General pregnancy precautions

General pregnancy precautions

Seatbelts: Pregnant women should wear seatbelts. The lap belt should lie across the hips below the uterus and the shoulder belt should lie between the breast and lateral to the uterus.

Hot tubs, saunas, tanning beds, swimming pools: Pregnant woman should avoid hot tubs in the first trimester as heat exposure during this time has been associated with a risk of neural tube birth defects. After the first trimester limit soak time to less than 10 minutes and temperature to less than 100 degrees. Saunas and tanning beds are not recommended.  Pubic swimming pools are not associated with adverse effects on pregnancy.

Immunization: Pregnant women should receive necessary vaccines, for example the influenza vaccine is recommend during flu season and the Tdap (tetanus toxoid, diphtheria toxoid and acellular pertussis) in third trimester. Pregnant women should avoid live viral immunization during pregnancy.

Toxoplasmosis: A parasite infection.  Prevention is based on avoidance of sources of infection. Pregnant women should avoid cat feces by not changing litter box, avoid outdoor soil where cats commonly use, avoid raw meat, poultry and seafood. Maternal symptoms include: flu-like symptoms with fatigue and malaise. Fetal effects include: growth restriction, enlarged liver and spleen, mental retardation and deafness.

Cytomegalovirus (CMV): A herpes virus infection. Pregnancy prevention is through good personal hygiene with hand washing, avoidance of sick contacts especially with oral/ nasal secretions. CMV may cause microcephaly (small head size), mental retardation, infection of the eyes and brain calcifications.

Parvovirus (B-19): Pregnancy prevention is through good personal hygiene with hand washing, avoidance of sick contacts especially with oral/nasal secretions. Maternal symptoms include:  lacy reticular rash on trunk (only children get slapped cheek rash), joint pain and flu-like symptoms.  Effects on baby include anemia, heart damage resulting myocarditis which may lead to non-immune hydrops (general body swelling). Risk of acquiring disease from casual contact is 5%, long term contact (class room) is 20% and household contacts is 50%.

Sleep position: Pregnant women should avoid lying flat on their back after 20 week point of pregnancy. Your uterus is enlarged at this time and can push on the aorta causing restricted blood flow to the baby.

Sexual activity: In the absence of any pregnancy complications women may continue with healthy sexual activity.

Airline travel: Most airlines allow travel up to 37 weeks domestically and 35 weeks internationally. General precautions to follow while flying: you should maintain hydration, periodically move your legs to decrease your risk of venous thrombosis (blood clots) and wear your seat belt. The amount of cosmic radiation exposure during travel is not harmful.

Hair dyes:  Exposure to hair dyes results in very limited absorption unless you have cuts in your scalp. Plant based dyes are considered safe. Pregnant women should avoid ammonia and peroxide based products and color hair in well ventilated area.

Insect repellant: Pregnant women may safely use topically applied DEET.

 

Zika Virus: The virus is spread by infected mosquitoes and through contact with blood and semen. Travel to certain areas or sexual contact with partner who travel there places you at risk, for latest travel information visit cdc.gov/zika/pregnancy/index.html. 1 in 5 people will develop symptoms that begin 2 to 7 days after a bite by infected mosquito. These symptoms are mild and last several days. Symptoms include fever, rash, joint pain and red eyes. There is currently no vaccine or medicine to prevent Zika virus infection. Pregnancy complications include microcephaly (small fetal head), mental retardation and pregnancy loss. Treatment is aimed at preventing infection. Pregnant women should avoid areas where Zika virus is endemic, avoid sexual contact with anyone who has traveled to area 8 weeks before getting pregnant and while pregnant. Avoid mosquito bites by using insect repellant with DEET, wear clothing to cover as much exposed skin as possible, use screens, bed nets and stay indoors if you must travel to Zika endemic areas.

 

 

Zika Outbreak: What Oregonians need to know

Dr. Joseph Stalfire, Obstetrics and Gynecology Published 3:47 p.m. PT Sept. 19, 2016 | Updated 9:27 a.m. PT Sept. 20, 2016

When I was stationed in Africa during my tour of duty with the United States Navy, my fellow sailors and I took malaria pills and made sure we were up to date on all of our immunizations. Keeping healthy meant understanding what the risks were in the part of the world we were in.

Now as a physician lead of obstetrics and gynecology for Kaiser Permanente’s Skyline Medical Office, my advice to patients considering travel is the same: know the risks and take proper precautions.

There has been a lot of panic as the Zika virus first discovered in 1947 in a Uganda jungle has gone global. But with proper information and planning, Oregon residents can avoid the Zika virus and the health risks it brings.

 

Dr. Joseph Stalfire is the physican lead of Obstetrics and Gynecology for Kaiser Permanente’s Skyline Medical Office in Salem. (Photo: Courtesy of Kaiser Permanente)

What you need to know about the Zika Virus

  • How is Zika transmitted? 
    Zika is primarily transmitted through mosquito bites. Pregnant women can pass the virus on to their fetus. Other transmission methods include sexual activity, blood transfusions and organ transplants.
  • Is Zika in Oregon? 
    As I write this, there have been 19 documented cases of Zika in Oregon, but they have all been travel related. The type of mosquito we have in Oregon doesn’t carry the virus, so the risk comes from either travel or contact with individuals who have traveled to an area with a Zika outbreak.
  • What are the dangers of Zika?
    The risks of infection in pregnancy to the unborn baby include congenital microcephaly, brain and eye abnormalities and fetal loss.
  • Should I travel to affected areas?
    If you are pregnant, or you and your partner are thinking about pregnancy, the best advice is to avoid areas with active Zika virus transmissions as determined by the Centers for Disease Control and Prevention (CDC). If you must travel use protections to prevent mosquito bites including wearing long sleeved shirts and pants treated with permethrin. Cover exposed skin with EPA-approved insect repellent with DEET. Stay indoors and use mosquito nets. Practice safe sex.

    Pregnant women with a partner who lives in or travels to a Zika area should abstain from sex for the duration of pregnancy or use barrier protection. Before traveling consult with your primary care physician. Current Zika outbreaks have been reported in Brazil, Columbia, El Salvador, Panama, Mexico, Puerto Rico and parts of Miami, Florida. Before traveling, check the CDC’s website for a complete up-to-date list of areas with Zika outbreaks and other infectious diseases to avoid, especially while pregnant.

  • What are the symptoms of a Zika infection?
    Only 20 percent of people infected with Zika show symptoms that include low-grade fever, rashes, achy joints and conjunctivitis. Symptoms are usually mild, occur two to 14 days after infection and rarely last more than a week.
  • We traveled to a Zika area. How long should we wait before having try a baby?
    The way I see it, if you travel to an affected area, you may not even know if you contracted it. See below for CDC recommendations, but my advice is that even without symptoms, you should be on the safe side and wait eight weeks before trying to conceive.

    Men with symptoms of Zika should wait six months before unprotected sex. Women with symptoms of Zika and asymptomatic women with possible exposure should wait eight weeks before unprotected sex. Men with recent travel or who live in a Zika infected area without symptoms should wait eight weeks before unprotected sex.. One important note: it is unclear how long Zika survives in semen.

  • Can breast milk transmit the virus?
    The Zika virus has been reported in breast milk in very small amounts and is unlikely to be harmful to the newborn. The American Congress of Obstetricians and Gynecologists’ official position is the benefits of breastfeeding outweighs the risk.
  1. Is there a cure?
    Currently there is no vaccine for the Zika virus. For people infected there is no specific treatment except managing the symptoms including rest, hydration, and taking over-the-counter medications such as Tylenol for fever.

Dr. Joseph Stalfire is the physician lead of Obstetrics and Gynecology for Kaiser Permanente’s Skyline Medical Office in Salem. 

This story is provided and presented by our sponsor Kaiser Permanente. For more information go to: kp.org/northwest.

 

 

Joseph Stalfire M.D., FACOG