Pregnancy may have a significant impact on infections, and vice-versa; and could have an adverse effect on the mother as well as the baby. Pregnancy is a relatively immunocompromised state, which may lead to increased severity of infections. Also, there are concerns related to the safety of medications in the pregnant women. Hence, for prevention, early diagnosis and expert treatment becomes utmost important.
Pregnant women are at an increased risk of urinary tract infections. These may range from asymptomatic bacteriuria (presence of significant number of bacteria in the urine without any
symptoms) to mild as well as severe infections. Asymptomatic bacteriuria occurs in 2%–7% of pregnant women, is seen mostly in early pregnancy with a higher incidence in diabetes mellitus and low socioeconomic status. It may lead to symptomatic urinary infection in 20%–30% if untreated and is associated with a higher risk of complications like an alarming increase in blood pressure, preterm delivery, and low birth weight. Hence, a urine test should be done to screen, at the first antenatal visit.
0.5%–2% of all pregnant women develop pyelonephritis (complicated urinary tract infection involving the kidneys), and is seen more in the second and third trimester; symptoms include
fever, chills, back pain, vomiting, and with/without symptoms of burning/pain while urination. Pyelonephritis is associated with an increased risk of preterm delivery, sepsis, and acute respiratory distress syndrome.
Some females may develop infection of the genital tract starting from rupture of membranes till 42 days postdelivery/abortion. This is known as puerperal sepsis and is an important cause of maternal deaths in our country. Symptoms are fever, pelvic pain, foul smelling discharge per vaginum.
Another important infection that is very common and needs mention is Influenza (Flu). Pregnant women, especially those in the third trimester, are at higher risk for severe disease and death than non-pregnant women. Influenza in the first trimester has been found to be associated with an increased risk of congenital abnormalities in the baby including cleft lip, neural tube defects, hydrocephalus, and congenital heart defects. Other adverse pregnancy outcomes include abortion, preterm delivery, stillbirth, and intrauterine growth retardation. Oseltamivir should be started in all the cases of suspected flu without waiting for the result of the throat swab test. Influenza vaccination is recommended for all pregnant women. Pregnant women should be offered influenza vaccination at the time of the first antenatal visit. Seasonal infections like dengue fever and malaria are associated with an increased risk of maternal deaths, stillbirth, preterm delivery, and neonatal death, compared to nonpregnant women.
Pregnant females are found to have a higher incidence of active tuberculosis, another very common infection in our country. TB in pregnancy is associated with an increased risk of prematurity, low birth weight, and neonatal death. Transmission to the baby (congenital TB) can occur due to transmission through the placenta. Hence early diagnosis and treatment is
must.
Infections in pregnant women are challenging to diagnose and treat. It is imperative to diagnose and treat early and systematically.
Seeking treatment for infections during pregnancy? Call us at +91 96646 30466 for expert care at Tathaagat Infectious Disease Clinic in Ahmedabad.
