accuracy of the method is about 100%. Disadvantage: cells smaller than 200 nanometers cannot be analyzed.
• Electron microscopy– instead of light rays, an electron beam is used to obtain an image. The image displayed on the screen during the procedure is magnified up to 50,000 times. The resolution of the electronic device exceeds that of the human eye by 106 times. To obtain a clearer image, the biopsy is sometimes treated with heavy metal salts. The result is that cellular structures absorb electrons to varying degrees, which are highlighted on the screen or film. This makes it possible to more clearly study cellular microobjects and isolate viruses.

• Centrifugation (cytochemical analysis)– allows you to analyze the chemical composition of organelles. The biomaterial is crushed in a homogenizer, loaded into a centrifuge, and launched. Organelles are separated and divided into components that are subject to study.
• PAP test - the cervix is ​​examined using the Papanicolaou test, the most common among cystoscopy, which has an efficiency of about 100%, which consists of centrifugation.
• X-ray diffraction study– cells are grown in a nutrient medium, after which the protein chains, cell DNA, and RNA are studied.
• Microsurgical method– removal or introduction of certain organelles into the cell.

Methods for examining the cervix are divided into complex and simple, depending on the color of the smear. For complex methods, multi-color combined staining (polychrome) is used. Simple staining methods use one dye (fuchsin, methylene blue, hematoxylin-eosin).

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When planning a pregnancy, women are asked to take tests for infections that can cause pathologies of fetal development, one of them is cytomegalovirus infection (CMV). Infection of the embryo with cytomegalovirus can lead to the death of the fetus, or the birth of a sick child.

CMV infection

Infection with cytomegalovirus occurs through contact with a sick person; once infected, it is impossible to completely get rid of the infection. But a healthy person develops immunity against CMV, which helps control the activity of the virus.

Diagnosis of CMV

The presence of infection in the body is detected by determining immunoglobulins to the virus in the blood using the ELISA method. To determine the risk for a child, it is enough to determine the concentration of IgG, which provides immunity against the virus and IgM; its detection in the blood indicates the active phase of the disease. 7-8 weeks after infection, IgM is no longer detectable in the blood, indicating that the body has developed immunity against the virus.

CMV during pregnancy

The active phase of an infectious disease can pose a danger to the fetus; at this time, the probability of infection of the fetus is 45-50%. Therefore, if a woman has never been infected with this virus, and this is evidenced by negative IgG and IgM, then her main task becomes to avoid infection during pregnancy.

When only IgG is detected in the blood, this indicates immunity to CMV; in such cases, the probability of infection of the fetus is less than 1%. This is what reproductive specialists are guided by when preparing women for IVF.

When can you do IVF?

Active CMV and IVF are incompatible, despite the fact that CMV transmission during IVF does not occur directly to the embryo, pregnancy can be planned only 6-7 months after infection, when IgM completely disappears in the blood and only IgG remains.

To determine when infection occurred, an indicator such as avidity is used. If the IgG avidity is more than 60%, then the infection occurred more than 5 months ago, which means you can already plan a pregnancy and do IVF.

Thus, in vitro fertilization is carried out if:

• IgG is negative and IgM is negative, but the woman is warned that she needs to be careful not to become infected with CMV, since CMV is transmitted through sexual contact and by kissing;
• IgG is positive and IgM is negative, indicating immunity to CMB.

If IgM is detected, it is necessary to be re-examined and postpone pregnancy planning or IVF for several months until normal immunity to this virus develops.

Cytomegalovirus infection (CMVI) is transmitted sexually, through saliva, common hygiene items (towel, soap), dishes. Nursing mothers pass the infection to their children through breast milk. A pregnant woman infects her fetus with an infection. Treatment of cytomegalovirus in women prevents its development and spread.

Previously, the disease was called "kissing disease" because it was believed that it was transmitted through saliva. With the development of medicine, it became clear that the infection is transmitted not only through this route. It is found in blood, urine, feces, semen, cervical mucus, and breast milk. The infection is also transmitted through blood transfusions and organ transplant operations.

Almost 100% of people are carriers of the infection at the end of life. Statistics show that by the age of one year, every fifth person on the planet is a carrier of cytomegalovirus. By the age of 35, more than 40% develop an infection, and by the age of 50, the same is true for 90%. These data make the infection the most widespread on the planet.

Cytomegalovirus in most cases is a passive infection that occurs when the immune system is weakened. The cause of the disease is the virus Cetomegalovirus hominis, a “relative” of herpes.

The virus does not have clear symptoms, prefers to live in favorable conditions and carefully selects the cells where it will multiply. When the immune system is weakened, the infection attacks the cells, preventing them from dividing, causing them to swell.

Cytomegalovirus cannot be treated. It can be deactivated with the help of immunomodulators and anti-inflammatory drugs. The infection is most dangerous during the period of conception, gestation and breastfeeding, as it causes disturbances in the development of the fetus.

Cytomegalovirus becomes firmly attached to cells and never leaves them. This does not mean that a person will be constantly sick. On the contrary, the infection does not manifest itself in any way in most carriers. The immune system protects the body from viral activity.

For the disease to develop, a significant weakening of the immune system is required. The infection can use any situation as a starting point, even vitamin deficiency, but most often it waits for something strong and unusual. For example, AIDS or the effects on the body of specific medications that destroy cancer pathologies.

Localization and symptoms:

• runny nose with damage to the nasal passages;
• constipation and weakness due to damage to internal organs;
• inflammation with damage to the genitourinary organs (inflammation of the uterus, cervix or vagina).

What diseases does CMV cause?

Cytomegalovirus can manifest as an acute respiratory infection. The person complains of weakness, fatigue, headaches, runny nose, and excessive salivation. Plaque appears on the gums and tongue, and the mucous membranes become inflamed.

The infection can affect internal organs. In this case, inflammation of the tissues of the liver, spleen, kidneys, adrenal glands, and pancreas is diagnosed. Against this background, bronchitis or pneumonia of unknown origin develops, which do not respond to antibiotics. CMV affects the brain and nerves, intestinal walls, and eye vessels. The salivary glands and blood vessels become inflamed. A rash may appear.

When the genitourinary organs are affected, women are diagnosed with inflammation of the uterus, cervix or vagina. In men, infections practically do not manifest themselves at all.

Diagnosis of CMV

It is impossible to detect cytomegalovirus on your own. Its symptoms are unclear and often similar to acute respiratory infections (runny nose, high temperature, sore throat, swollen lymph nodes). Most often, the infection accumulates in the salivary glands, where it is comfortable, so the only symptom may be their inflammation. In rare cases, enlarged liver and spleen are diagnosed.

The only difference between cytomegalovirus and a common acute respiratory infection is the duration of the disease. The impact of the first lasts 30-45 days.

A dermatovenerologist diagnoses cytomegalovirus. The virus is examined using DNA diagnostics - polymerase chain reaction (PCR). Saliva, blood, semen, and cervical mucus are examined under a microscope. During pregnancy, amniotic fluid is analyzed. An abnormal cell size becomes a sign of the virus.

Cytomegalovirus can be detected using an immune test (monitoring the reaction of the immune system). Analysis for this virus is desirable for women who are planning a pregnancy.

Diagnosis of CMV in pregnant women

When cytomegalovirus cells enter the body, the immune system begins to produce antibodies that prevent the active effects of the infection. Thus, the disease enters a latent phase.

To identify an infection in a pregnant woman, a blood test is performed for specific immunoglobulins IgM and IgG. IgM antibodies can accurately indicate the presence or absence of a virus, and IgG indicate an exacerbation of infection only at high levels.

IgM antibodies indicate a primary or recurrent form of cytomegalovirus. If the result is positive, we can talk about the presence of a primary infection or the transition of the virus from an inactive phase to a painful one. If test results show positive IgM, you cannot plan a pregnancy, because the risk of transmitting the virus to the child is high.

In this case, the antibody level is checked every 2 weeks, which makes it possible to determine at what stage the infection is. With a sharp drop in the number of IgM antibodies, there is a recent infection or exacerbation. In case of a slow decline, an inactive phase is diagnosed.

If the IgM level is negative, the infection occurred more than 30 days before the test, but transition to the active phase is still possible. If the result is negative, fetal infection is rare.

Indicators of IgG immunoglobulin may indicate a latent virus, aggravated and primary infection. Everything depends on its quantitative indicators. Increased values ​​indicate the presence of the virus. In this case, the likelihood of fetal infection cannot be determined.

If the IgG value is normal, we can say that there is no virus or that the infection occurred more than 90-120 days before the test. With such indicators, infection of the fetus does not occur. The exception is the simultaneous detection of IgG and IgM antibodies.

In the absence of infection, the amount of IgG will be below normal. Despite the absence of dangerous cytomegalovirus, it is women with this indicator who are at risk. They can become infected during pregnancy.

After infection with cytomegalovirus, IgG levels are constantly detected in the blood. During pregnancy, a transition from the latent phase to the painful phase is possible, even with IgG levels. After infection and transition to the active phase, the indicators increase 4 times or more (compared to the initial figures) and slowly fall.

CMV in a smear of a pregnant woman and other tests

A pregnant woman needs to be tested for TORCH infections (rubella, herpes, CMV, toxoplasmosis and others). The examination is not necessary, but it helps to avoid consequences. The results of these tests will help you understand what dangers and risks pregnancy poses. If the result is positive, you should get tested in another laboratory.

If CMV is detected in a smear at a later stage, you need to carefully monitor the health of the expectant mother. Correct behavior helps to avoid problems with the child's development. You need to strengthen your immune system and eat right. Immunomodulators and antiviral agents are prescribed.

If CMV is detected in a smear in the first 12-13 weeks of pregnancy, pathologies cannot be avoided.

Primary infection during pregnancy occurs in 1-4% of cases. Reactivation (repetition of the acute form) occurs in 13% of pregnant women. Secondary infection with other strains of CMV is also possible. There are 3 registered in total.

Primary infection with cytomegalovirus during pregnancy is extremely dangerous. When the virus first enters the body, there are no antibodies in the blood, which allows it to easily penetrate the fetus through the placenta. During primary infection from a person with an acute exacerbation, infection of the fetus occurs in 50% of cases.

It’s another matter if a pregnant woman became a carrier long before conception. In this case, in the absence of exacerbation, the virus is rarely transmitted to the child. The fact is that when the virus worsens, antibodies are already present in the mother’s blood and begin to fight the pest. During the fight, the cytomegalovirus weakens and cannot break through the placenta. In this case, the risk of fetal infection is 1-2%.

It is important during what period of pregnancy the infection or exacerbation occurred. In the first trimester, the virus can contribute to miscarriage and abnormal fetal development. In the second trimester, the danger is not so likely, and in the third, defects are not diagnosed. However, exacerbation of the virus in the later stages is dangerous due to polyhydramnios and, as a consequence, premature birth and congenital cytomegaly.

Congenital cytomegaly in a newborn

The condition is characterized by the presence of jaundice, anemia, enlarged organs (liver and spleen), pathologies of vision and hearing, blood changes, and serious disorders of the nervous system can be diagnosed.

A blood test will help confirm the presence of the virus. If IgM antibodies are detected, we can talk about acute cytomegalovirus infection. If IgG antibodies are detected, one cannot say for sure, because they could be transmitted to the child from the carrier mother. If they disappear after three months, then there is no infection.

Symptoms of cytomegalovirus in a pregnant woman

In the expectant mother, the infection manifests itself as the flu. There are signs of high fever, weakness, inflammation of the mucous membranes, and runny nose. The picture looks like a respiratory infection, which usually does not go to the doctor.

Probability of fetal infection

The likelihood of infecting the fetus depends on the concentration of cytomegalovirus in the blood. Those who are infected for the first time are most likely to transmit the infection. Antibodies have not yet been developed, so the concentration of the virus is high. Carriers have lower concentrations. Prevention is to protect the pregnant woman and newborn from patients with the acute phase.

Treatment regimen for cytomegalovirus

Cytomegalovirus is incurable. However, with a sufficiently strong defense of the immune system and under the influence of certain antiviral drugs, it does not appear.

Immunity does not develop against cytomegalovirus, so if you have a weak immune system, you need to take medications. Three-month treatment regimen for cytomegalovirus:

• 1 week – decaris (levamisole);
• break of 2 days;
• Week 2 and the following - decaris according to the reverse scheme (2 days only);
• a break of 5 days.

The total is 2950 g of decaris in 3 months. If the drug is ineffective, the course may include T-activin, timotropin, reaferon. It is also possible to use gamma globulin with high levels of anticytomegalovirus.

Popular drugs

When treating CMV, drugs that are effective against herpes are used. However, the course of treatment with such drugs should not be delayed due to their toxicity. Ganciclovir is rarely used because the drug is expensive. However, it is effective against CMV in newborns, reducing the chances of death, weakening the effects of pneumonia and thrombocytopenia, mitigating nervous pathologies, and avoiding abnormal development of the eyes and auditory nerves.

Virazole, ganciclovir and vidarabine are not used because they do not have a strong effect. Foscarnet, guanosine analogues and cymevene are not prescribed to newborns. In adults, these drugs inhibit CMV and prevent its synthesis in cells.

Pregnant and lactating women are prescribed a full range of drugs to strengthen the immune system and drugs that suppress the virus (interferon). However, anti-HCMV therapy for pregnant women and newborns has not been improved. Most often, symptomatic therapy and prevention are carried out.

In women with a burdened medical history (presence of abortions and serious diseases of the genital organs), treatment is carried out using immunity-correcting agents.

Treatment of cytomegalovirus during pregnancy comes down to personal hygiene, heat treatment of food and drug therapy. A woman should consult a gynecologist and virologist.

Hospitalization of pregnant women with CMV occurs 14 days before birth. Infected newborns are isolated from their mother and other children. When breastfeeding, you need to follow good hygiene. It is necessary to thoroughly disinfect the room and linen, and sterilize instruments. The child is examined daily by a doctor. On days 2, 5 and 12, scrapings from the mucous membranes of the eyes, mouth and nose are taken from the newborn for analysis.

It is possible to terminate pregnancy in case of acute form of cytomegalovirus.

IVF for cytomegalovirus

Before artificial insemination, a woman must be tested for CMV. No doctor will issue permission for fertilization if cytomegalovirus is confirmed. A woman must undergo treatment before applying for IVF.

Infertility due to cytomegalovirus

Cytomegalovirus and herpes can cause infertility. These viruses are present in the body of almost every person, but become dangerous only under certain circumstances. The effect of cytomegalovirus and herpes virus on reproductive function has been practically not studied.

CMV itself does not cause infertility, but it causes diseases that lead to it. According to studies, CMV and HHV-6 are contained in the sperm of most infertile men. These viruses provoke inflammation of the genitourinary organs, chronic inflammation,... Cytomegalovirus predominates in men with inflammation of the genitourinary tract. The virus is also able to penetrate germ cells.

Cytomegalovirus can interfere with the natural conception of a child, as well as artificial insemination.

STIs), have always been and will be relevant and pressing topics.">

Cytomegalovirus and infertility - how are these two concepts related? Cytomegalovirus and infertility in women are indeed closely related, and infertility can be called one of the most serious consequences of cytomegalovirus.

Cytomegalovirus is the cause of infertility: why does this happen? The fact is that herpes and cytomegalovirus cause diseases that can subsequently lead to infertility rather than being the cause of infertility themselves. Cytomegalovirus and herpes were found in the semen of most infertile men, which allows us to draw certain conclusions. In addition, the development and active spread of cytomegalovirus in the female body, as is known, can lead to the occurrence of such female diseases as oophoritis, vaginitis and endometritis. All this can, after a certain time, provoke female infertility, as a rule, in the absence of proper treatment for these gynecological diseases.

The spread of cytomegalovirus in the body entails disruption of the functioning of the genitourinary system, chronicity of diseases of the urological and gynecological areas, as well as varicocele. In addition, the virus tends to penetrate germ cells and develop its activity there.

In addition, cytomegalovirus can even complicate pregnancy through artificial means, not to mention its occurrence naturally.

Cytomegalovirus: is it possible to get pregnant?

Can you get pregnant with cytomegalovirus or not? CMV does not have a direct effect on pregnancy. The problem is that a woman with this virus has a severely weakened immune system, which entails constant respiratory diseases, inflammation in the body, namely the chronicity of certain diseases, inflammation of the genitourinary system. All this often leads to the formation of adhesions, which become a big obstacle to pregnancy ().

Therefore, to achieve a successful pregnancy, the question of treating these gynecological disorders arises. If the disease affects a man, it is necessary to treat the dysfunction of his genitourinary system.

Cytomegalovirus and IVF

Cytomegalovirus, which causes infertility, sometimes forces a woman to seek help from in vitro fertilization. Can IVF be performed on a woman with CMV? Cytomegalovirus before IVF is not a reason to refuse in vitro fertilization.

Is it possible to do IVF with herpes and cytomegalovirus? Yes, but before that you need to undergo a course of treatment. This therapy involves the use of antiviral drugs. In addition, immunomodulatory therapy is prescribed, which can increase the body's defenses.

According to experts, cytomegalovirus and IVF are compatible. However, it is impossible to completely get rid of the virus completely. However, it can be suppressed.

What treatment should be given for cytomegalovirus before IVF?

Typically, treatment during this period uses drugs that inhibit viral reverse transcriptase. They are called nucleoside-acting drugs. In addition, modulators and stimulants are indicated to increase the body's defenses. Even if a woman becomes pregnant using IVF, she must have a strong immune system. This is necessary so that the embryo can fully attach to the uterus and not be rejected.

However, treatment of cytomegalovirus is indicated when it enters the active stage, when it unfolds its vital activity in the female body and causes irreversible harm to it. However, before treatment, it is necessary to carry out appropriate diagnostics, which will determine whether the virus is present in the body, when the infection occurred and at what stage the disease is now.

It will not be possible to achieve complete remission with this diagnosis. The essence of therapy is to suppress viral activity. The following nucleoside drugs are mainly used for treatment:

1. Acyclovir;
2. Foscarnet;
3. Ganciclovir.

Immunomodulators such as Cycloferon and Interferon are also used in treatment.

Properly prescribed treatment is necessary to prepare a woman’s body for in vitro fertilization. It is interesting that during such preparation the body begins to rebuild itself and the body’s defenses noticeably increase. This can lead to pregnancy naturally when the woman no longer expects it and has almost lost hope. If this happens, you will need to be closely monitored by a doctor during pregnancy. This is necessary to prevent various kinds of complications that can harm the health of the mother and fetus, as well as lead to the development of defects in the functioning of systems and organs.

Another of the insidious sexually transmitted diseases is caused by a virus of the same group to which the herpes virus belongs. Since viruses are widespread and are also transmitted by airborne droplets (i.e., through the air), it is not surprising that, according to WHO, almost 90% of people are carriers of cytomegalovirus (CMV) infection. However, only a few get sick, namely those whose virus has become more active due to decreased immunity or if the person has become infected with a certain form of the activated virus.

CMV was first described in 1893, and was initially semi-officially called the “kissing” disease, since it was assumed that the infection was transmitted through saliva. Only in 1923 was it proven that the disease is mainly transmitted through sexual contact, as well as from a pregnant woman to the fetus, and even through close household contacts. In recent years, there have been reports that CMV has manifested itself after blood transfusions and organ and tissue transplants, although this has not been proven. And finally, in 1956, the virus was examined under an electron microscope. Most often, CMV is disguised as an acute respiratory disease, since it manifests itself with exactly the same symptoms: fever, runny nose, swelling of the pharynx, although in addition to this usual set, enlargement of the cervical lymph glands, spleen and liver is also often observed. In the most severe cases, paralysis and damage to brain structures occurs, which leads to death. Unlike acute respiratory infections, cytomegalovirus infection lasts up to 4-6 weeks. More often, CMV occurs locally, affecting only the salivary glands, which swell, giving the patient’s face a specific appearance. But more often, this type of disease is not accompanied by a disability, goes unnoticed, and in the future it is possible to bring the patient to memories only as a result of careful targeted questioning. In addition, CMV can occur repeatedly, since immunity to the virus is not formed. If a child is sick, in addition to symptoms similar to flu or acute respiratory infections, he may have pneumonia, dysfunction of the stomach and intestines, and in the most severe cases, damage to the endocrine system (impaired production of hormones in the pituitary gland, adrenal glands, testicles). If the virus is activated in a pregnant woman, then, as a rule, intrauterine fetal death occurs; less often, a child is born so sick that she dies in the next few weeks. Therefore, if a woman has repeated cases of fetal or newborn death, it is MANDATORY to check her for the presence of CMV. If a child is born alive, then his liver and spleen are enlarged, jaundice and anemia increase. Disorders of the nervous system are manifested by seizures, brain damage, and mental retardation. The eye and optic nerves may be affected. Diagnosing CMV is difficult, since the virus is simply not visible under a regular microscope. Therefore, first, especially sensitive cells are infected with tissues in which the virus is suspected, and only then, after a few days, they look at what destruction has occurred in them. In addition, neutralization reactions with antisera, as well as ELISA (immunofluorescence) are used. Treatment of the disease should be carried out only if there is a clinical diagnosis of the disease, as well as for preventive purposes for women who are about to give birth, since, as already mentioned, CMV is widespread, but usually does not cause trouble to the carrier. To treat CMV, immunostimulants and antiviral drugs are used - Acyclovir, Virolex, Zovirax, Ciclovir and others, and in severe cases Cymevene.