The pregnant traveller
Abstract
Travelling during pregnancy has become increasingly common. Many pregnant women travel for pleasureand recreation and a lot of them continue to work and therefore often travel on business, sometimes to areas with poor standards of sanitation and limited access to health care providers. During pregnancy, it is extremely important that a woman has a regular access to maternal health care, also in temporary destinations, especially in areas characterised by harsh environmental conditions, and places where the prevalence of infectious diseases is high. It must be remembered that the course of contagious or parasitic illnesses, such as hepatitis E and malaria, is generally more severe in pregnant travellers, due to pregnancy-related immunosuppression. The assessment of indications and contraindications for the use of mandatory/recommended vaccinations and antimalarial drugs is also very important in pregnant travellers. When pregnant women travel for long term, it is absolutely necessary that they receive prenatal care in a new place of residence. Scheduled maternity care usually begins in week 10–12 of pregnancy, and continues once a month until the 7 month of pregnancy, next every second week until week 36 and then once a week until the delivery.
Keywords: pregnant womantravellingtropics
References
- Morof DF, Carroll ID. Pregnant travelers. In: Brunette GW. ed. CDC Yellow Book 2018. Health Information for International Travel. Oxford University Press, New York 2017.
- Kingman CE, Economides DL. Travel in pregnancy: pregnant women's experiences and knowledge of health issues. J Travel Med. 2003; 10(6): 330–333.
- Kourtis AP, Read JS, Jamieson DJ. Pregnancy and infection. N Engl J Med. 2014; 370(23): 2211–2218.
- Patra S, Kumar A, Trivedi SS, et al. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med. 2007; 147(1): 28–33.
- Rijken MJ, McGready R, Boel ME, et al. Malaria in pregnancy in the Asia-Pacific region. Lancet Infect Dis. 2012; 12(1): 75–88.
- Carroll ID, Williams DC. Pre-travel vaccination and medical prophylaxis in the pregnant traveler. Travel Med Infect Dis. 2008; 6(5): 259–275.
- Hezelgrave NL, Whitty CJM, Shennan AH, et al. Advising on travel during pregnancy. BMJ. 2011; 342: d2506.
- Mackell SM, Anderson S. The Pregnant and Breastfeeding Traveler. In: Keystone JS, Freedman DO, Kozarsky PE, Connor BA, Nothdurft H. ed. Travel Medicine. 3rd Edition. Elsevier Saunders 2013: 219–230.
- Gabbe SG. Obstetrics – Normal and Problem Pregnancies. 5th Ed. Churchill Livingstone Elsevier, New York 2007.
- ACOG Committee on Obstertic Practice. Committee opinion: number 264, December 2001. Air travel during pregnancy. Obstet Gynecol. 2001; 98(6): 1187–1188.
- Huch R, Baumann H, Fallenstein F, et al. Physiologic changes in pregnant women and their fetuses during jet air travel. Am J Obstet Gynecol. 1986; 154(5): 996–1000.
- Magann EF, Chauhan SP, Dahlke JD, et al. Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants, and aviators. Obstet Gynecol Surv. 2010; 65(6): 396–402.
- Ryan KJ. Kistner’s Gynecology and Women’s Health. 7th Ed. St. Louis: Mosby 1999.
- Scurr JH, Machin SJ, Bailey-King S, et al. Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial. Lancet. 2001; 357(9267): 1485–1489.
- Korzeniewski K. Medycyna podróży. PZWL, Warszawa 2016.
- Rasmussen SA, Watson AK, Kennedy ED, et al. Vaccines and pregnancy: past, present, and future. Semin Fetal Neonatal Med. 2014; 19(3): 161–169.
- Robert E, Vial T, Schaefer C, et al. Exposure to yellow fever vaccine in early pregnancy. Vaccine. 1999; 17(3): 283–285.
- Lindsay S, Ansell J, Selman C, et al. Effect of pregnancy on exposure to malaria mosquitoes. Lancet. 2000; 355(9219): 1972.
- Roggelin L, Cramer JP. Malaria prevention in the pregnant traveller: a review. Travel Med Infect Dis. 2014; 12(3): 229–236.
- McGready R, Hamilton KA, Simpson JA, et al. Safety of the insect repellent N,N-diethyl-M-toluamide (DEET) in pregnancy. Am J Trop Med Hyg. 2001; 65(4): 285–289.
- Aggarwal R, Krawczynski K. Hepatitis E: an overview and recent advances in clinical and laboratory research. J Gastroenterol Hepatol. 2000; 15(1): 9–20.
- Rasmussen SA, Jamieson DJ, Honein MA, et al. Zika Virus and Birth Defects--Reviewing the Evidence for Causality. N Engl J Med. 2016; 374(20): 1981–1987.
- McGovern LM, Boyce TG, Fischer PR. Congenital infections associated with international travel during pregnancy. J Travel Med. 2007; 14(2): 117–128.
