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Toxoplasmosis
Why is it dangerous to change my cat's litter now that
I'm pregnant?
Cat feces can carry a parasite that causes
toxoplasmosis, an infection that isn't serious for you
but can pose a danger to your developing baby. Some
birds and other animals, as well as some raw meats,
can also carry the parasite.
Toxoplasmosis causes most severe damage to the fetus
if a woman comes down with it in her first trimester.
Happily, the odds of contracting toxoplasmosis during
pregnancy are low--only about one in 1,000 women do
so. Studies also indicate that about one-third of
American women are immune to toxoplasmosis altogether.
And if you live with cats the likelihood is even
higher that you've already contracted the disease and
developed an immunity to it.
What are the symptoms of toxoplasmosis?
The symptoms in adults are fairly mild: Swollen lymph
glands in the neck, fever, chills, headache, muscle
aches, and fatigue. They usually appear about two to
three weeks after you've been exposed. But some
infected adults show no symptoms at all.
For a fetus, the effects of toxoplasmosis are more
dire. It can result in low birthweight, fever,
jaundice, and seizures, as well as long-term health
conditions such as mental retardation, and vision
problems.
I'm still worried--what can I do to make sure I don't
have it?
You can take a blood test that measures whether or not
you're immune to the parasite. If you have no
antibodies, you're not immune. The recommended
procedure is to repeat the antibody test every month
or so until you deliver. Should the tests become
positive along the way, it's likely you're infected.
Treatment involves taking special antibiotics over a
period of several months, and greatly reduces the risk
that the baby will be born with any serious problems.
Another option is to test whether your fetus is
infected. This can be done through amniocentesis, as
well as by examining a fetal blood and/or amniotic
fluid sample. Babies at risk can also be tested after
delivery. If a baby does show signs of the infection,
he'll receive long-term antibiotic treatment and be
followed closely. It's reassuring to know that only
one baby in 10,000 is born with severe congenital
toxoplasmosis.
How can I avoid getting it in the first place?
Since the parasite can be found in raw or undercooked
meat, eat your burger or steak well-done. And when
you're handling raw meat, wash your hands thoroughly
afterward. If you're gardening where there might be
cat feces, wear rubber gloves, and wash your hands
well after touching the soil.
As for your cat, feed him storebought pet food to be
sure he's not eating undercooked meat. And rein him
in. Keep him inside, if possible, to prevent him from
hunting mice, since they can harbor the parasite. If
you can't keep your cat from prowling the
neighborhood, don't hold him close to your face, or
share your bed, sheets, pillows, or blankets with him.
Always wash your hands thoroughly after playing with
him. Use gloves when emptying the litter and wash your
hands when you're finished. Better yet, have someone
else take over cat-box duty for the duration of your
pregnancy--something you surely won't miss.
If, after all this, you're still worried, you can have
your cat tested by a veterinarian to see if he has an
infection. And if he does, you should board him with
someone else for six weeks or so until the infection
can no longer be passed along.
German Measles (Rubella)
What is rubella?
Rubella, or German measles, is an infection
characterized by a pink-red rash that first appears on
the face and later spreads to other parts of the body,
a mild fever, and swollen lymph nodes. The virus runs
its course in about three days. Although rubella is a
relatively mild illness, it's very dangerous for a
pregnant woman as it can cause birth defects from
deafness to encephalitis (inflammation of the brain)
and heart defects. Fortunately, at least 75 percent of
women in their childbearing years are immune to the
disease, either from a childhood vaccination or a bout
with German measles as a child.
What if I'm not immune? What can I do?
Ideally, you should get vaccinated before you get
pregnant and then wait three months before trying to
conceive. This gives your body enough time to
completely kill off the injected virus so you won't be
in danger of passing it to your baby. If you got the
vaccine in the early weeks of your pregnancy before
you knew you were carrying a child, don't worry; the
chances it will harm your baby are very low. Still,
your doctor may recommend a detailed ultrasound at 18
weeks to give you some reassurance.
If you become infected with German measles during
pregnancy, the risk to your baby depends on when you
contracted the infection. If it happens during the
first month, there's a one in two chance your baby
will be affected. By the third month, the risk drops
to one in 10. Unfortunately, nothing can be done
during the pregnancy to protect the fetus. You'll need
to work closely with your healthcare provider to test
for birth defects and prepare for when the baby's
born.
Herpes
I'm 9 weeks pregnant and I just had my first outbreak
of herpes. (I didn't notice it until after my husband
and I had intercourse.) He has a history of herpes,
and, to the best of my knowledge, I do not. How will
this affect my fetus?
Drs. Gottesfeld: A primary or first herpes outbreak
can affect your developing fetus; however, this is
quite rare. The main concern with herpes in pregnancy
is at the time of delivery. If you have an active
lesion or symptoms of an impending outbreak when you
are in labor, it is important to notify your provider.
It's likely that your doctor or midwife will recommend
that your baby be delivered by Cesarean section to
decrease the risk of transmitting the herpes virus to
your newborn.
Since a primary outbreak during pregnancy does
increase your chances of miscarriage and premature
labor, aquaint yourself with the signs and symptoms of
these problems. Also, notify your midwife or doctor
about this outbreak so she can keep an eye on you and
your baby. Good luck!
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