COMMON INFECTIONS IN PREGNANCY

Pregnancy

Infection is a condition where an otherwise healthy person has the growth of unwanted micro-organisms within his or her body in such a manner as to make the person ill or sick. Sometimes, our body tends to fight off these micro-organisms, and the person remains healthy without treatment. At other times, the person needs help in form of treatment, as he or she is not able to fight it off and therefore falls ill.

Pregnancy is one of those conditions where infections should be taken seriously as the woman’s ability to fight infections can sometimes be compromised. What would ordinarily be a trivial infection in a non-pregnant woman can potentially be a serious medical issue in an expectant mother.

Generally, there are numerous infections which can afflict pregnant women, but the four types mentioned below are of utmost importance, as they occur commonly, and some of them have very serious consequences for the Mother and baby.

  1. Urinary Tract Infections and Infections of the Vagina
  2. Viral Infections such as HIV, Hepatitis, Rubella, Toxoplasmosis
  3. Malaria (this will be dealt with in another article as its uniqueness warrants special attention)
  4. Sexually Transmitted infections (STIs) like Gonorrhoea and syphilis

Urinary tract infections should not be confused for infections of the vagina as they are two different entities. Urinary infections generally go up into the bladder and kidneys while vaginal infections generally remain in the vagina. Sexually transmitted infections also affect the vagina but go on to affect other components of the Reproductive system like the womb, tubes and ovaries. During delivery, the baby is likely to encounter untreated vaginal infections and STIs with sometimes serious consequences. Luckily, symptoms of all these diseases are somewhat similar and easy to spot.

 

WHAT SYMPTOMS DO I EXPECT TO SEE ?

For Vaginal Infections And STIs

  1. Grey, yellow or greenish and thick vaginal discharge, usually foul smelling. Most normal pregnant women have a clear, white and odourless discharge. This is nothing to worry about as it is just a result of the woman’s hormones. Any discharge other than this should be investigated.
  2. Unusual redness of the vagina. Here the vagina looks and feels very raw. This is quite relative, but any woman who has increasing redness of her vagina may need to have it checked out for re-assurance.
  3. Pain during Intercourse. The vagina is usually more pliable during pregnancy, and many women report actually finding intercourse rewarding during this period. Unusual pain during intercourse in a woman who would otherwise look forward to intercourse should be a red flag.

For Urinary Tract Infections

  1. Pain and burning sensation on urination
  2. Unusual appearance of urine. Urine is usually clear, no matter the colour. Once it starts appearing like it has sediments or pus in it, it will need investigation.
  3. Pain in the lower abdomen. Now, this may not be very reliable, as most pregnancies come with lower abdominal pain. A negative urine test following any suspicious pain can be re-assuring.

For Viral Infections

Viral infections are quite numerous and taking each one on its merit will defeat the aim of this article. General symptoms are itemised to make it simple:

  1. Any general body rash.
  2. Eye discharge
  3. Unusual yellowness of the eyes called jaundice (hepatitis can cause this)
  4. Episodes of generalised body aches
  5. The symptoms above become more important if there has been recent contact with animals, or persons who have or had same symptoms.

WHAT TREATMENT DO I EXPECT IF I AM INFECTED?

Treatment depends on the type of Infection.

  1. With some vaginal infections, a few days of oral antibiotics is all that is needed. Remember, not all antibiotics are safe in pregnancy, so the choice of medicine should be made by a qualified medical professional.
  2. In some severe infections, e.g where a urinary infection has spread to the bladder and kidneys, the woman is admitted and intravenous (IV) antibiotics are given through the vein. This is a more aggressive treatment.
  3. In some viral infections like HIV, the essence is to start anti-retroviral treatment EARLY to avoid infecting the baby. The baby is also preferably delivered through Cesarean Section to minimise chances of infection as the baby’s head can be bruised in a vaginal delivery which increases chances of infection.
  4. A vaginal disease of note is the Group B streptococcus infection. Once this is detected in a pregnant Mother, it should be monitored, as it has been known to cause infant deaths even after normal delivery. Antibiotics are usually given during time of delivery, and to the baby if it starts showing signs of infection.

WHAT ARE THE CONSEQUENCES IF INFECTIONS ARE NOT TREATED?

  1. Untreated or poorly treated Urinary Tract infection can spread to the bladder and kidneys, and may remain a medical problem for the mother even after delivery as it can eventually cause life threatening Kidney failure.
  2. Generally, poorly treated infections tend to lead to premature labour and delivery, and the attendant problems of prematurity.
  3. Untreated HIV +ve mothers stand a markedly increased chance of infecting their babies as the viral load of their blood is usually high.
  4. Untreated STIs may have serious consequences for the baby as the baby may be born with birth defects (e.g weak hearts, blindness, deafness etc). The Mother may also find it difficult to give birth in future as the infection goes on to affect other parts of her reproductive system.
  5. Other viral infections like rubella and toxoplasmosis have vaccines which are not available in every country. Thankfully, the health problems they cause are not as frequent as the others. But when they occur, they can be severe, leading to babies with serious birth defects like the ones mentioned above. Avoiding contact with animals as much as possible can be beneficial.

WHAT PRECAUTIONS DO I TAKE?

It should be noted that the best and cheapest form of treatment is prevention. Literature surrounding the condition of pregnancy can be daunting for some mothers, so the easiest thing to do is REGISTER EARLY for ante-natal check ups with qualitative facilities where most of these problems will be nipped in the bud.

It is also a well known fact that well equipped ante-natal centres are a rarity in some parts of the world, so for those not lucky enough to be near one, the following steps may be helpful:

  1. Avoid putting on tight underwear. Tight underwear encourages the growth of bacteria that cause infections.
  2. Preference should be for light cotton underwear. Nylon pants accumulates sweat that encourages bacteria. Cotton absorbs sweat while keeping you comfortable.
  3. For those without cultural compulsions, the recommendation is to sleep without underwear. This increases the length of time your external reproductive organs receive fresh air.
  4. When urinating, the recommendation is to wipe from front to back, e.g from vagina towards the anus. Doing otherwise (back to front) encourages the deposition of anal bacteria towards the vagina.
  5. Drink lots of fluid. The urinary tract of humans tend to wash itself of bacteria when there is adequate fluid in the system. Once your fluid intake reduces, bacteria that would otherwise have passed out through your urine will remain and cause infection.
  6. Emphasis should be placed on hygiene. Underwears should be changed frequently and properly laundered before re-use. Baths should be taken regularly and the vagina given adequate attention during showers. Avoid excessive use of soap in the vagina. The aim is not for the vagina to be free of discharge. Remember not all discharges are infections.
  7. Avoid contact with animals as much as possible. Infected cats and Dogs are known to spread toxoplasmosis. Meat should be properly cooked, and dairy products adequately pasteurised.
  8. Unless you are sure of the health status of your sexual partner, intercourse should be BARRIER protected (e.g Condom).
  9. HIV +ve mothers should take their medications regularly and avoid breastfeeding their babies.
  10. Keep up to date with all your vaccines.

The list of possible precautions is by no means exhaustive. But any mother who tries following the above greatly enhances her chances of an infection free pregnancy, regardless of where she resides.

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