Placentitis is an inflammatory, usually bacterial, infection of the placenta that is much less relevant to human medicine today than it is to veterinary medicine. The disease exclusively affects pregnant women and in most cases is transmitted vaginally, causing premature rupture of the amniotic sac so that the infection can spread to the fetal membranes. As a result, abortion usually occurs in early stages of pregnancy, whereas in later stages the child can often be born but is usually not viable because of the infected organ structures.
What is placentitis?
Placentitis involves an inflammatory infection of the placenta. This condition sometimes affects women during pregnancy and can result in abortion of the embryo. Thus, maternal diseases such as syphilis, toxoplasmosis or rubella can spread to the fruit. In most cases, the causative infection of placentitis is transmitted vaginally. However, in diseases such as syphilis, transmission via the blood cannot be ruled out in the case of intact fetal membranes. For human medicine, placentitis now no longer plays too significant a role.
Causes
Transmission of placentitis infection most commonly occurs when the amnion ruptures prematurely. When the amnion, as part of the amniotic sac, is prematurely ruptured or injured, the pathogens can easily migrate into the fetal membranes during vaginal transmission and infect the fetus. Most commonly, the causative agents of placentitis are bacterial, but viruses and fungi are also theoretically possible. Lack of hygiene often plays an increased role in the infection. In addition to group B streptococci, staphylococci, enterococci, bacteria of the chlamydia group and listeria or coli bacteria are among the most common pathogens of the disease. Listeria in particular reaches the fetus via the placenta. Most other bacteria are not able to do this. Via infection of the placenta, the fetus is automatically infected as well.
Symptoms, complaints and signs
The symptoms of placentitis depend on both the stage of pregnancy and the type of pathogen. For example, with pathogens of the chlamydia group, the affected person may suffer from Q fever, which causes the symptoms of flu and a feeling of weakness that is sometimes severe. Pain also occurs concomitantly. In some circumstances, the rupture of the amnion makes itself felt in the form of discharge. However, since placentitis can have different faces and therefore hardly anything can be said in general terms about the symptoms, any kind of discomfort during pregnancy should be clarified by a doctor.
Diagnosis and course of the disease
The physician makes the diagnosis of placentitis by taking a medical history and performing accompanying laboratory tests. Placentitis differs in its course with the particular pathogen. In some circumstances, severe inflammation may be accompanied by severe fever and greatly elevated CRP levels. Depending on the stage of pregnancy, the infection of the fetus can cause an abortion. Even if an abortion does not occur, however, the chances of survival of the embryo in the long term remain minimal. The pathogens usually migrate to the embryo‘s organs. After birth, the child is thus still infected with the disease. In most cases, it therefore succumbs to the consequences of placentitis, although it may have survived the infection while still in the womb.
When should you go to the doctor?
Placentitis should be treated by a doctor in any case, because the disease can lead to the loss of the child and thus to stillbirth or premature birth. To avoid these complications, placentitis should always be diagnosed and treated early. A doctor should be consulted at the very first signs of this condition. As a rule, the doctor should be consulted when the pregnant woman suffers from severe fever and a feeling of weakness. The symptoms are very similar to the symptoms of flu. However, if they last longer, a doctor should be consulted. Likewise, a discharge may indicate placentitis and should also be examined. Placentitis can be diagnosed and treated by a gynecologist. In emergencies, the hospital should be visited. In most cases, placentitis can be cured by taking antibiotics, resulting in a positive course of the disease without complications.
Treatment and therapy
The physician decides on a course of therapy for placentitis depending on the type of pathogen and the mother’s symptoms. In principle, the administration of medication during pregnancy is a delicate matter. However, since placentitis is a serious disease that endangers not only the life of the embryo but also the mother, the physician must usually still opt for drug treatment in this scenario. In most cases, the administration of antibiotics is essential. Ampicillin is the most commonly used, but the type of antibiotic ultimately also depends on the pathogen in each individual case. Depending on how high the mother’s CRP level is, and depending on the level of any accompanying fever, the doctor may have to induce a delivery, which will rarely deliver the baby viable.
Complications
In most cases, placentitis results in abortion. Even if the child survives the pregnancy and birth, the children usually die immediately after birth because they are not viable. In most cases, the parents and relatives of the patient are then in need of psychological therapy and treatment, as this causes depression or other psychological upsets. The mother suffers from very severe pain due to placentitis and further also from flu. There is a general weakness and a significantly reduced resilience of the patient. Treatment of placentitis is usually not possible. During pregnancy, however, the mother is dependent on taking antibiotics and other medications to survive the pregnancy. The triggering disease thus passes to the embryo, so that the child is born with various malformations. However, further pregnancies are not affected by placentitis. Possibly, contact with pets should be avoided during pregnancy.
Prevention
There are several guidelines to prevent placentitis. For example, infection with toxoplasmosis can be triggered via close contact with pets, so especially cats. However, this usually occurs at most when the animal regularly salivates in the pregnant woman’s face or even comes into contact with wounds on her body. General hygiene is thus one of the best preventive measures against placentitis. Infections such as rubella, steptococcus or pneumococcus can also be prevented by vaccination. In principle, regular blood checks via laboratory tests are recommended during pregnancy so that any infections can be detected at an early stage. However, since placentitis rarely occurs in humans today due to high standards of hygiene, pregnant women still do not have to live in fear of the disease.
Follow-up
In placentitis, only limited measures of aftercare are usually available to those affected. In this disease, first and foremost, a rapid and, above all, a very early diagnosis is necessary in order to alleviate the symptoms of the disease in time and to limit them. As a rule, the disease cannot be cured on its own, so that those affected are dependent on treatment by a doctor. In most cases, those affected are dependent on an abortion. Affected persons are dependent on intensive encouragement and support from their own family after this procedure, whereby loving conversations are especially necessary to prevent the development of depression and other psychological upsets. If the pregnancy is continued despite the placentitis, the affected women are usually dependent on taking antibiotics. Regular intake with the correct dosage should always be observed. In case of any uncertainties or questions, a doctor should be contacted first. It should also be noted that antibiotics should not be taken together with alcohol. The further course of placentitis depends strongly on the time of diagnosis, so that a general prediction is usually not possible in this case.
What you can do yourself
In this disease, the child of the expectant mother is extremely endangered, which means a great burden for the patient. Therefore, psychotherapeutic support is highly recommended.The other family members who have to deal with the diagnosis of placentitis can also be included in this therapy. Although it is often not advisable to take medication during pregnancy, it is essential to follow medical advice here. Prescribed medications such as antibiotics must be taken as prescribed. Not only the health of the patient but also that of her child depends on this compliance. The affected patient should be advised to get plenty of rest, if possible even bed rest. In the case of high fever, cold calf compresses have proven effective. They can gently lower the temperature. A healthy diet is particularly recommended in this pregnancy situation. The patient’s diet should include plenty of fresh fruit, salad and vegetables, as well as high-fiber foods such as oatmeal, whole-grain bread or flaxseed, lean cold cuts and light cheese. It is better for the patient to avoid alcohol, sugar and sweets. Instead, she may drink plenty of water, teas or diluted juices. Of course, the patient should not smoke and should not expose herself to unnecessary stress. Meditations, breathing exercises and relaxation techniques such as Jacobson’s Progressive Muscle Relaxation are well suited to bring the patient to rest.
