Advice from Canpol's experienced mothers.

Pregnancy risks - how to avoid them

Pregnancy is the time when you should take particular care of your health. Conditions and ailments harmless at other times may affect development of a baby inside the mother's womb.

Do not, however, worry in advance. If you take care of your health, follow a healthy diet, observe appropriate rules of hygiene, then you minimise the risk of an illness. When you are planning the pregnancy, do a medical check-up and ask your doctor about diseases against which you should get vaccinated. At the beginning of the pregnancy, do blood tests for diseases such as toxoplasmosis, cytomegaloviral infection, listeriosis and rubella. Below you will find other effective methods protecting you against those hazards:

Rubella

It is an infectious disease transmitted via droplet contact. It is particularly dangerous during pregnancy, especially during first 16 weeks. Then it may cause rubella-related defects in the foetus. When the mother develops full-blown rubella, a possibility of passing the infection to the foetus is very high, reaching about 80%, however, this is the case only at the beginning of the pregnancy. The further into the pregnancy you are, the safer it is.

Rubella attacks only women without immunity acquired in childhood or who were not vaccinated before getting pregnant. The vaccine gives protection for about 10 years, while permanent protection is acquired only and solely during the illness.

Rubella during pregnancy is treated by administration of immunoglobulin no later than 5 days after contact with an ill person, therefore, be careful in contacts with people. Observe your body and keep your eyes open, as in rubella quick a diagnosis is crucial. If you suspect or are certain there is a risk of infection, see a doctor immediately. Do not wait for first symptoms which usually appear after at least 14 days.

How can you get infected with rubella?

You can get infected with the rubella virus only by a contact with an ill person. Hazardous places include kindergartens, schools, healthcare clinics. Women working with children or nurses are particularly vulnerable.

Symptoms:

First symptoms appear after 2 - 3 weeks from contact with an ill person and persist for a few days.

- Typical rubella symptoms include fever, swollen lymph nodes behind ears, on your neck and back of your head, and worsened mood.

- On the body may, but not necessarily, appear pale pink rash, that can spread over the whole body in one day. It may also be accompanied by joint pains, particularly in adults.

How can you protect yourself against rubella?

- First of all, consider vaccination against rubella if you did not have it as a child.

- When you are pregnant, observe your body. Try to avoid people with rubella or belonging to so-called risk group (kindergarten personnel, nurses). When you know that there are cases of illness at a place attended by your older child, yet your child is still healthy, try to keep him/her at home, if possible, during the illness.

- Your doctor providing pregnancy care will certainly ask about your medical history of rubella. When you do not remember, you can do a test for IgG and IgM antibodies. A positive result means you are immune to rubella and that you do not have to worry.

Listeriosis

It is an infectious disease caused by the bacterium Listeria. It is primarily an animal disease, extremely rare in humans. It is dangerous for pregnant women and newborns, as well as cancer patients, for people after transplantations and immunocompromised patients.

Symptoms:

The illness develops for a few days to even 3 months and usually is asymptomatic.
When left untreted in patients from the high risk group it may cause meningitis, or even death.
In the severe form, the typical flu-like symptoms develop: muscle and neck pains, high fever, diarrhoea, vomiting, or even convulsions, when the nervous system is affected.
In some cases symptoms can be mild and mistaken for flu. Therefore you should inform the doctor you ate raw meat or meat products, or had a contact with a sick animal. That will significantly shorten the time of diagnosis and a correct treatment will be initiated earlier. Tests for listeriosis include, e.g., tests of blood or vaginal discharge for presence of Listeria. When the result is positive, the disease is treated with antibiotics safe for the developing foetus and for the mother.

How can you get infected with listeriosis?

Listeriosis is acquired by humans through the gastrointestinal route.
- unpasteurised milk and blue cheeses like Camembert, Brie or oscypek (smoked sheep cheese)
- ice-cream
- raw and smoked fish and seafood
- raw, smoked and grilled meat (all types)
- raw, smoked and fermented cured meats
- raw unwashed vegetables and fruit
- packed lettuce mixes and ready salads
as well as through a contact with sick animals, contaminated soil or water.

How to protect yourself against infection?

To minimise the risk of infection you should observe a number of rules:
- Avoid eating raw, smoked and grilled meat, fish and seafood.
- Fish, meat dishes and pasteurised milk stored in a fridge for a few days are a medium for bacteria, thus you should eat only freshly prepared meals.
- Always wash your hands before each meal.
- Wash your hands thoroughly also after preparing meals of raw meat, poultry and fish.
- Never eat meat from unknown sources. Do not buy it on a market, as products there are swarming with flies and other insects.- Before eating raw fruit and vegetables, wash them thoroughly .
- You should avoid eating ready-meals and fast food, as they can be a source of Listeria.
- Listeria develops in humid and cold places. The bacteria is killed through exposure to a high temperature and pressure, therefore pasteurising and cooking is recommended.

Toxoplasmosis

It is an infectious disease caused by a protozoan, Toxoplasma gondii. Toxoplasmosis is a zoonotic disease. It is particularly dangerous to pregnant women, as it may cause miscarriages and development defects in the foetus.

Symptoms:

The disease usually is asymptomatic. A typical flu-like symptoms may occur, including muscle and head aches, high fever, general weariness, reddening of throat and swelling of lymph nodes. Skin lesions may occur, but not necessarily.
Toxoplasmosis can be diagnosed with a blood test. Similarly to listeriosis, it is treated with antibiotics.

How can you get infected with toxoplasmosis?

- The parasite is present in feline faeces only if animal have a possibility to going out. You can get infected when emptying a sandbox.
- You can get infected by the gastrointestinal route while eating raw or partly cooked meat, drinking raw milk or eating fruit or vegetables not washed thoroughly.
- By working in a garden, where animals (cats) can infect the soil with excretions (faeces, saliva).

Protection against infection:

- Avoid contact with cats and their faeces. If you have a cat, wear protective gloves when emptying its sandbox, or preferably ask somebody else to do it.
- Before eating, wash fruit and vegetables thoroughly. Particular attention should be paid to strawberries and other fruit growing in the soil or directly above it.
- When working in a garden, wear protective gloves to avoid contact with the soil.
- After each contact with raw products (meat, fish), wash thoroughly your hands, board and the cutlery.
- Try to avoid eating raw, smoked and grilled meat and unpasteurised milk.

Salmonella

It is an infectious diseases caused by a bacteria, Salmonella enteritidis. Salmonella is usually treated at a hospital, with antibiotics and hydration of the body. A special diet is also recommended. During and after the treatment stool is sampled for tests, to exclude the risk of infecting other people.

Symptoms:

 First acute symptoms of Salmonella poisoning usually occur after 6 to 72 hours of infection. Headache, high fever, watery diarrhoea sometimes with blood, shivering, stomach ache, nausea and vomiting. They disappear after about 2 to 3 days, but you recover only after 7 days. Sometimes it takes longer, depending on a severity of infection and effectiveness of the body's defence mechanisms.

 How can you get infected with Salmonella?

 - You can get infected with Salmonella through gastrointestinal route, by eating raw eggs, meat and fish. The bacteria can be present in unpasteurised milk and milk products, and in ice-cream and cakes with cream containing raw eggs (tiramisu, layered cakes, etc.)
- Salmonella bacteria can be present on incorrectly washed boards for cutting raw meat, cutlery, tenderisers.
- Outside a living body, in favourable conditions such as the presence of protein, warmth and moisture, they can survive even for a few months. Sponges and scourers are an excellent medium for the bacteria.
- Directly from animals, e.g., poultry bred at home.
- From other people ill with salmonella and healthy carriers of that bacteria.

What can you do to avoid getting infected with Salmonella?

- Hygiene is the most important thing. Frequent washing of your hands will effectively protect you against this bacteria.
- After preparing meals from raw meat or fish, you must wash thoroughly all the cutlery, dishes and your hands. You should have a special board for cutting raw meat, preferably a glass one, as the wood is a good place for bacteria colonies formation.
- Refrain from eating dishes made of or containing raw eggs: kogel-mogel, cold cheese-cake or steak tartar. However, if you decide to have one of those dishes, you should remember to wash and scald (put into boiling water for 15 seconds) the eggs before breaking.
- All tops and cupboards should be washed with water and washing liquid, and thoroughly dried, so bacteria will not be able to survive.
- One shelf in a fridge should be designated for raw meat, poultry and fish, so it does not come in contact with other food.
- Frozen meat should be used immediately. Defrosted products should never be frozen again.

Cytomegaloviral infection

In healthy persons it can be asymptomatic and the body deals with it on its own. It is estimated that about 60 to 80% people in Europe are carriers of this virus.
You should remember that previous exposure to cytomegalovirus does not confer immunity for the whole life, as it is a case with rubella.
There is no effective medicine or vaccine for this disease during pregnancy, however, there is a medicine administered to new-borns immediately after birth.

Symptoms:

 Symptoms of the disease occur quite sporadically and they are rather similar to mononucleosis.
- Headache, muscle ache, sometimes coughing may occur.
- Swollen lymph nodes on the neck, or in general.
- Throat ache resembling angina.

How can you get infected with cytomegalovirus?
- Through a sexual intercourse with an infected person: saliva, semen, vaginal discharge.
- Through blood - during transplantation or blood transfusion.
- Body fluids of any kind, like saliva or urine.
- Transfusion of blood derivatives, organ or marrow transplants from persons being carriers.

Protection against infection:

 - Hygiene is of the uttermost importance. Wash you hands often. Before contact with food, after using a toilet, getting home, or following contact with other persons. Do not seat when using a public toilet.
- If possible, try to use your own dishes and cutlery.
- If possible, avoid places like kindergartens, nurseries, schools and hospitals.
- Try to avoid contact with saliva, urine, blood or other human fluids, as they can be a reservoir of cytomegalovirus. It is particularly important when you have a small child. Try to ask somebody close for help in changing diapers or dressing wounds. Wash your hands thoroughly after completing all activities.

 Remember that, as in any other case, a pinch of common sense and sober approach account for over half of success. When it is your second pregnancy and your older child goes to a kindergarten or to school, it will be hard to avoid those places and people there. So do not panic, as otherwise it will seem that during pregnancy you cannot have contact with anything and anybody, even your own child. Cases of the diseases listed above are not frequent, and by adhering to basic rules of hygiene, in most cases we are effectively protected against infection. 

Joanna

Mum of 6 year old Alicja and 2 year old Ewa, 6 years of professional experience

Marta Piątkowska

Midwife
- consulting