Infections during pregnancy can pose a threat to the fetus. Even a simple urinary tract infection, which is common during pregnancy, should be treated immediately. An infection that goes untreated can lead to preterm labor and rupture of the membranes surrounding the fetus. Some infectious diseases include:
- Toxoplasmosis
Toxoplasmosis is an infection caused by a single-celled parasite named Toxoplasma gondii. Although many people may have toxoplasma infection, very few have symptoms because the immune system usually keeps the parasite from causing illness. Babies who became infected before birth can be born with serious mental or physical problems. Toxoplasmosis may cause flu-like symptoms, swollen lymph glands, or muscle aches and pains that last for a few days to several weeks. Mothers can be tested to see if they have developed an antibody to the illness. Fetal testing may include ultrasound and testing of amniotic fluid or cord blood. The standard course of treatment is antibiotics. The following measures can help prevent toxoplasmosis infection:
- Wear gloves when you garden or do anything outdoors that involves handling soil. Cats, who may pass the parasite in their feces, often use gardens and sandboxes as litter boxes. Wash your hands well with soap and warm water after outdoor activities, especially before you eat or prepare any food.
- Have someone who is healthy and not pregnant change your cat's litter box. If this is not possible, wear gloves and clean the litter box daily (the parasite found in cat feces can only infect you a few days after being passed). Wash your hands well with soap and warm water afterward.
- Cook meat thoroughly (especially chicken and pork), until it is no longer pink in the center or until the juices run clear. Do not sample meat before it is fully cooked.
- Food poisoning
A pregnant woman should avoid eating undercooked or raw foods because of the risk of food poisoning. Food poisoning can dehydrate a mother and deprive the fetus of nourishment. Food poisoning can also cause meningitis or pneumonia in a fetus, resulting in possible death. Tips for preventing food poisoning include:
- Thoroughly cook raw food from animal sources, such as beef, pork and poultry.
- Wash raw vegetables thoroughly before eating.
- Keep uncooked meats separate from vegetables, cooked foods and ready-to-eat foods.
- Avoid raw (unpasteurized) milk or foods made from raw milk.
- Wash hands, knives and cutting boards after handling uncooked foods.
- Sexually transmitted diseases
- Chlamydia — infections like chlamydia may be associated with premature labor and rupture of the membranes.
- Hepatitis — an inflammation of the liver that results in liver cell damage and destruction. Five main types of the hepatitis virus have been identified. The most common type that occurs in pregnancy is hepatitis B (HBV). This type of hepatitis spreads mainly through contaminated blood and blood products, sexual contact and contaminated intravenous needles. Although HBV resolves in most people, about 10 percent will have chronic HBV. Hepatitis B virus can lead to chronic hepatitis, cirrhosis, liver cancer, liver failure and death. Infected pregnant women can transmit the virus to the fetus during pregnancy and at delivery.
The later in pregnancy a mother contracts the virus, the greater the chance for infection in her baby. Signs and symptoms of HBV include jaundice (yellowing of skin, eyes and mucous membranes), fatigue, abdominal pain, loss of appetite, intermittent nausea and vomiting. A blood test for hepatitis B is part of routine prenatal testing. HBV positive mothers may receive a drug called hepatitis B immune globulin. Infants of HBV positive mothers should receive hepatitis B immune globulin and the hepatitis B vaccine within the first 12 hours after birth. Babies of mothers with unknown HBV status should receive the hepatitis B vaccine within the first 12 hours after birth. Babies of mothers with negative HBV status should be vaccinated before hospital discharge. Premature infants weighing less than 4.5 pounds born to mothers with negative HBV should have their first vaccine dose delayed until one month after birth or hospital discharge. It is recommended that all babies complete the hepatitis B vaccine series to be fully protected against hepatitis B infection.
- Human immunodeficiency virus (HIV) — a woman with human immunodeficiency virus (HIV) has a one in four chance of infecting her fetus. AIDS (acquired immune deficiency syndrome) is caused by the human immunodeficiency virus (HIV), which kills or impairs cells of the immune system and progressively destroys the body's ability to fight infections and certain cancers. The term AIDS applies to the most advanced stages of an HIV infection. HIV is spread most commonly by sexual contact with an infected partner.
HIV may also be spread through contact with infected blood, especially by sharing needles, syringes or drug-use equipment with someone who is infected with the virus. According to the National Institutes of Health, HIV transmission from mother to child during pregnancy, labor and delivery, or breastfeeding has accounted for nearly all AIDS cases reported among U.S. children.
Some people may develop a flu-like illness within a month or two after exposure to the HIV virus, although many people do not develop any symptoms at all when they first become infected. Persistent or severe symptoms may not surface for 10 years or more, after HIV first enters the body in adults, or within two years in children born with an HIV infection.
The Institute of Medicine, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics and other health organizations recommend HIV testing for all pregnant women. Prenatal care that includes HIV counseling, testing and treatment for infected mothers and their children saves lives and resources. HIV positive women may need to take a number of medications during pregnancy and labor. Blood tests are also performed to check the amount of circulating virus. Newborn babies of HIV positive mothers may also receive medication. Studies have found that giving a mother antiretroviral medications during pregnancy, labor and delivery can reduce the chance of a mother transmitting HIV to her baby from 25 percent to less than 2 percent. Since the CDC began recommending routine HIV screening for all pregnant women in 1995, the estimated incidence of mother-to-child transmission has dropped by approximately 85 percent. Cesarean delivery is often recommended for HIV positive women with high viral loads. Because breast milk contains the virus, HIV positive women should not breastfeed their babies. Studies show that breastfeeding increases the risk of HIV transmission.
- Herpes — genital herpes can be spread to the baby during delivery if a woman has an active infection at that time. Herpes is a sexually transmitted disease caused by the herpes simplex virus (HSV). Herpes infections can cause blisters and ulcers on the mouth or face (oral herpes) or in the genital area (genital herpes). HSV is a life-long infection. Symptoms of HSV may include painful blisters or open sores in the genital area, which may be preceded by a tingling or burning sensation in the legs, buttocks or genital region. The herpes sores usually disappear within a few weeks, but the virus remains in the body and the lesions may recur from time to time.
It is important that women avoid contracting herpes during pregnancy because a first episode during pregnancy creates a greater risk of transmission to the newborn. Women may be treated with an antiviral medication if the disease is severe. Genital herpes can cause potentially fatal infections in babies if the mother has active genital herpes (is shedding the virus) at the time of delivery. Cesarean delivery is usually recommended for active genital herpes. Fortunately, infection of an infant is rare among women with genital herpes infection.
Protection from genital herpes includes abstaining from sex when symptoms are present and using latex condoms between outbreaks.