The Truth Behind Infections and Illnesses During Pregnancy

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Sometimes it could be just the flu but at other times it could a urinary tract infection or worse…chicken pox or salmonella. But just how can these illnesses and infections affect you and your unborn baby.

WORDS CHRISTEL GERALYN GOMES

It can be scary to fall ill while you’re pregnant, especially since you are now worrying about the fragile, developing life of your baby. There are various illnesses that can cause complications to your pregnancy, influenza included!

The following list is not exhaustive, but here’s some of what to look out for and how they can affect your baby.

Influenza
Surprisingly the normal flu can be a lot more dangerous while you’re pregnant! According to Dr Lim Min Yu, consultant at NUH Women’s Centre, influenza is more likely to cause severe illness in pregnant women than in women who aren’t. Pregnant women with flu have a greater chance for serious problems for their unborn baby, including premature labour and delivery. “Influenza in pregnancy can be very serious,” says Dr Lim.

See your doctor if your fever is above 38.0 degrees Celsius, if you experience chest pain and shortness of breath or if your symptoms persist beyond a week, advises the doctor.
Note, however, that there are several other upper respiratory tract infections that “may be referred to incorrectly as ‘flu’. These may be caused by viruses such as rhinovirus, coronavirus, adenovirus and respiratory syncytial virus. These tend to have milder symptoms and last for a shorter time”, says Dr Lim.

In terms of treatment and prevention, get vaccinated! Dr Lim says, “The flu vaccine given during pregnancy is safe and has been shown to protect both the mother and her baby (up to six months old) from flu.” If you do get a serious case of the flu during pregnancy, Dr Lim adds that your doctor can prescribe an antiviral medicine for treatment.

Urinary Tract Infection
Urinary tract infections (UTIs) are common and half of all women will experience it once in their lives. They occur when your urinary tract becomes infected with bacteria. Symptoms according to Dr Lim include frequent urination, a burning sensation when urinating, blood in your urine, lower abdominal pain, shaking, chills, fever and sweats.

Unfortunately, you are more prone to catching a UTI while you are pregnant as “this may be asymptomatic or present with symptoms such as frequent urination (which is a common symptom of pregnancy itself without urinary tract infection) or painful urination”, says Dr Tony Tan, specialist in obstetrics and gynaecology & consultant, Raffles Women’s Centre. “It is important to screen and treat for asymptomatic urinary tract infection as this increases the risk of miscarriages and preterm labour. The screening is usually done in the first trimester of pregnancy,” he adds.

While a UTI is easily treated with antibiotics, if untreated, it can spread to the kidneys, which can cause preterm labour. Always see a doctor as soon as possible if you suspect that you have the infection. Your doctor will send your urine for testing to confirm infection. “A simple dipstick test may be suggestive of infection, and together with symptoms, the doctor may decide to start treatment, even before the urine culture result is back,” says Dr Lim.

You can also help yourself by drinking 1.5 to 2 litres of water every day.

Chickenpox
Chickenpox during pregnancy can be very dangerous. “About 15 per cent of adults who get chicken pox may develop a complication called varicella pneumonia, which can be severe and even life-threatening. In pregnant women, this is also associated with higher rates of preterm birth. The risk of developing pneumonia is highest if they get chicken pox during the third trimester,” says Dr Lim.

Infection during the first or second trimester, especially between 13 and 20 weeks of pregnancy carries a risk of congenital varicella which is when the foetus could be affected with skin scarring, eye disease, and limb shortening, explains Dr Tan.

Also, if you develop chickenpox between five days before giving birth and two days after delivery, it can be life threatening to the baby, cautions Dr Lim.

The good news is, that by the time you are an adult, you are most likely to be immune from chicken pox from when you’ve had it as a child or from a previous immunisation. If you are not immune and are planning a pregnancy, it is a good idea to first go for your immunisation jabs.

“A single dose of the chicken pox vaccine prevents chicken pox for about 80 to 85 per cent of those who were vaccinated and prevents a severe case for most of the rest. A second dose provides more protection, so the current recommendation is to get two doses”, says Dr Lim. If you are not immune to chickenpox and have been exposed to it during pregnancy, “you may be considered for varicella zoster immunoglobulin (VZIG). Treatment of chickenpox is with an antiviral drug called acyclovir and should be prescribed if the patient is seen within 24 hours of the appearance of the rash”, adds Dr Lim.

Salmonella
Salmonella is a type of food poisoning caused by the bacteria salmonella. It can be caught by eating infected food – often undercooked meat or fish – or by touching an infected animal. If severe, bad diarrhoea may require hospitalisation.
 
Symptoms may appear up to three days after infection and include diarrhoea, tummy aches, nausea and vomiting, fever, chills, general aches and blood in your stool. “Without prompt treatment with antibiotics, severe salmonellosis can be life-threatening,” says Dr Lim. Luckily, Dr Tan assures us that salmonella infection in pregnant women is rare in Singapore.

Genital Herpes
The herpes virus stays in a bundle of nerves near the spine forever and can be reactivated at any time and so once you’ve had it, it tends to recur during periods of stress.

“If there is an infection for the first time late in pregnancy (soon before delivery), there is a risk of infecting the baby during labour and delivery. Therefore a caesarean section is recommended,” says Dr Lim.

However, “there is minimal risk of spreading herpes to the baby within the womb even if there is a recurrence during pregnancy”, says Dr Tan.

The solution? “There are various strategies to reduce this transmission to the baby at the time of delivery. One option is to take suppressive antiviral medication from 36 weeks onwards to reduce the risk of recurrence during time of delivery. The other strategy is to examine the vulva at the time of labour, and to perform a caesarean section if there is recurrence of herpes ulcers at that time,” says Dr Tan.

Toxoplasmosis
Toxoplasmosis is especially dangerous because it either has only mild flu-like symptoms or no symptoms at all. “This infection is caused by a parasite, which is found in cat faeces, soil, and raw or undercooked meat. If passed to an unborn baby, the infection can cause hearing loss, blindness, or intellectual disabilities,” says Dr Lim.

To be safe, Dr Lim advises you to do the following during pregnancy:   

  • Wash your hands with soap after touching soil or raw meat    
  • Wash fruits and vegetables before eating
  • Cook meat completely
  • Wash cooking utensils with hot, soapy water
  • Do not clean cats’ litter boxes but leave the chore to your husband instead


Listeriosis
This is a bacterial infection and it can be found in certain foods. Infection can cause early delivery or miscarriage. According to Dr Lim, high-risk foods include ready-to-eat seafood, such as smoked fish or mussels, raw seafood including sushi and sashimi, premixed raw vegetables including coleslaw, precooked meats such as pate, deli meat and cooked chicken, unpasteurised milk, soft-serve ice creams and soft cheeses like Brie and Camembert.

Symptoms include fever, muscle aches, chills, sometimes diarrhoea or nausea and if the disease progresses, severe headache and stiff neck.
    
Always err on the side of caution and see a doctor if you have any concerns during your pregnancy.

Thanks for sharing!