29. Toxoplasmosis
Toxoplasmosis is a disease caused by the microbe Toxoplasma gondii.
It is spread by eating infected raw meat, drinking infected raw goat’s
milk, eating infected raw eggs, eating food that has been contaminated
by insects or by contact with an infected cat or its feces. You can
pick up the protozoa from a cat’s litter box, from counters or other surfaces the cat walks on, or from the cat itself when you pet it.
Infection in a mother-to-be can lead to
miscarriage or an infected infant at birth. Usually an infection in a
pregnant woman has no symptoms. An infected baby may appear normal at
birth. Between 80 and 90% develop serious eye infections months to
years later. Babies whose mothers had toxoplasmosis in the first
trimester are usually the most severely affected. About 1 in 1000
babies is born with toxoplasmosis.
To prevent transmission of the
microorganism, cook foods thoroughly and use hygienic measures in the
kitchen. Get someone else to change the kitty litter. Keep cats off
counters, tables and other areas where you could pick up the microbe.
Wash your hands thoroughly after every contact with your cat or raw
meat, and don’t nuzzle or kiss your cat.
30. Urinary-Tract and Kidney Problems
A urinary-tract infection (UTI)
refers to an infection anywhere in the urinary tract, which includes
the bladder, urethra, ureters and kidneys. Your healthcare provider may
do a urinalysis and a urine culture for UTIs at your first visit. He or
she may also check your urine for infections on subsequent visits.
UTIs are common during pregnancy because
of increased pressure on the area. The uterus sits directly on top of
the bladder and on the tubes, called ureters, that lead from the kidneys to the bladder. An enlarging uterus puts increasing pressure on the bladder and ureters.
Symptoms of a bladder infection include
frequent or burning urination, the urge to urinate, though nothing
comes out, and blood in the urine (if the infection is severe).
Pyelonephritis is an infection of
the urinary tract that also involves the kidneys; it occurs in 1 to 2%
of all pregnant women. Symptoms of pyelonephritis include many of those
associated with a bladder infection. The infection may require
hospitalization and treatment with intravenous antibiotics.
Kidney stones occur about once
in every 1500 pregnancies. Symptoms usually include severe back pain
and blood in the urine. In pregnancy, ultrasound is usually used to
diagnose a kidney stone. A kidney stone in pregnancy is usually treated
with pain medication and by drinking lots of fluid or receiving I.V.s
to hydrate you so you can pass the stone.
31. Tay-Sachs Disease
Tay-Sachs disease is one of the most
common Jewish genetic disorders. It is an inherited disease of the
central nervous system. The disease occurs most frequently in
descendants of Ashkenazi Jews; about one out of every 30 American Jews
carries the Tay-Sachs gene. Some non-Jewish people of French-Canadian
ancestry (from the East St. Lawrence River Valley of Quebec) and
members of the Cajun population in Louisiana are also at increased risk.
Do You Have a Fever?
Fever often accompanies illness. A
fever, especially a high one, can be serious because your baby relies
on you for its temperature control. A prolonged high fever, especially
in the first trimester, may cause some birth defects. To bring down a
high fever, drink lots of liquids (1 pint of fluid a day for every
degree above 98.6F), take acetaminophen and dress appropriately to help
you cool down. If your healthcare provider prescribes medication for an
infection or other illness that may be causing the fever, take all of
it as prescribed.
The most common form of the disease
affects babies, who appear healthy at birth and seem to develop
normally for the first few months of life. Then development slows, and
symptoms begin to appear. Unfortunately, there is no treatment and no
cure for Tay-Sachs disease at this time.
Babies born with Tay-Sachs disease lack a protein called hexosaminidase A, or hex-A.
When hex-A isn’t present, substances build up and gradually destroy
brain and nerve cells, until the central nervous system stops working.
Tay-Sachs disease can be diagnosed before
birth by amniocentesis and chorionic villus sampling (CVS). The disease
is hereditary; a Tay-Sachs carrier has one normal gene for hex-A and
one Tay-Sachs gene.
There are various types of Tay-Sachs
disease. The classic type, which affects babies, is the most common.
Other rare deficiencies of the hex-A enzyme are sometimes included
under the umbrella of Tay-Sachs disease. These often are referred to as
juvenile, chronic and adult-onset forms of hex-A deficiency.
32. Your Lifestyle May Impact Your Pregnancy
Your lifestyle and your environment can
affect your health and your growing baby’s health. Environmental
poisons and pollutants that can harm a fetus include lead, mercury,
PCBs (polychlorinated biphenyls) and pesticides.
Exposure to lead increases the
chance of miscarriage. Lead is readily transported across the placenta
to the baby; toxicity occurs as early as 12 weeks of pregnancy.
Lead exposure can come from many sources, including water pipes,
solders, storage batteries, some construction materials, paints, dyes
and wood preservatives. Workplace exposure is possible; check to see if
you are at risk.
Reports of mercury exposure have
been linked to various problems in a baby. Exposure occurs with
ingestion of contaminated fish; one report linked contaminated grain to
mercury poisoning.
PCBs are mixtures of several
chemical compounds used for industrial purposes. Most fish, birds and
humans have small, measurable amounts of PCBs in their tissues. Typical
exposure comes from some of the foods we eat, such as fish.
Exposure to pesticides during
pregnancy is also held responsible for an increase in problems.
Pesticides include a large number of agents. Human exposure is common
because of the extensive use of pesticides; those of most concern
include DDT, chlordane, heptachlor and lindane. Stop using pesticides
in your home and around your work area during pregnancy.
You may not be able to eliminate all
contact with pesticides. To protect yourself against these agents,
avoid exposure when possible. Thoroughly wash all fruits and vegetables
before eating them. If you know you’ll be around certain chemicals,
wash your hands thoroughly after exposure.
