Perinatal infection & how to manage in developing country

Perinatal infections especially neonatal bacterial sepsis is the commonest cause of neonatal mortality in India. The fetus may get infected in utero or during birth from the infected bitth canal or may develop nosocomial infeetions any time af ter birth. Few other factors are responsible like spontaneous premature rupture of embrane if un çare & unattended, unnoticed leaking of membıanes at any stage of pregnaney, fetal birth in an unhygienic condition, prolonged labour with mpture membranes and compromised and prematüre birth of a fetus.
Common maternal infeetions in India:
U.T.I, helminthesiasis, monilial and trichomonal vaginosis, Chlamydia infection, recurrent gastloenteritis and amoebiasis, malarial fever, recurrent throat and ehest infection, hepatitis A, B, &. E, maternal syphilis, TORCH infection and AİDS.
Intrauterine infeetions:
It may oecur due t virüs, protozoa, spirochaetes and occasionally by bacteria ineluding mycobacterium tııberculosis. They are popularly known as TORCH infection. Fetal infection oecurs either as a result of direct transplantation passage or due to ascending infection.
Factors predisposing neonatal infectoions:
Low birth weight fetus, contaminated in utero environment, infected birth canal, infection at birth or after birth, congenital anamolies, top feeding, sex of the child, amniocentesis, cordocentesis, amnio infusion, enclotracheal intubation, assisted ventilation, umbilical catheterization and exchange transfusion.
Types of infection:
Superficial infeetions- pyoderma, conjunetivitis, umbilical sepsis and oral thrush.
Infective diarrhoea, septicemia, meningitis, pneumonia, pylonephritis, selerema, necrotizing enterocolitis, systemic candiasis, tetanus neonatorum (iare), congenital tuberculosis(rare), DIC (rare).
How to manage in developing countries:
1. preventive aspect
2. curative aspects
preventive: adolescent health çare, awareness regarding STD and menstrual hygiene, pre rfıarital counseling, pre pregnaney counseling, provision of elean drinking water and net, elean sunounding, stop promiscuity, use of condomn to be promoted, improve general health, avoid sex diserimination, good ante natal çare, requisite investigations-routine ik specific, high vaginal swab colleclion, pap smear of cervix, any fever and infection duıing pregnaney to be investigated and treated adequately, toxoplasmic in endemic and cat-friendly population, handle cat safely, meat should be eaten af ter thorough cooking, vouline aclministration ot chloroqııine to ali the mothers.
Curative:
Early recognition and evaluation of extent of disease , biochemical and radiological investigation, prompt adminislration of effective antimierobial agent, optimal supportive management, immunotherapy, and human and emotional care.