Birth Injury:

Infections

When a pregnant woman develops an infection, the infant's neurological outcome depends on the type of infection, the gestational age of the fetus at the time of the infection, the route of infection, and the quality of obstetric and neonatal care. There are two major types and routes of maternal infection.

Hematogenous Viral Infection

Hematogenous viral infection: Generally, maternal viral infections originate in the mother's blood. They are transmitted to the fetus via the maternal blood bathing the villi (the tiny, fingerlike projections of the placenta through which the mother and baby exchange nutrients, gases, and fetal wastes) in the intervillous space.

Viral infections can attack a fetus's brain cells and precipitate a metabolic disorder that restricts their normal growth and development. Physicians may conduct a series of tests on the mother during a pregnancy to screen for toxoplasmosis, other viruses, rubella, cytomegalovirus, and herpes symplex. This is known as TORCH testing. Also, neuroimaging studies performed after the infant is delivered may reveal a pattern of congenital brain lesions that is characteristic of infection.

Ascending Bacterial Infection

Ascending bacterial infection: Maternal bacterial agents usually ascend through the cervix, penetrate the placental membranes, and penetrate the amniotic fluid. This can occur even when the membranes are intact. These infections may cause changes in the placenta that interfere with its capacity to deliver oxygen and nutrients to the fetus and/or to eliminate wastes and carbon dioxide. The fetus also may be exposed to bacteria during vaginal delivery and develop an infection after birth, known as sepsis.

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