Table 1: Potential Contraindications to International Travel during Pregnancy The following table outlines potential contraindications to international travel in pregnancy according to the Center for Disease Control and Prevention (CDC) Footnote 4. Many factors come into play including the purpose of travel, destination, perceived risk, underlying medical and/or pregnancy related complications, available medical facilities and insurance. The decision to travel if pregnant is best decided between the pregnant woman and her obstetrical care provider. The safest time to travel is between 18 and 24 weeks in the second trimester. Safe Time to TravelĪccording to the American College of Obstetricians and Gynecologists (ACOG), most common obstetric emergencies occur in the first and third trimesters Footnote 3. The following paper will outline the risks to the pregnant traveller and the current recommendations based upon the existing body of literature. The other major issue in advising pregnant travellers is that there is very little evidence based on randomized controlled studies and much of the information in the literature is theoretical. Some fungal infections such as coccidiodomycosis and blastomycosis are associated with a higher incidence of disseminated disease in pregnancy especially in the third trimester Footnote 2. Similarly, certain infections such as influenza and varicella may have a more severe clinical course, an increased rate of complications and a higher case fatality rate. In addition, pregnancy may increase the risk of acquiring certain infections such as malaria, toxoplasmosis, leprosy and listeriosis Footnote 1. Pregnant women may be more susceptible to and/or more severely affected by certain infectious diseases due to changes in immunity and physiology. At some travel destinations, medical resources to deal with pregnancy-related complications may be significantly different than Canadian standards. Travelling while pregnant poses many challenges due to the inherent risks and changing physiology in pregnancy the risk to the fetus in-utero from maternal exposure to medicines and vaccines, and the risks and complications of delivery. Manufacturers have sought approval and provided evidence as to the safety and efficacy of their products only when used in accordance with the product monographs or other similarly approved standards or instructions for use. Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) or other similarly approved standards or instructions for use by the licensed manufacturer(s). Persons administering or using drugs, vaccines, or other products should also be aware of the contents of the product monograph(s) or other similarly approved standards or instructions for use. PHAC acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and medical practices, and is disseminating this document for information purposes to both travellers and the medical community caring for travellers. The Committee to Advise on Tropical Medicine and Travel (CATMAT) provides the Public Health Agency of Canada (PHAC) with ongoing and timely medical, scientific, and public health advice relating to tropical infectious disease and health risks associated with international travel. Personal Protection Measures to Prevent Insect Bites.Inactivated Bacterial and Viral Vaccines, Toxoids.† Committee to Advise on Tropical Medicine and Travel. CATMAT gratefully acknowledges the work of Dr. Gideon Koren for his contribution to the development of the statement. + This statement was prepared by C. Beallor and approved by CATMAT. Liaison Representatives: Dr. C. Greenaway Mrs. A. Hanrahan Dr. C. Hui Dr. P. Teitelbaum Dr. A. Pozgay Legault Dr. P. McDonald Dr. N. Marano Dr. P. Arguin Dr. P. Charlebois Dr. A. Duggan McClean Dr. C. Beallor Ms. A. HenteleffĮx-Officio Members: Dr. M. Tepper Dr. J. Given Dr. R. Weinman Dr. F. Hindieh Dr. J.P. * Members: Dr. P.J. Plourde (Chair) Dr. S. Houston Dr. S. Kuhn Dr. A. McCarthy Dr. K.L. Volume 36 ACS-2, March 2010 An Advisory Committee Statement (ACS)Ĭommittee to Advise on Tropical Medicine and Travel* † Statement on Pregnancy and Travel Contributors
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |