2.01.2013

Pregnant in Healthcare: diseases to avoid

This is a hard article to entitle. Obviously, no one wants to be exposed to contagious diseases at any time, but by virtue of working in a hospital, there will be sick people around. This is a list of infections and diseases that should be avoided by pregnant women working in healthcare that was compiled by a former coworker of mine. Explanations of some of the possible effects of exposure to the fetus are directly from the links and citations noted. It's not my intention to cause anyone to worry, but just to give a little information to be used when building your caseload.

Please don't debate with me about the frequency of these complications or ask whether your child is at risk- I'm not a doctor, you should definitely discuss your concerns with your own OB. But this is information that I think is hard to find in one place and beneficial to many women trying to work while pregnant.

Herpes varicella/ Herpes Zoster (chicken pox, shingles) – exposure in the first 20 weeks or last 5 days of pregnancy can cause congenital varicella syndrome with a spectrum of musculoskeletal and visual birth defects.

Rubella (German measles) – Early exposure can cause congenital rubella syndrome, characterized by eye defects, heart defects, and mental retardation. Also raises the risk of miscarriage or stillbirth. This is covered by the MMR vaccine so you should be immune if you received it as a child.

Toxoplasmosis – early exposure is less likely transmitted but can mean more serious results, late exposure is more likely transmitted but has less serious results. This can cause eye, hearing, and learning problems.

Cytomegalovirus – transmission is rare, but possible effects of CMV on a baby include learning disabilities, mental retardation, and vision or hearing loss after delivery.

Parvovirus (slapped-cheek disease, fifth disease) – Can cause severe anemia which raises the risk of miscarriage or stillbirth.

Herpes Simplex – (STD) Exposure at birth may result in brain damage, blindness or death for the newborn.

Hepatitis B – this infection can be passed to the infant at birth, which poses the risk for developing chronic Hep B.

Pt with AIDS with mental status change (can be Cryptococcal Meningitis or "crypto") - this is a fungal, opportunistic infection. It can be transmitted to the baby and both of you could need to be treated. Certain drugs to treat this can cause miscarriage, so obviously inform your doctor if you are pregnant.

Bacterial Meningitis – can cause brain damage, hearing loss, or learning disabilities.

It has also been recommended to me that pregnant women avoid contact with people who have the flu. And it's always good practice to avoid contact with anyone with a fever or new unexplained vomiting or diarrhea. This article from Nursing Center has some additional information on risks that pregnant healthcare workers are exposed to, with some suggestions for how to mitigate these risks.

As a currently pregnant, currently recovering from very mild illness person, I can attest that it's pretty miserable being sick when you don't have many options for medication, are already tired, are at greater risk for dehydration, and are worried about the development of your child.

Knowledge is power- hope this list helps you feel more empowered as a pregnant healthcare worker!

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