Although Wyoming has a much smaller population and wide open spaces, there is always concern regarding certain illnesses that can signficantly affect a pregnancy. I am going to share some information about some of the known and treatable diseases and infections which I and other Midwives and Women's Healthcare Providers see in our daily practices. Skim through this material and pay close attention to anything which is of personal concern for you. Not all of this information will be relevant for everyone but is certainly a good reference for you to go back to at anytime. Here are several health concerns which all expectant mothers should be aware of, and please share these concerns if you have them, with your healthcare professional.
CHICKENPOX (VARICELLA)
Chickenpox is caused by the varicella virus. Most people contract chickenpox as a child or were vaccinated for it. If you've had it, it is extremely rare to get it again. Your body has antibodies to help protect you and your baby.
Having chickenpox as an adult or while you're pregnant can be more severe. Chickenpox-related pneumonia can be very significant and even life-threatening. Catching chickenpox during the first seven months of pregnancy carries a small risk of causing birth defects. If the infection happens close to the time of birth, it can be fatal to baby if they are exposed once they're born.
If you haven't had chickenpox or the vaccine, avoid contact with anyone who has chickenpox. If you think you've been exposed, a blood test can check to see if you have immunity. Treatment with an injection of a specific immunoglobulin can help prevent a serious infection in the baby. If your blood test results show that you have never had this infection, your healthcare provider will recommend you get immunized after your pregnancy. In my practice I routinely check for immunity with a blood test that is performed at your new OB visit.
CYTOMEGALOVIRUS (CMV)
Cytomegalovirus (CMV) is a common virus that can infect almost anyone. It is related to the viruses that cause chickenpox, herpes simplex and mononucleosis. Once you're infected, the virus remains with you for life, but is not always active. Most people don't know they have CMV because it causes mild or no symptoms.
If you are pregnant and develop an active CMV infection, you can pass the virus to your baby. Premature babies are at the highest risk for infection. If you have flu-like symptoms, a blood test can determine whether you have the disease. There is no cure for CMV, but drugs can help treat newborns and people with weakened immune systems.
FLU
Flu season is usually October through May. Catching the flu when you're pregnant increases your risk for developing pneumonia. It can also cause serious problems for your unborn baby if you become ill with the flu during pregnancy. Getting a flu shot helps protect you and protects your baby after birth until the baby can be vaccinated at six months old. The flu shot given in your arm is made from an inactive virus and is safe to get during pregnancy. The nasal spray version does use a live flu virus and is not recommended if you are pregnant.
When you're pregnant, health experts recommend that you get a flu shot as soon as it becomes available in the fall.
GENITAL HERPES
Genital herpes is a viral disease that causes painful blisters and sores on the sex organs of both men and women. It can also cause flu-like symptoms. A newborn baby exposed to this virus may suffer serious and permanent neurological damage and can even lead to death. Herpes is spread by direct contact with someone who is infected and has active sores or blisters. If you or your sexual partner have had herpes outbreaks in the past, tell your health care provider. There is no cure for herpes, but there are precautions you can take to protect your baby before and during childbirth. Taking medication during the last 4-6 weeks of pregnancy can lower the chances of a flare-up.
If you have active herpes sores when you go into labor or when your water breaks, you will need to have a cesarean birth.
HEPATITIS B
Hepatitis B is an infection of the liver caused by a hepatitis virus. Because it can be passed to your newborn baby, this is a very serious disease. Treatment reduces a baby's risk of dying from the disease. It also prevents the child from unknowingly passing the infection to others later in life.
You will be routinely tested for hepatitis B early in your pregnancy at your new OB visit. If you test positive, your baby will receive special treatment immediately after birth. Newborn babies are now often immunized for hepatitis B before leaving the hospital. If you have hepatitis B, you can still safely breastfeed.
HEPATITIS C
Hepatitis C is another type of hepatitis virus that can infect the liver and be transmitted to a baby during childbirth. But it is much less likely to be passed to the baby than the hepatitis B virus. You wont be routinely tested for hepatitis C unless you have known risk factors. These risk factors include sharing hypodermic needles or having unprotected sex with someone infected with hepatitis C before you became pregnant.
Tell your healthcare provider if you know you have risk factors. Your baby will be checked for hepatitis C at birth and followed during early childhood to see if it develops. There are successful treatment programs for this disease.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
Human immunodeficiency virus (HIV) attacks the body's natural ability to defend itself against infection and sickness. When your immune system fails due to HIV, your body becomes and easy target for infections and certain cancers that don't typically attack the immune system.
A person is considered to have acquired immunodeficiency syndrome (AIDS) when their immune system is so weakened by the virus that it cannot fight off disease or when the person comes down with a specific disease associated with HIV. Risk factors for HIV include sharing intravenous needles or having sex with an infected person.
You will be routinely tested for HIV early in your pregnancy at the new OB appointment. It is recommended that you are tested again closer to your due date if you are at high risk for this disease. There is no vaccine to prevent HIV today. The risk of an infected person passing the virus to their newborn child is about one in four but specific medications taken during pregnancy can reduce the risk of infection to fewer than 2 out of 100 babies. If you have HIV, you should not breastfeed.
LISTERIOSIS
Listeriosis (food poisoning) can be a serious infection. It is caused by eating food contaminated with the listeria bacteria and causes flu-like symptoms like fatigue, chills, fever and muscle aches. Some listeriosis infections during pregnancy can lead to miscarriage, stillbirth, premature birth, or life-threatening infection in the newborn baby.
If it is caught early, listeriosis can be treated with antibiotics. The source of the listeria bacteria is contaminated food, including unpasteurized milk or cheese, hot dogs, luncheon meats, smoked seafood, and unwashed vegetables to name a few.
RUBELLA (GERMAN MEASLES)
Rubella (German measles) is another viral disease that can be harmful if you catch it during the first three months of your pregnancy. Once you've had rubella you are immune for life. Several skin rashes that come with a fever may look like rubella at first. A blood test at the beginning of your pregnancy will determine if you are immune to this disease.
If you think you've been exposed to rubella, call your health care provider immediately. A blood test will show whether you have immunity or if you need to be concerned about your baby. If your blood test results show that you have never had this infection, your health care provider will recommend that you get immunized after the pregnancy. Even if you never had rubella (German measles) you may have immunity because of early childhood vaccination.
MUMPS
Mumps is not common during pregnancy because of the childhood vaccine and low infection rate in at-risk adults. Having the mumps during your pregnancy rarely causes abnormalities in the baby. If you are not immunized, try to avoid contact with anyone who has the mumps.
TETANUS, DIPHTHERIA, PERTUSSIS
The Tdap vaccine is recommended between 27-36 weeks of pregnancy to lower the risk of three serious infections:
Tetanus. A serious disease caused by a bacterial toxin that affects your nervous system, also called lockjaw. Although rare, it affects the breathing muscles. Left untreated it causes death in one out of every five cases. Everyone should get a tetanus shot every 10 years.
Diphtheria. A highly contagious bacterial infection that causes serious respiratory disease.
Pertussis (Whooping cough). A very contagious respiratory infection. In newborns it causes severe coughing spells and makes it hard to breathe. This can be life-threatening.
Health experts recommend that all family members and caregivers get a vaccine at least two weeks before coming into close contact with your new baby. It is also recommended that women be vaccinated during each pregnancy, regardless how much time there is between each pregnancy. If you haven't already been vaccinated, you should get a dose of Tdap immediately after your baby is born.
Toxoplasmosis
Toxoplasmosis is an infection you can get from eating raw or under-cooked, contaminated meat. If you become infected with toxoplasmosis during pregnancy, you may have mild flu-like symptoms or no symptoms at all. But this illness can affect your unborn child, possibly causing permanent eye and neurological damage.
Cats can also transfer this disease. Outdoor cats may ingest the parasites that cause toxoplasmosis by eating small animals like birds, mice or rats. They pass the organism into their stool, contaminating their cat litter box. To avoid toxoplasmosis:
Only eat meat that has been thoroughly cooked, especially wild game such as deer and elk.
Use gloves or ask someone else to scoop the litter box while you're pregnant.
Wash your hands carefully after handling uncooked meats, or working in the garden. I recommend pregnant women wear nonpermeable garden gloves as well.
ZIKA VIRUS DISEASE (ZVD)
Zika virus disease is another infection that has come into light in the last couple years. Most people who get the virus have been bitten by an infected Aedes mosquito. Although less common, infected men can pass the virus to their partners through sexual contact. If you have the Zika virus, you can transmit it to your baby during pregnancy or a childbirth.
The symptoms of the disease are fever, skin rash, joint pain, and conjunctivitis (red eyes). They usually appear 3-14 days after the mosquito bite or sexual contact with an infected partner. Symptoms are not noticeable or mild and can last up to a week. There is currently no vaccine or specific medical treatment of Zika.
Catching this infection during pregnancy can cause serious problems for your baby. Microcephaly (baby's head is smaller than expected), abnormal brain development, visual difficulties, hearing problems, and other neurological disorders have occurred. If you think you've been exposed to the Zika virus, call your health care provider right away.
Aedes mosquitoes live in tropical, subtropical, and temperate climates. The Zika virus is found primarily in South American countries, Puerto Rico, and the U.S. Virgin Islands. There have been scattered reports of transmission by mosquitoes in the southern United States. If you are pregnant or considering pregnancy, do not travel to areas with reported Zika outbreaks. You will find up-to-date travel information at WWWnc.cdc.gov/travel/page/zika-travel-informaton
If your partner lives in or travels to an area where the Zika virus is active or spreading, either use a condom every time you have sex or don't have sex at all.
CORONAVIRUS-COVID-19
Fortunately for residents of Wyoming, the response to the Coronavirus/Covid-19 pandemic has been swift and effective. Here in Sweetwater County, testing became available at breakneck speed and Sweetwater Memorial Hospital opened the first drive through testing facility available in the region. I am proud to say that Memorial Hospital has taken every precaution and has followed exacting guidelines to ensure that the transmission of Coronavirus/Covid-19 be minimal and non life-threatening. Currently these precautions have altered visiting guidelines as well as hospital procedures. It is expected as the situation improves, these guidelines and rules will be updated.
As this virus is not yet fully understood, I will provide answers and solutions that have been provided by United States health officials through resource links which I have listed on the Links and Resources Page. These links are informative and based on official medical research and not hearsay. I will post genuine medical information regarding prevention and treatment options as it becomes available.
As always, feel free to contact me via E-mail or make and appointment if you wish to discuss any of the information I have provided or other questions or concerns that you may have.
Starla
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