Fever In Pregnancy
List Of Causes And When To Call A Doctor

Pregnancy Complications

fever in pregnant women

Fever In Pregnancy

Contents

What Is The Most Common Cause Of Fever In Pregnancy?
Rubella
Measles, Typhoid Fever and Smallpox
Chickenpox
Scarlet Fever
Malaria
Influenza
Toxoplasmosis



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Pregnancy Complications
Pregnancy Symptoms
What Is The Most Common Cause Of Fever In Pregnancy?

The most common cause of a fever in pregnancy is the flu or a urinary tract infection. While unpleasant, both are highly treatable with medications and plenty and rest (the flu shot can even prevent the flu/influenza). For more read, is the flu dangerous for pregnant women? If you are pregnant and have a fever, it is important to ask your doctor to check the symptoms to rule out other more serious causes. Acute fevers caused by rubella, chickenpox, toxoplasmosis and malaria are much more dangerous and may lead to miscarriage in early pregnancy and premature labor in the third trimester.

When To Call The Doctor

Rubella (Also known as German measles)
Maternal viraemia is where the mother's blood is infected with a virus and the virus reaches her baby directly through the placenta. This is how rubella spreads. Fetal infection is just as likely to occur where the mother has no symptoms as with severe symptoms. If the fetus becomes infected with rubella the consequences vary greatly - it could lead to fetal death, birth defects or in lucky rare cases no apparent damage. In some epidemics the incidence of congenital defects has been 50 per cent in the first month, 30 per cent in the second month and 15 per cent in the third month; with rare cases of damage after this. The congenital defects produced vary according to the stage of pregnancy. Infection during the first and second months may produce vision problems (cataracts) and cardiac problems (heart lesions); during the third month deafness may result. Deafness and visual or neurological defects may not be recognized until later in childhood. One study showed that 23 per cent of children exposed to rubella in the womb who were apparently normal at birth showed defects by the age of two.

The clinical diagnosis of rubella-like illness is difficult and a diagnosis of rubella is only correct in about 20 per cent of cases. It is therefore necessary to carry out immunological investigations whenever possible. The usual blood test is the haemagglutination inhibition (HI) test. HI antibodies appear soon after the mother develops a rubella rash and reaches a peak within 6 to 12 days. Absence of antibody immediately after exposure to infection indicates susceptibility; its presence indicates previous infection and immunity. Patients who present within 2 weeks of exposure and who have a rapid rise in antibodies in blood samples taken 1 or 2 weeks apart may be assumed to have had a recent infection. In doubtful cases the patient's serum should be examined for rubella-specific IgM. This is a more complex test but the presence of this antibody is strong evidence of recent primary infection.

An effective vaccine is now available against rubella (it can be for rubella alone or may be combined with a vaccine for both measles and mumps). It is given to all young girls across the UK and United States. It has been so successful that in 2004, the United States declared that rubella had been eliminated. Pregnant women are advised to avoid contact with any known case of rubella. In prenatal clinics every patient should have her antibody status determined at her first visit. This indicates those women who are immune because of previous infection, which may be useful information if any exposure occurs. The women who are susceptible should be vaccinated as soon as the pregnancy is over. An abortion procedure is considered justifiable if the patient has certain evidence of infection in the first trimester.

Measles
Measles is reported to affect the fetus, but has not been proved to cause fetal abnormalities.

Typhoid Fever
Before the introduction of antibiotics typhoid fever was a serious complication of pregnancy causing miscarriage, stillbirth or premature labor occurred in many cases.

Smallpox
Since this disease has been globally eradicated it is now unlikely to complicate pregnancy. Formerly the prognosis was grave for both mother and fetus.

Chickenpox
There is no evidence that this infection causes congenital abnormalities, but the child may be born covered with the rash.

Scarlet Fever
This disease is caused by the haemolytic streptococcus (the type of bacteria responsible for strep throat and skin infections) and may also cause puerperal fever (a now rare fever that is treated by antibiotics), and a scarlatiniform rash (skin lesions associated with scarlet fever). If the disease occurs during pregnancy miscarriage can result.

Malaria
Pregnant women should not travel to malarious areas unless it is essential, but if their journey is necessary they should take appropriate preventative care. A malaria infection can lead to miscarriage, premature labor and low birth weight frequently occur, especially in cases of malignant tertian malaria (the most severest form of malaria). Read also, travel during pregnancy for more advice.

Influenza
A severe attack of influenza may have the same effect as any other severe fever in causing intrauterine fetal death. With infection in the first trimester the incidence of congenital abnormality, particularly neural tube defects, may be slightly increased.

Toxoplasmosis
This is an uncommon disease caused by a small protozoon, Toxoplasma gondii, found in the intestines of cats. If the mother is infected (usually by handling cat litter), the effect on the fetus is greatest when infection occurs in the second trimester. Most infected infants die, but those that survive for a time may have blindness, mental defects, hydrocephalus (water on the brain) and calcification of the cerebral lesions. Diagnosis is difficult. New laboratory methods for identifying the presence of specific IgM antibodies have been developed but at present it is not thought justifiable to use these for prenatal screenings because of the low incidence of the disease. Fortunately one attack gives immunity and subsequent children are protected.

  Related Articles on Pregnancy Problems

For more advice, see the following:

Digestive problems in pregnancy: Hernia, appendix, reflux.
Postmaturity: Baby is 2 weeks or more overdue.
Placenta insufficiency: Can cause fetus growth problems.
Kidney infection during pregnancy: Signs and dangers.

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WOMENS HEALTH ADVICE: ABOUT PREGNANCY COMPLICATIONS
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