Getting sick when you're pregnant can be a very scary situation. Not only do you feel ill, but you're also concerned that your sickness will hurt your baby. Fortunately, the average cold or stomach upset is nothing to worry about. But some illnesses need to be taken seriously, such as the parasitic infection toxoplasmosis and the viral infection hepatitis B. If these infections aren't treated properly and promptly, they can harm you and your baby. Fortunately, taking the proper steps to reduce the chance that you'll contract these illnesses is easy.
Pregnancy Infections: Hepatitis B
Hepatitis B is a viral infection that causes liver inflammation. The virus is spread by contact with blood or other bodily fluids from an infected person. You are at increased risk if you live with or are sex partners with an infected person, have multiple sex partners, or are a health-care worker. This virus can produce a number of distressing symptoms, including fatigue, nausea, and jaundice. Fortunately, most people recover completely.
However, about 5 to 10 percent of women who have had hepatitis B continue to carry the virus in their system and can pass it on to their babies. These lifelong carriers of the virus are at increased risk of developing severe liver diseases such as cirrhosis (hardening of the liver) and liver cancer.
About 20,000 babies are born each year to women who either carry hepatitis B due to past infection or get it for the first time during pregnancy. Without treatment, as many as 50 percent of these babies contract the virus, usually during labor and delivery. The risk is highest when a woman gets hepatitis during the third trimester or carries a particularly active form of the illness. Most infected babies become chronic carriers who face a high risk of serious liver disease as adults.
The CDC recommends that all pregnant women be screened for hepatitis B. If you carry the virus, there's an 85 to 95 percent chance that infection can be prevented in your baby if he receives immune globulin therapy and the hepatitis B vaccine within 12 hours of birth, and two more doses of the vaccine in the first six months of life. The CDC also recommends that all babies be vaccinated against hepatitis B. Your best defense against this virus is prevention: Avoid exposure to the virus, and get the vaccine, which is considered safe during pregnancy — especially if you have risk factors.
Pregnancy Infections: Toxoplasmosis
Though you may never have heard of it before, toxoplasmosis is one of the most common infections in the world today. A person gets infected with this parasite by eating undercooked meat or through contact with cat feces. It's particularly prevalent in populations without high standards of hygiene, or in places where people often eat raw or undercooked meat, such as France.
Because toxoplasmosis is symptomless or mimics a mild flu, most cases go undiagnosed. If you've had this parasite before, you don't have to worry about it, because you will have developed immunity. You can't pass it on to your unborn baby, and it's unlikely that it will give you any trouble. The parasite will simply drift around dormant as long as your immune system is functioning normally. If you're planning to conceive and don't know whether you've had toxoplasmosis, ask your health-care provider if you should have a blood test that can show whether or not you're immune. This test is not a routine pregnancy screening (unless you have symptoms of toxoplasmosis), because it can't distinguish a harmless past infection from an active new one.
Though toxoplasmosis is not as common in the U.S. as it is in other nations, you can still get it and pass it on to your baby. In fact, between 1 in 1,000 to 1 in 10,000 babies in this country are born infected with the illness, which can pose a serious health threat to newborns. About 1 in 10 infected babies has a severe infection, resulting in conditions such as enlarged liver and spleen, jaundice (yellowing of the skin and eyes), and pneumonia. If left untreated, some babies die within a few days of birth. Those who survive may suffer from mental retardation, seizures, and other health problems for the rest of their lives.
Perhaps the most frightening fact about toxoplasmosis is that up to 90 percent of infected babies appear completely normal at birth. Fifty-five to 85 percent of these children develop health problems months to years later, including eye infections, hearing loss, and learning disabilities. Fortunately, if you had the illness but your baby is symptomless, he'll be tested and diagnosed at birth so he can receive the proper treatment. Infected babies are treated with two medications, pyrimethamine and sulfadiazine, throughout the first year of life, or even longer, to help prevent lasting disabilities.
If you experience any symptoms of toxoplasmosis, such as swollen glands and general malaise, talk to your doctor immediately. He may recommend one or more of several available blood tests. These tests require expert interpretation, and therefore the Centers for Disease Control and Prevention (CDC) recommends that all positive test results be confirmed by a laboratory with special expertise in diagnosing the infection.
If the laboratory confirms you have toxoplasmosis, the next step is to determine whether or not your unborn baby is infected. Tests such as amniocentesis will help confirm the diagnosis. If your doctor thinks that your baby is infected, he'll treat you with pyrimethamine and sulfadiazine. These drugs will help reduce the frequency and severity of the baby's symptoms after birth. If tests show that the fetus is not yet infected, you may be given a special antibiotic called spiramycin, which can reduce the likelihood of your baby's infection.
Here are a few ways that you can avoid the illness altogether:
- Never eat raw or undercooked meat. When you prepare meat at home, cook it to an internal temperature of 160 degrees and make sure it's pale pink or brown, not red. At restaurants, order your meat well done, and if you wind up with a reddish piece, send it back and ask that it be cooked until it's brown in the middle.
- After handling raw meat, wash your hands with soap and water immediately and don't touch your eyes, nose, or mouth, which is how the parasite gains entry to your body.
- Clean all of your cutting boards, work surfaces, and utensils thoroughly with hot, soapy water after contact with raw meat or unwashed produce.
- Peel or thoroughly wash all raw produce before you eat it.
- Don't empty or clean the cat's litter box during pregnancy.
- Don't feed your cat raw or undercooked meat. Doing so can start the cycle of infection.
- Keep your cat indoors to prevent him from hunting birds or rodents. Contact with these animals could infect him with the parasite.
Richard H. Schwarz, MD, obstetrical consultant to the March of Dimes, is past president of the American College of Obstetricians and Gynecologists, and the chairman of the department of obstetrics and gynecology at New York Methodist Hospital in Brooklyn.
The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.
Content courtesy of American Baby