Giving the right advice to the pregnant woman keen to travel requires appropriate mix of caution and bravery, simply as this is a phase of great risk and there is a lack of controlled studies on the effects of travel , vaccinations … on pregnant women.
It is clearly sensible to discuss travel plans well in advance (6 weeks) with your GP / Obstetrician/ Travel Medicine Doctor.
Some Contraindications to travel especially abroad are:
Obstetric Factors
- complicated present or past pregnancy
- preterm labour
- retarded intrauterine growth
- twin pregnancy
General Medical Factors
- High Blood Pressure
- Diabetes
- Cardiac Arrhythmias
- High risk of blood clots (Vein thrombosis)
Hazardous Destinations
- a good travel doctor has access to information regarding general warnings
- www.cdc.gov/travel
- www.smarttraveller.gov.au
General and pre-travel information
- Geraldton travel clinic: www.gmgn.com.au/travelclinic.html
Most international Airlines carry pregnant women up to 32-35 weeks, but require a letter stating your fitness to travel and confirming date of delivery. It is also wise to carry all pregnancy documentation, Blood group, medical history , antenatal record .
The Oxygen pressure in air plane cabins is reduced , which is generally not a problem but might become if you pregnant and also anaemic or have sickle cell disease. To prevent blood from clotting in veins hydrate well, do regular in travel exercises of legs, wear below knee compression stockings.
Vaccinations should bare some exceptions - were risk of catching the true illness outweighs the harms of vaccine - be generally avoided in pregnancy. Advice on vaccination has to be based on a thorough medical and vaccination history, up to date knowledge of destination health risks. Vaccination for Diphteria Tetanus, seasonal and pandemic Flu, Hepatitis A + B, Pneumococcus , Typhoid could be considered in pregnancy.
BCG(tuberculosis), Mumps Measles Rubella, Chickenpox – vaccines are contraindicated. Tricky is the decision on Yellow fever vaccination.
The most popular travel souvenirs are common viral infections and particularly diarrhoea and vomiting in pregnancy. Persistence with oral rehydration are important to avoid particular risk of shock , metabolic illness , preterm labour in pregnancy. (Buy oral rehydration packs from your travelclinic or pharmacy!) It is not clear if anti diarrhoea medicines like immodium are safe , but they have been used in pregnancy. Only certain antibiotics can be used in pregnancy.
Malaria is a significant risk to mother and baby, avoid travel to malaria areas if possible! Mosquitos seem to be attracted to the pregnant due to increased skin temperature and higher CO2 production. Screens , Bed-nets sensible clothing , staying indoors at night and the sparingly use of insect repellents seems advisable. DEET (the commonest repellent) particularly if applied thick to large areas of skin get’s absorbed , and even travels the placenta into the babies blood. Discuss oral antimalarials with your doctor.
Other travel issues are common ailments and discomforts of pregnancy, ready access to medical facilities, safety of national blood supplies, availability of anti D for rhesus negative mothers.
Helko Schenk
Geraldton 26 1 2010
It is clearly sensible to discuss travel plans well in advance (6 weeks) with your GP / Obstetrician/ Travel Medicine Doctor.
Some Contraindications to travel especially abroad are:
Obstetric Factors
- complicated present or past pregnancy
- preterm labour
- retarded intrauterine growth
- twin pregnancy
General Medical Factors
- High Blood Pressure
- Diabetes
- Cardiac Arrhythmias
- High risk of blood clots (Vein thrombosis)
Hazardous Destinations
- a good travel doctor has access to information regarding general warnings
- www.cdc.gov/travel
- www.smarttraveller.gov.au
General and pre-travel information
- Geraldton travel clinic: www.gmgn.com.au/travelclinic.html
Most international Airlines carry pregnant women up to 32-35 weeks, but require a letter stating your fitness to travel and confirming date of delivery. It is also wise to carry all pregnancy documentation, Blood group, medical history , antenatal record .
The Oxygen pressure in air plane cabins is reduced , which is generally not a problem but might become if you pregnant and also anaemic or have sickle cell disease. To prevent blood from clotting in veins hydrate well, do regular in travel exercises of legs, wear below knee compression stockings.
Vaccinations should bare some exceptions - were risk of catching the true illness outweighs the harms of vaccine - be generally avoided in pregnancy. Advice on vaccination has to be based on a thorough medical and vaccination history, up to date knowledge of destination health risks. Vaccination for Diphteria Tetanus, seasonal and pandemic Flu, Hepatitis A + B, Pneumococcus , Typhoid could be considered in pregnancy.
BCG(tuberculosis), Mumps Measles Rubella, Chickenpox – vaccines are contraindicated. Tricky is the decision on Yellow fever vaccination.
The most popular travel souvenirs are common viral infections and particularly diarrhoea and vomiting in pregnancy. Persistence with oral rehydration are important to avoid particular risk of shock , metabolic illness , preterm labour in pregnancy. (Buy oral rehydration packs from your travelclinic or pharmacy!) It is not clear if anti diarrhoea medicines like immodium are safe , but they have been used in pregnancy. Only certain antibiotics can be used in pregnancy.
Malaria is a significant risk to mother and baby, avoid travel to malaria areas if possible! Mosquitos seem to be attracted to the pregnant due to increased skin temperature and higher CO2 production. Screens , Bed-nets sensible clothing , staying indoors at night and the sparingly use of insect repellents seems advisable. DEET (the commonest repellent) particularly if applied thick to large areas of skin get’s absorbed , and even travels the placenta into the babies blood. Discuss oral antimalarials with your doctor.
Other travel issues are common ailments and discomforts of pregnancy, ready access to medical facilities, safety of national blood supplies, availability of anti D for rhesus negative mothers.
Helko Schenk
Geraldton 26 1 2010
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