Infections in Pregnancy

Nov 18, 2014 posted by Meenu Gopal
This week I would like to talk about different illness that can affect the outcome of pregnancy and the role of preventive care.

Let us start with the first trimester and how important the role of being immunized against mumps, measles ,rubella, influenza. Infection by any of these  easily preventable illness can cause first trimester abortions, congenital birth anomalies, deafness  and sterility in unborn kids.

Traditionally,the only viral infections of concern during pregnancy were those caused by rubella virus, CMV, and Herpes Simples Virus(HSV). Other viruses now known tocause congenital infections include Parvovirus (B19), chicken pox virus, measles virus, enteroviruses, adenovirus, and human immunodeficiency virus (HIV).

Worldwide congenital HIV infection is the major cause of infant and child morbidity and mortality .In the USA in 2010 there were 217 children less than 13 years of agewho had HIV and 70% got them during childbirth.

30 to 60% of women receiving prenatal care have proof of past HSV(herpes simplex virus)infection in blood tests. Although both HSV-1 and HSV-2 may cause newbornherpes affecting the eyes, HSV-2 is responsible for 70% of cases.

Measles virus infection (rubeola) during pregnancy, as with chicken pox(VZV infection), tends to present as severe respiratory infections in newborns.

Group B Streptococcus is the most common bacterial life-threatening infections in newborns and can also affect the mother. As per standard recommendations at 35-37 weeks of pregnancy, all pregnant women should get tested with a vaginal swab for culture.

Urinary tract infections (UTI) are an especially important topic in pregnancy, as even urine infections with no symptoms can lead to complications like kidney infections and preterm labor.

Any infection in the urine with or without symptoms should be treated to prevent the above complications.

Cautious use of antibiotics is especially important during pregnancy because they can affect both the mother and the fetus. Without exception all antibiotics cross the placenta; thus, the fetus is exposed to the adverse effects of every antibiotic taken by the mother. Although prescription drugs account for less than 1% of all congenital malformations, potential teratogenic effects must be considered since antimicrobials are so commonly prescribed. As always ask your doctor about the safe antibiotics in pregnancy for you in case you need any.

Influenza in pregnancy can be more harmful to both mother and baby than if you get the flu as a non pregnant person. There is risk of pneumonia and preterm labor for the mother and baby.

Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy has been shown to protect both the mother and her baby (up to 6 months old) from flu. (The nasal spray vaccine should not be given to women who are pregnant.)

The Flu Shot is Safe for Pregnant Women and highly recommended.
It is beyond the scope of this chat to cover in detail more aspects of infection in pregnancy but I will keep chiming in more over the coming weeks.

Meenu Gopal, MD

 
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Nov 18, 2014 posted by Bob Singh
Nov 18, 2014 posted by Meenu Gopal
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