21. Lyme Disease
Lyme disease is an infection carried
and transmitted to humans by ticks. It crosses the placenta, which can
cause complications for baby. The disease appears in stages. In most people, a skin lesion with a distinctive look, called a bull’s-eye,
appears at the site of the bite. Flulike symptoms appear next, and 4 to
6 weeks later, heart or neurological problems may develop. Arthritis
may be a problem much later.
Treatment for Lyme disease includes
long-term antibiotic therapy. Many medications used to treat Lyme
disease are safe to use during pregnancy.
To avoid exposure to Lyme disease, avoid
places known to have ticks, such as heavily wooded areas. If you can’t
avoid these areas, wear long-sleeved shirts, long pants, socks and
boots or closed shoes. Keep your head and hair covered with a hat or
scarf. Check your hair for ticks; they often attach to the hair or
Methicillin-resistant Staphylococcus aureus (MRSA; sounds like MERSA)
is a bacteria that causes difficult-to-treat infections because
antibiotics often don’t work against them. The bacteria (Staphylococcus
aureus, also called staph) are resistant to many antibiotics; antibiotics that were effective in the past no longer work.
Methicillin is a strong antibiotic once
useful in treating staph in the past, but it is less useful today.
Other antibiotics ineffective against MRSA include dicloxacillin,
nafcillin and oxacillin. A nickname used in the media for MRSA or
Staphylococcus aureus is “super-bug.”
MRSA is a serious infection and is passed
from person to person, usually by poor hygiene. It can start as
inflamed skin, with boils or pimples. The area may be red and hot to
the touch. MRSA can spread through the bloodstream. When this happens,
it can cause sepsis or septic shock. A very common location of MRSA is
the nose or nostrils. Other possible sites are open wounds, I.V.
catheters and the urinary tract.
Washing hands with regular soap,
alcohol-based foams or hand sanitizers works well in preventing MRSA.
Don’t share towels, soap or other personal items. If you develop any
pimples or boils, don’t pop them. Keep the area tightly covered, and
call your healthcare provider immediately.
Pregnant women may be at greater risk for
MRSA. If either you or your partner work in a hospital or healthcare
facility, prison or anyplace where you have a lot of contact with
people, you could be at risk. Discuss any of your concerns with your
healthcare provider. He or she can give you advice about your
Take care of cuts and scratches. If you
get a cut or scrape, keep it clean, dry and covered. Know what a MRSA
infection looks like—it usually begins as a skin infection then develops small red bumps like pimples. This can be accompanied by a fever or a rash.
Call your healthcare provider if you
believe you have been exposed to MRSA. Some antibiotics work well
against MRSA, including TMP-SMZ (trimethoprim/sulfamethoxazole),
vancomycin and doxycycline.
Your healthcare provider will probably
lance and clean any infected area. Cultures or rapid tests of the skin
may be done. A vaccine against MRSA is being developed.
There is no evidence to indicate MRSA
during pregnancy causes increased risk of problems. It’s very unlikely
a mother would pass MRSA to her baby during delivery. In addition,
breastfeeding is safe for a woman with MRSA.
23. Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) affects 1 in
every 1000 pregnant women. It’s an autoimmune disease that can attack
your body’s joints and/or organs.
Many medicines used to treat RA are safe
for a pregnant woman to use. However, some medications can be dangerous
to use during pregnancy. Talk to your healthcare provider before you get pregnant about any medicine you take for your rheumatoid arthritis.
Acetaminophen is OK to use throughout
pregnancy. However, NSAIDs should not be used in later pregnancy
because they may increase the risk of heart problems in baby.
Prednisone is usually acceptable, although methotrexate should not be used because it may cause miscarriage and birth defects.
Enbrel is one of the newer medications
used to treat RA. Don’t use this medication without checking first with
your healthcare provider.
RA may not affect your labor and
delivery; however, 25% of women with RA have a preterm birth. It may be
harder to find comfortable labor positions if you have joint
24. Rubella (German Measles)
Rubella is a viral infection that
causes few problems in a nonpregnant woman. It is more serious during
pregnancy, especially in the first trimester. There may be no symptoms,
or you may have a rash (most common) or flulike symptoms. Rubella
infection in a mother-to-be can increase the rate of miscarriage and
cause birth defects, especially heart defects.
One of the blood tests you have
at your first or second prenatal visit is a rubella titer. It
determines whether you have been vaccinated against rubella or if you
previously contracted the disease. Most women have had rubella, but if
you haven’t, you will be vaccinated after pregnancy to safeguard you in