Monday, April 9, 2012

Pregnancy ~ Bacterial & Viral Infections ~ Should YOU Be Concerned???

Well, should you? As Iris affirms to Arthur in one of my favorite films, The Holiday; “Arthur, this is a big deal.” Group B Strep (GBS) & Cytomegalovirus (CMV) infections are something every pregnant mom should know and be concerned about. 
Who knew? I certainly didn’t. In today’s fast paced world, when you are expecting a baby, you really need to pick and choose what you read and digest. Empowerment is the key. So, you may ask, “How do I become empowered?”
Empowerment comes from becoming educated, proactive and vigilant about the safety of the baby you are carrying. It means getting all the facts and having the cards stacked in your favor. It means never hesitating to call and ask your health care team about any concerns or questions you may have. Remember, your health care team is there to educate and inform you ~ that’s their job. And always ~ you should trust your gut. 
Due to the hustle and bustle of your health care team’s office, the time is not always available for them to explain to you what exactly you should be doing and looking out for to insure the wellbeing of your baby from trimester to trimester.
Dr. James McGregor, Researcher, MDCM, Professor of OB-GYN, Division of Perinatology, University of Southern California, Keck School of Medicine, and Marti Perhach, Group B Strep International’s Co Founder, share amazing information which may even save the life of your baby and/or let your little one lead a totally normal life if you educate yourself. You can help avoid the risk of bacterial and viral infections by taking some very simple steps.
It all begins during your first trimester with your first visit to your health care team at approximately 8 weeks gestation. Your first health care check up is extremely important. During this visit your urine will be cultured for GBS. So, you may wonder, “What is the big deal about GBS???”

Did you know approximately 10% - 30% of pregnant women are contaminated with GBS and, roughly 2% of these pregnant moms will pass these germs during delivery to their babies. You may say, “Well 2% ~ that’s not a lot.”
If infected, babies will show signs of GBS infection between 6 hours and 7 days of birth, although late onset after the first week of baby’s life may also result according to the U.S. Centers for Disease Control and Prevention (CDC). GBS may cause infections in your baby’s spinal cord, lungs, blood (sepsis) or brain. Although fatal in 5% of the infants carrying GBS, this bacterium is the prime cause of infectious death among newborns. Moms who are under the age of 21, black or Hispanic are at an increased risk.
If your urine culture is positive for Group B Strep (GBS) or for an asymptomatic bacteriuria at this visit, antibiotics will/should be prescribed. Make sure you ask for the results of your urine culture on your next visit, and have a test of cure (TOC) done if positive, to insure the infection has resolved, once your antibiotics are finished. Discuss with your health care team how GBS will impact your birth plan and the IV medication which will be required during labor and delivery.
If your urine is negative for GBS, you will have a rectovaginal swab taken at 35 – 37 weeks gestation and cultured in accordance with The American College of Obstetricians and Gynecologists (ACOG) National Guidelines. This test is extremely important as the use of preventative antibiotics for moms who test positive for GBS must be given during labor to prevent the transmission of this underlying yet potentially lethal germ to their babies.
The CDC confirms and reminds us 1 in 4 pregnant women carry GBS, the most common cause of life-threatening infections in newborns. “Women should have accurate information to know how to best protect their babies”, states Perhach. If you would like further information on GBS, please go to, www.groupbstrepinternational.org or the Facebook Group page, Group B Strep International.
According to Dr. McGregor, any infection can be “potentially” life threatening to the baby. Cytomegalovirus (CMV) poses a major risk to pregnant women who are around babies and young children. So, moms who are child care providers, daycare workers, preschool teachers, therapists, and nurses need to take extra precautions as preschoolers are the majority of carriers. CMV is present in saliva, urine, feces, tears, blood, mucus and other bodily fluids. You cannot catch CMV by simply being in the same room with someone, unless bodily fluids are exchanged. Additionally, there is no information to indicate CMV is transmitted in the air.
OB/GYNs, for the most part, do not warn women of childbearing age about this infection and how to avoid it. ACOG and the CDC recommend OB/GYNs counsel women on basic prevention measures to guard against CMV. But according to a 2007 survey, fewer than half (44%) of OB/GYNs reported counseling their patients about preventing CMV. Were you told about CMV???
CMV is very prevalent among healthy children 1 to 3 years of age who are at high risk for contracting CMV. As CMV can be transmitted to an unborn child from a pregnant mother experiencing a primary or recurrent CMV infection, how can you minimize your risk? Very easily ~ here are a few simple steps you can proactively incorporate into your daily routine as outlined at www.stopcmv.org:
-     Wash your hands often with soap and water for 15-20 seconds, especially after changing diapers, feeding a young child, wiping a young child's nose or drool, and handling children's toys.
-     Do not share food, drinks, or eating utensils used by young children.
-     Do not put a child's pacifier in your mouth.
-     Do not share a toothbrush with a young child.
-     Avoid contact with saliva when kissing a child.
-     Clean toys, countertops, and other surfaces that come into contact with children's urine or saliva.
Remember, in following the above steps, you can be proactive and help prevent your baby from being born with CMV which may lead to permanent medical conditions and disabilities such as deafness, blindness, cerebral palsy, mental and physical disabilities, seizures, and death. While congenital (before birth) CMV in baby is more common than Down’s Syndrome with only 14% of moms having ever heard of CMV, more children have disabilities due to congenital CMV than other well-known infections and syndromes including Down’s Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and Pediatric HIV/AIDS.
FitPregnancy.com’s section, Protect Your Baby From a Tot-Borne Virus, by Kim Acosta in 2008, advises moms to kiss their tots on their heads ~ and not on their mouths cheeks to avoid CMV. FitPregnancy’s December/January 2012 “Q & A” magazine segment asks the haunting question, “Should I worry about CMV? After reading the magazine’s response by Amanda Kallen, M.D., a Yale University School of Medicine clinical instructor who co-authored a 2010 review on the topic, the reply is definitely, “YES!!!” Both website and magazine sites give great information ~ and both are must reads. 
Be your baby’s guardian of the womb today by taking an active role in your personal hygiene and healthcare decisions. Consult with your health care team about the best ways to avoid  CMV if you:
-       Are concerned about CMV infection during pregnancy.
-       You develop a mononucleosis or flu-like illness during pregnancy.
-       You feel you may be a candidate for CMV screening and / or treatment.

 If you would like further information on CMV, please go to www.stopcmv.org, where I have gathered a lot of my information.
In preventing infections which may prove harmful to you and your baby, Dr. McGregor also advocates:
a.     Good dental hygiene and care
b.     Reporting any vaginal bleeding, discharge or fluid    leakage to your health care team.
c.     Avoiding membrane stripping to induce labor.

 Moms, please check out the websites above. Empowerment comes when you are educated, proactive and vigilant. Remember, a sweet little life is depending on you…xo