Avoiding infections in pregnancy
Like all adults and children, pregnant women are at risk for developing viral and bacterial infections. Some infections during pregnancy are of particular concern as they be more severe in pregnant women or may harm the fetus or newborn. However, you can take steps to decrease the chance of developing a potentially harmful illness during pregnancy.
Avoiding Exposure To Infections In Pregnancy
The following practices can help reduce the chance of exposure to infections known to cause problems during pregnancy.
Hygiene
Pregnant women can get infections by person-to-person contact, such as kissing, sexual contact, and handling another person’s body fluids (eg, saliva or urine) and then touching their eyes, nose, or mouth. Good hygiene practices, such as frequent hand washing and avoiding contact with another person’s saliva through shared foods, drinks, or utensils, can lessen your chances of becoming infected with potentially harmful illnesses.
Good hygiene is particularly important for pregnant women who have young children or work with them, as in day care centres or schools. Some potentially harmful infections, such as cytomegalovirus, are more prevalent in young children.
Hand washing
Hand washing is an essential and very effective way to prevent the spread of infection. Hands should be washed before and after touching raw foods and eating, after going to the bathroom, after changing a nappy or assisting a child with toileting, after wiping a young child’s nose, after handling garbage or dirty laundry, after touching animalsor pets, after handling children’s toys, after contact with another person’s saliva, and after gardening or touching dirt/soil.
Hands should be wet with water and a plain or antimicrobial soap and then rubbed together for 15 to 30 seconds. Pay special attention to the fingernails, between the fingers, and the wrists. Rinse the hands thoroughly and, ideally, dry with a single use towel.
Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. Spread hand rubs over the entire surface of hands, fingers, and wrists until dry. Hand rubs are available as a liquid or wipe in small, portable sizes that are easy to carry in a pocket or handbag. When a sink is available, visibly soiled hands should be washed with soap and water.
Food precautions
Products made from unpasteurized milk, raw cake batter, raw or very undercooked meat or fish or shellfish and store-made meat/seafood salads can contain bacteria that may be harmful for pregnant women. Raw fruits and vegetables should be washed before consuming.
Insect borne illnesses
Pregnant women should take precautions that reduce the risk of acquiring mosquito-borne infections eg, Zika virus. Mosquito bites can be prevented through use of protective clothing (or screens or netting), avoiding the outdoors when mosquitoes are most active (dawn and dusk), and use of DEET-based insect repellents. DEET is the most effective insect repellent currently available. Products with 10 to 35 percent DEET are adequate in most circumstances. Used as recommended, DEET has an excellent safety record. Pregnant and breastfeeding women can use DEET.
Sexually transmitted infections
Pregnant women should be aware that your risk of being infected with a sexually transmitted infection may increase if you have more than one sexual partner or if your partner has more than one sexual partner. If your partner may have other sexual partners, you should ask him to wear a condom to reduce the chance of getting a sexually transmitted infection, or you can use a female condom. You should avoid having sex, even with a condom, if your partner has signs of a sexually transmitted infection, such as discharge from the penis, pain when urinating, or blisters or sores on the genital skin.
Users of recreational drugs can acquire infections such as hepatitis and HIV from needle sharing and then transmit these infections through sexual contact.
Travel
Avoiding travel to high risk locations is one way to minimize the chances of becoming infected with certain infectious diseases, such as zika, malaria and yellow fever. The possibility of acquiring a food- or water- borne infectious disease is also higher in some parts of the world. For example, unpasteurized cheese is more widely available in France than in Australia. Women who are planning international travel during pregnancy should consult with a travel clinic about infection-related issues for the planned destination.
Immunization
If possible you should be up-to-date on your immunizations before pregnancy. Some immunizations, such as influenza and pertussis can and should be given during pregnancy. Children and other family household members should also be up to date with their immunizations; this decreases a pregnant woman’s risk of exposure to infections during pregnancy and both the mother and baby’s risks of exposure to infection after birth.
Animal borne illnesses
Women who are pregnant or planning pregnancy should avoid contact with all rodents (and rodent droppings) and should not change cat litter boxes, or should wear gloves and then wash their hands.
Airborne infections
Some infections are transmitted when a person inhales droplets containing germs that an infected person coughs or sneezes into the air. Minimizing close contact with an ill person and wearing a mask can reduce transmission. Good hand washing also decreases the chance of infecting oneself after touching surfaces with germ-containing droplets.
Infections During Pregnancy
Several infectious diseases can cause problems in pregnancy. Currently, these infections cannot be prevented with a vaccine. These infections are best avoided by practicinggood hygiene and avoiding direct contact with infected individuals to the best of your ability.
Parvovirus B19 (Slapped cheek or Fifth disease)
Parvovirus B19 infection, also known as “ slapped cheek” and”fifth disease,” is a common childhood viral infection. Since the infection is common during childhood, 40 to 60 percent of women are already immune by the time they become pregnant.
In adults, parvovirus causes mild to severe symptoms, including joint pain, fatigue, and body aches. A rash may appear on the face, trunk, arms, and legs. The rash on the face can be intensely red as though the person had been slapped (this is called a “slapped cheek” appearance). The illness generally resolves without treatment.
It is difficult to avoid contact with people who are infected with parvovirus because the infection is common in the community and an infected person is contagious before symptoms develop. Frequent hand washing and avoiding shared food, drinks, or utensils can help to prevent infection. If you are exposed to parvovirus during pregnancy and you have not been tested previously, a blood test for parvovirus is recommended. A positive test soon after exposure means that you had the infection in the past and are now immune, so the fetus is protected from infection. If blood testing is initially negative, it mamay be repeated three to four weeks later to confirm that you have not developed the infection.
Pregnant women who become infected with parvovirus are monitored closely for signs of complications. Rarely, parvovirus can cause a miscarriage, fetal anemia (low blood count), or fetal heart problems.
Cytomegalovirus infection (CMV)
Cytomegalovirus (CMV) is a virus that is transmitted by sexual contact or close contact with an infected person’s saliva, urine, or other body fluids. Being infected with CMV causes few or no problems in people with a healthy immune system. However, the virus can cause serious problems for infants of mothers who are infected with CMV during pregnancy. The risk of becoming infected with CMV for the first time is higher for pregnant women who live with young children or work in day care centers.
Currently, there is no way to prevent CMV infection. Medications to treat CMV in newborns are currently being studied. Vaccines against CMV are also being tested, but are not yet available.Good hygiene practices, especially hand washing, are important to decrease the chances of developing CMV infection during pregnancy.
- Wash your hands often with soap and water, especially after changing diapers, feeding a young child, wiping a young child’s nose or drool, and handling children’s toys
- Don’t share food, drinks, or eating utensils with young children
- Don’t put a child’s pacifier in your mouth
- Don’t share a toothbrush with a young child
- Avoid contact with saliva when kissing a child
- Clean toys, countertops, and other surfaces that come into contact with children’s urine or saliva
If you develop a low-grade fever, sore throat, enlarged lymph nodes, and fatigue while pregnant, see your doctor.
Most pregnant women with CMV do not need to be treated with antiviral therapy. Maternal antiviral therapy does not prevent fetal disease or reduce the risk of complications in the newborn. Although there is a low risk of passing CMV infection to a newborn from breastfeeding, the benefits of breastfeeding outweigh the minimal risk of passing CMV through breast milk.
Toxoplasmosis
Toxoplasmosis is a parasitic illness that usually causes no symptoms. However, toxoplasmosis can affect the fetus if a woman becomes infected during pregnancy.
Pregnant women should avoid eating rare and uncooked meat, which can be a source of this parasite. House cats can also carry toxoplasmosis in their faeces. Pregnant women should have someone else change the litter box or wear gloves and then wash their hands carefully afterwards. It isalso important to wear gloves while gardening and to wash hands after working in the yard since the soil can be contaminated by cat faeces.
Listeria
Listeria is a bacterial infection that can rarely cause fetal death, premature birth, or newborn infection. It can be passed from an infected mother to her fetus through the blood. Signs and symptoms of Listeria include fever, chills, and back pain; a flu-like illness is the most common symptom.
Listeria is a very uncommon illness in Australia because of high food safety standards. Most people who become infected with Listeria have eaten food that is contaminated. Contaminated foods do not appear rotten or spoiled and it is not possible to know, based upon appearance or smell, if a food is safe. For this reason, women who are pregnant are advised to avoid foods that could contain Listeria. These food include
- Processed/delicatessen meats
- Unpasteurised cheeses and dairy products
Australia all cheese locally produced will be pasteurised although some imported cheeses may be not.
Chickenpox and rubella
If you have had chickenpox (varicella) and rubella, you do not have to worry about getting infected again during pregnancy. If you have not had these infections or vaccines to protect you from these infections, be sure to avoid contact with anyone with these infections, as they can be readily transmitted. These infections can be serious for both the mother and baby. However, if a nonimmune pregnant woman is exposed to an individual with chickenpox, VariZIG, a purified human immune globulin preparation, administered within 10 days of exposure and can reduce the risk of developing varicella infection and also attenuate the severity of infection in those who become infected. Vaccination to protect you from chickenpox or rubella is not safe during pregnancy.
Group B streptococcus
Many women normally carry group B streptococcus in their vagina and/or rectum. Although you will not have symptoms, you can transmit the bacteria to the baby during birth. This can cause a serious newborn infection. For this reason, pregnant women are checked for group B strep a few weeks before expected delivery and given antibiotics during labor if they carry the bacteria.
Genital herpes
Women who get genital herpes for the first time near the end of pregnancy or have genital lesions when they go into labor can transmit the infection to the baby during vaginal birth. Anti viral medication taken during pregnancy for women who have a history of recurrent genital herpes can prevent relapses during pregnancy.
Hepatitis
There are several types of hepatitis. Hepatitis infection can be acquired in several ways, including sexually, by blood transfusion, by sharing needles, or during birth. If you or your partner has a history of hepatitis, talk to you doctor about the risk of newborn infection and ways to prevent it.
HIV
HIV can be passed from a mother to her baby during pregnancy and birth. If you have HIV, appropriate treatment and pregnancy care can reduce this risk to a very low level. For this reason, it is important for all pregnant women to be tested for HIV.
Treatment Of Infections During Pregnancy
The safety and availability of treatment for infection in pregnant women depends upon the type of infection and risk of harm (from the treatment or the infection) to the woman and her fetus.
Where To Get More Information
We as your obstetric care provider are the best source of information for questions and concerns related to your medical problem. Please feel free to ask further questions.
