Infections during pregnancy

Pregnancy is an exciting time for a woman but what if an expectant mother develops an infection? It becomes a major concern as there is always a fear that the infection may pass on to the baby. The most common infections in pregnancy are hepatitis B and C, toxoplasmosis, herpes, genital herpes, rubella and HIV.

Rubella is a viral infection. If contracted especially in the first or early part of the second trimester, the baby can be affected. Rubella can cause miscarriage, stillbirth, deafness, cataract and brain damage. It can be detected through a prenatal blood test. Expectant mothers can be immunised for life if found to be non-immune.

Hepatitis B is transmitted via sex and direct contact with infected blood products. It can be easily detected through prenatal tests. Hepatitis B usually affects the liver. If a mother is hepatitis B positive, her infectivity has to be assessed by the HbeAg test. Active and passive immunisation of the baby should also be ensured at birth.

Hepatitis C infects the liver and is transmitted by infected blood products, contaminated needles and syringes and through sex. An expectant mother may pass on this infection to the baby but the risk is much lower as compared to HIV and hepatitis B.

Hepatitis E infects the liver and is transmitted through contaminated water and food. If contracted in the third trimester of pregnancy, it can be fatal, increasing maternal and fetal morbidity as well as mortality.

Toxoplasmosis is an infection caused by cat faeces. This infection can adversely affect the baby. So avoid contact with cats and litter, if possible. Treatment can reduce the risk of the baby being infected and the severity, if the infection is contracted.

Cytomegalovirus is a type of herpes virus. It is known to cause many problems in unborn babies, such as visual impairment, hearing loss and neurological problems.

Chickenpox can be dangerous for a pregnant woman and her unborn baby, depending on which trimester she gets this infection. 95 per cent women are immune to this as they have a childhood history of chickenpox. A simple blood test can determine the immunity status.

Genital herpes can be dangerous for the baby, especially at the time of delivery. If it occurs early in pregnancy, treatment is available. A mother diagnosed with genital herpes may be advised a caesarean section to avoid transmission to the baby during labour.

HIV or retroviral infection is screened as a part of routine antenatal tests. If results are positive, counseling is required on how to prevent transmission to the baby and how to treat this infection during pregnancy and delivery. HIV can be transmitted to the baby during delivery. Treatment in pregnancy can successfully reduce transmission to less than 1 in 100. A mother having HIV will be advised not to breastfeed the baby.

Parvovirus B is common in children and is characterised by a rash on the cheek. It is also called as Slapped Cheek disease. Usually more than 60 per cent women are immune to it, but it is a highly contagious infection which can be contracted during pregnancy. Immunity can be checked through a blood test.

Sexually Transmitted Infections: All pregnant women should be screened for syphilis during pregnancy and appropriate treatment should be given to prevent congenital syphilis and other effects such as miscarriage and stillbirths.

Infections continue to remain in the body
Hepatitis B, hepatitis C and HIV are infections which once found during pregnancy will be there till delivery and thereafter.  Herpes, toxoplasmosis, CMV and hydatid cyst remain in a dormant state. These infections, when acquired during pregnancy, remain for life. Dr Vimee Bindra, consultant gynaecologist and obstetrician at Apollo Hospitals explains, “Even after successful treatment of these infections, it has been found to remain dormant for long in the body and can be detected by tests. Similarly, hepatitis B and C are also found in the body for lifelong. It is very important that proper awareness is created about these diseases for women. Also, the pre-counseling sessions before pregnancy give a brief idea about these diseases and it help women to seek treatment before planning a pregnancy. So that, the complications at later stages are reduced.” Pregnancy makes women more susceptible to certain infections and also increases their severity.

- Dr Vimee Bindra

Infection symptoms mimic pregnancy

Often, infections are not easy to diagnose as they mimic symptoms that are related to pregnancy. The most common symptoms  are nausea, vomiting, lack of appetite, weakness and abdominal cramps. Hence, diagnosing the infection on time is very important. Dr Laxmi Kiran, senior gynecologist at Rainbow Hospitals explains, “The blood tests during pregnancy have been made compulsory due to these reasons wherein the underlying diseases if any, are identified early.” Many a time, relatives question the reason for so many tests. It is very important to diagnose these infections early and treat them, if possible. If they are diagnosed in the second and third trimester, then the fetus is likely to get affected.

Dr Lakshmi Kiran