Five women stayed in an area with a potential risk of altitude sickness, for an average of 9.3 days. None received acetazolamide for prevention of altitude sickness and none developed symptoms. One woman developed fever within the first month after returning home. An abnormal finding during prenatal follow-up was found in eight women. In three women, an echogenic focus (golf-ball) was observed in the fetal heart at anatomical scan, in three
woman fetal intrauterine growth restriction was suspected, in one oligohydramnios was observed on ultrasound, in one an abnormal second-trimester biochemical screen was obtained, and in one an ectopic pregnancy was diagnosed. selleck inhibitor Pregnancy was complicated by premature labor in two cases and gestational diabetes mellitus in one case. None of the subjects receiving prophylactic antimalarials had a miscarriage. The course and outcome of all pregnancies are summarized in Table 3. Among the 41 newborns, 2 had neonatal jaundice, 2 had a cardiac murmur, 1 was premature, and 1 had ventricular septal defect diagnosed by echocardiography. In another case, muscular dystrophy was diagnosed at 4 months. However, in all these cases, travel was this website uneventful for the mother, no infectious diseases were reported, and no contraindicated vaccines were administered.
About 50 million people travel to developing countries and tropical destinations annually, 20% to 70% of whom report some kind of a health problem,[7] mainly diarrhea, respiratory problems, very and injuries. Traveling to a tropical destination during pregnancy might pose unique threats to the pregnant patient or her fetus. Hazards of infectious
diseases, for example, might be augmented in the face of an altered immune response and the presence of a susceptible fetus. Additionally, diarrhea and acute gastroenteritis which are common among travelers are well-known risk factors for premature labor. Most reports of travel to the tropics during pregnancy are anecdotal, and therefore cannot provide evidence-based recommendations. The optimal timing for travel in terms of gestational age is not clear. The first and third trimesters might carry a higher risk for obstetrical emergencies, as most spontaneous abortions occur in the first trimester, whereas preterm labor, preeclampsia, and antepartum hemorrhage occur mostly in the third trimester. In this study, only one subject was in the third trimester during travel. It is possible that with advanced pregnancy and the presence of a viable fetus, women are more apprehensive about leaving their home to go to a developing country for a prolonged period of time, thus explaining the low occurrence of late gestations at departure among travelers. In addition, travel for leisure, which was the case in most subjects, may be perceived by the pregnant woman as a non-essential thing to do during advanced pregnancy, that can be deferred until more appropriate times.