Viral Infections During Pregnancy

During pregnancy, women are prone to infections, which may be bacterial, viral, fungal or parasitic in nature.  Let us now see few viral infections that can occur in an expectant mother.

Chicken Pox

It is caused by the varicella-zoster virus. A previous history of having chicken pox disease in women make them immune to this disease. However, if a pregnant woman has never been infected with the varicella-zoster virus, the early stages of pregnancy, she contracts chickenpox. On infection, this virus crosses the mother’s placental barrier, infects the child and leads to birth defects.  These include leg deformities, retinal and eye deformities, damage to the brain’s cerebral cortex,  hydronephrosis in the kidney etc. Prior to or during delivery if the baby is exposed to the chicken pox virus,  critical damage to the central nervous system disease may be seen.

Note: Vaccination should be done before the start of your pregnancy well in advance, at least a minimum of one month prior, in women who have never had chickenpox.  Vaccination is not recommended during pregnancy.

Cytomegalovirus

Cytomegalovirus (CMV) is another very common viral infectious disease (1-4%). The mode of transmission of CMV is through sexual intercourse, from the baby to the mother (during pregnancy), saliva, and urine. Congenital abnormalities and multi-organ damage are seen (brain, blood, eyes, ears, spleen, liver, and skin are at risk). It is more severe if CMV is contracted within 20  weeks of pregnancy in a mother.

Note:  There is NO accepted vaccination for CMV. Infection is detected by amniocentesis, ultrasound and blood tests.

Enterovirus infections

It is a subgroup of infections, which include

1. Hepatitis B:

Screening and vaccination for hepatitis B  is a must during pregnancy. Pregnant women affected with hepatitis B should be treated with hepatitis B vaccine and the immunoglobulin (within 12 hours post birth) to slowly reduce the transmission to the baby. 

 

2.  Coxsackievirus:

Coxsackie virus infection in pregnant women is not as lethal as it is in the newborn (leading to death), contracting it from their mother. The disease leads to hepatitis, myocarditis (inflammation of the heart) and encephalomyelitis (inflammation of the spinal cord and brain).

3. Poliovirus

Infection in pregnant women with poliovirus is more lethal ( at times leading to death in susceptible women) than in the newborn.  In newborn, the infection manifests anywhere from headaches to full body paralysis. Vaccination against this is a must, especially in developing countries.

4. Herpes simplex virus

Herpes simplex virus (herpes),  is a sexually transmitted disease (STD) that passes from the infected mother to the baby during childbirth. Newborn are treated with antiviral drugs against herpes.

HIV: human immunodeficiency virus

HIV is a deadly disease causing severe depression in immunity. Based on the “viral load”  (amount of the HIV virus in the blood) treatment is decided. Generally, highly active antiretroviral therapy (HAART) is given in an HIV positive mother and the viral load is maintained under 1000 to reduce the chances of transmission to the baby (if the load cannot be brought below 1000, a cesarean section is generally preferred)

Rubella

Rubella Aka “German measles” is seen to a lesser extent currently. Rubella infection causes congenital defects ( if infection occurs within 12 weeks of pregnancy), stillbirth, and miscarriage.

Influenza

Influenza Aka “flu” is caused by a group of viruses from the Orthomyxoviridae family.  It may lead to pneumonia which may be harmful to the expectant mother. A flu shot (vaccine) is recommended.

Measles

Most adults are immune to measles, meaning that they have either had measles in the past or they have been vaccinated against the disease. There is an increased risk of having a low birth weight baby if you have measles while you are pregnant. If you develop measles shortly before the birth of the baby, there is a high risk that your newborn baby will also get the disease, especially if the baby is premature. Vaccination against measles is not done during pregnancy. Like chickenpox, it is best if you make sure to get vaccinated against the disease before you become pregnant.

Fifth disease

Caused by the B19 parvovirus. The main presentation is a bright red rash on the face. Other symptoms include mild fever, flu-like symptoms, sore throat,  and pain in the joints. Majority of pregnant women with this infection go ahead with a healthy pregnancy

 

 

 

 

 

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Aishwarya

Dr. Aishwarya Rajeev has completed her MDS degree and is currently pursuing her PhD. She is an avid reader and loves to teach and write!

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