Hi mbak Yuli (Syafica’s Mom) Saya lampirkan artikel tentang kasus cacar air selama kehamilan (maaf, masih dalam versi bahasa Inggris), juga ada kutipan ‘tanya jawab kebidanan dan kandungan’ dari tabloid Nakita yang kebetulan bahas masalah yang sama.
Menurut artikel itu, infeksi cacar air, terutama di usia kehamilan muda atau kehamilan tua (sekitar sekian hari sebelum dan sesudah melahirkan), bisa beresiko juga untuk janin/bayi. Si ibu pun bisa kena resiko dari virus ini juga, apalagi karena memang cacar air pada orang dewasa umumnya lebih ‘severe’ dibandingkan jika infeksinya terjadi pada anak-anak. Memang nggak mungkin lagi dijadwalkan vaksinasi cacar air untuk sang ibu karena sedang dalam kondisi hamil, tapi ada treatment yang bisa dilakukan, tergantung dari usia kehamilan dan kondisi ibu dan janin. Bisa dengan minta bantuan DSOG untuk lihat lebih rinci hasil USG janin terhadap kemungkinan birth defects, pengobatan dengan acyclovir(Zovirax) secara oral atau infus jika memang kasusnya termasuk ‘berat’, atau bisa juga dijadwalkan untuk mendapat suntikan antibodi Varicella Zooster Immunoglobulin baik untuk ibu hamil atau pada si bayi setelah lahir nanti Lebih baik segera konsultasikan dengan DSOG untuk treatment yang paling tepat dan aman untuk ibu dan calon anaknya. Hope that helps, Sylvia – Jovan’s mum ---------------------------------------------------------------------------------------------------------------------------------------- http://www.babycenter.com/refcap/9329.html Chicken pox during pregnancy By the BabyCenter editorial staff (Approved by the BabyCenter Medical Advisory Board) Is it risky to be exposed to chicken pox during pregnancy? In most cases, no. It's not a problem if you've already had chicken pox because your body has developed antibodies to the virus, which in most cases makes you immune to further infection. And even if you think you never had chicken pox, there's a good chance you did; surveys show that about 95 percent of adults born and raised in the United States are immune. (Women who grew up in tropical climates are somewhat less likely to be immune because chicken pox is less common in those areas.) If you have any doubts, see your practitioner for a blood test to find out if you're immune. If you're not immune and you do develop chicken pox while you're pregnant, there's a very small chance that it will affect your baby and some possibility that it will be dangerous for you. But keep in mind that this situation is very rare: Researchers estimate that there are only about six cases of chicken pox for every 10,000 pregnancies. What can happen to my baby if I get chicken pox while pregnant? It depends on how far along you are in your pregnancy, though in general, the chances of the virus harming your baby are very small. If you get chicken pox during the first half of pregnancy, your baby will be at a slight risk (1 to 2 percent) for getting something called congenital varicella syndrome, which can cause birth defects, including scarring of the skin, limb defects, eye problems, and other serious abnormalities. (In a very small number of cases, it can cause a miscarriage.) You'll have a detailed ultrasound at 18 to 20 weeks to see if any there are signs of defects and a follow-up sonogram later to see how your baby is progressing. (Remember that a sonogram can't detect every problem, so it can't completely guarantee you a healthy baby.) Fortunately, though, the vast majority of babies whose mothers have chicken pox during the first or second trimester are not born with any of these problems. If you get chicken pox in the second half of pregnancy but more than five days before giving birth, your baby will likely be fine. Here's why: About five days after coming down with chicken pox, your body develops antibodies to the virus and passes them on to your baby through the placenta, offering him protection that his own immature immune system can't provide. If you develop chicken pox five to 21 days before your baby is born, he might develop chicken pox within days after birth, but because of the antibodies he received from you, it's much less likely to be serious. (Some babies exposed to chicken pox in utero, particularly those exposed five to 21 days before birth, may develop a case of shingles during infancy or early childhood without having had chicken pox after birth, but it's usually not serious.) If you come down with chicken pox between five days before giving birth and two days after delivery, then your baby will have been exposed to the virus but won't have had time to receive antibodies from you before birth. In this case, he has a 30 to 40 percent chance of developing what's called neonatal varicella, or newborn chicken pox, which can be serious and even life threatening, especially if left untreated. Fortunately, your baby's risk of a severe case can be greatly reduced if he gets a shot of varicella zoster immune globulin (VZIG), a blood product that contains chicken pox antibodies. (He'll get it soon after birth if your chicken pox showed up within 5 days of delivery or during labor or as soon as you discover your rash if it's within two days after delivery.) If your baby shows any sign of developing the infection — such as coming down with a fever or showing a rash of even a few spots — he'll be treated intravenously with the antiviral drug acyclovir. Is chicken pox more risky than usual for me if I get it during pregnancy? Some experts believe that chicken pox is also more risky for women themselves when they're pregnant, but in any case, it's definitely more risky for you to get the virus as an adult than as a child. That's because 10 percent of adults who get the infection also develop something called chicken pox pneumonia, which can be severe or even life threatening. What should I do if I'm exposed? If you're not already immune or if you're uncertain of your status, call your practitioner and have a blood test done to confirm your status. If you find out you're not immune (or are unable to get results within four days of exposure), your practitioner may recommend that you get a shot of VZIG (varicella zoster immune globulin). Getting this shot within four days (96 hours) of exposure can lessen your chances of a severe infection, though it won't do anything to protect your baby. (Note: This protection lasts only about three weeks. If you're exposed to chicken pox again more than three weeks after your injection, you'll need another shot.) If I'm not immune and I get exposed, what are the chances I'll catch chicken pox? Chicken pox is highly contagious, and if you've never had it before and have direct contact with an infected person, you're very likely to get it. In fact, it's estimated that 90 percent of people who've never had chicken pox will get it if someone in their household has the disease. How soon would I see symptoms? After exposure to chicken pox, it usually takes about 14 to 16 days to see symptoms, though it can take anywhere from 10 to 21 days. You usually get mild flu-like symptoms for the first day or two, followed by an itchy rash, which starts out as little red bumps that blister as they get larger, then eventually dry out and scab over. The rash often starts on the face, chest, or abdomen, and new eruptions gradually appear on other parts of your body. You're contagious from about 48 hours before the first crop of bumps appears until all of them are crusted over. What should I do if I think I have chicken pox? If you start to have symptoms and think you have chicken pox, call (don't visit) your healthcare provider right away. Don't show up unannounced at your practitioner's office and risk infecting other pregnant women there. If you need to be seen, they'll make special arrangements so that you won't be sitting in a crowded waiting room. If you do have chicken pox, you might be given a prescription for an antiviral drug called acyclovir. If you develop any signs of pneumonia, like a fever with rapid breathing, difficulty breathing, dry cough, or chest pain, call your practitioner right away. How can I lessen my risk of getting chicken pox while pregnant if I'm not immune? Unfortunately, you can't get the chicken pox vaccine if you're already pregnant. If you're not immune, you'll just need to be careful to avoid anyone who has chicken pox, shingles (a related disease), or flu-like symptoms. (You can't catch shingles, but you can catch chicken pox from someone who has shingles.) And, because people are quite contagious about two days before they actually develop the telltale rash, you should avoid contact with anyone who's recently been exposed to chicken pox and hasn't had it before. (About shingles: Shingles is a condition that you can develop as an adult if you've had chicken pox before and the virus becomes reactivated in your system. This is more common in older adults. It's extremely rare for a pregnant woman to develop shingles and even if you did get shingles while pregnant, it's not thought to pose any risk to the baby.) Some experts recommend that members of your household who are not immune to chicken pox get vaccinated so you're less likely to be exposed to the disease while pregnant. This is particularly important if they've recently been around someone with chicken pox because, if given within a few days, the vaccine decreases the risk of coming down with chicken pox. Finally, be sure to get vaccinated after you have your baby, so you don't have to worry about chicken pox during your next pregnancy! TAKUT CACAR AIR (SUMBER: tabloid Nakita: Tanya Jawab Kebinan dan Kandungan - Dr. Judi Januadi Endjun, SpOG) Saat ini saya hamil sekitar 3 bulan, anak kedua. Waktu usia kehamilan 4 minggu, saya demam diikuti pusing, sakit tenggorokan, dan ada benjolan sebesar kelereng di leher. Kemudian di dada keluar bintil-bintil merah sebesar jerawat berisi cairan yang lalu menyebar ke seluruh tubuh. Kata dokter, saya kena cacar air (varisela) dan diberi obat CTM, Fevrin serta Salicyl Talk. Seminggu kemudian, setelah obat habis, saya diberi Amoxillin, Proviral, dan obat demam. Mengingat usia kandungan yang masih sangat muda, saya mengkhawatirkan dampak obat-obatan itu pada kandungan. Apalagi saya pernah dengar, beberapa bayi menjadi cacat karena ibunya menderita penyakit cacar sewaktu hamil. Apakah penyakit cacar yang saya derita bisa mempengaruhi keadaan janin? Seberapa jauh pengaruh penyakit yang saya derita dan obat-obat yang saya makan terhadap kesehatan janin dan bagaimana cara mendeteksi keadaan janin setelah saya sembuh dari penyakit cacar? Jawab: Penyakit cacar air masih sering dijumpai di Indonesia, terutama pada anak-anak.Penyakit ini kadang menyerang wanita hamil. Meski umumnya cacar air ialah penyakit ringan, tapi pada wanita hamil kadang-kadang bisa menjadi lebih berat, dan dapat menyebabkan bayi lahir sebelum cukup bulan (persalinan prematur) atau tertular penyakit itu sewaktu berada di kandungan. Secara teoritis, bila ibu hamil kurang dari 20 minggu (4 bulan 3 minggu) terkena infeksi cacar air, maka janin yang dikandungnya akan tertular dan dapat mengakibatkan kelainan. Tapi frekuensi cacat bawaan tak lebih tinggi pada bayi yang lahir dari ibu yang menderita cacar air dalam masa kehamilannya dibandingkan dengan ibu yang tak menderita cacar air. Suatu penelitian dengan jumlah besar telah dilakukan di Jerman dan Inggris oleh Enders dkk pada 1994 yang melibatkan 1.373 wanita hamil. Enders menyimpulkan, bila infeksi terjadi setelah kehamilan 20 minggu, tak ada bukti secara klinis bahwa bayi yang dikandung ibu penderita cacar air terserang penyakit itu. Bila infeksi cacar air terjadi pada kehamilan kurang dari 13 minggu, dijumpai 0,4 persen janin terkena infeksi dari ibunya. Risiko tertular paling tinggi pada usia kehamilan 13-20 minggu, yaitu sebesar 2 persen. Berdasarkan keterangan yang Ibu berikan, kemungkinan infeksi cacar air pada Ibu terjadi di usia kehamilan 6 minggu dan risiko tertular pada janin Ibu ialah 0,4 persen (kecil). Untuk mengetahui apakah janin Ibu tertular atau tidak, sangat sulit. Ada satu cara yang dapat dipakai untuk keperluan tersebut, tapi tindakannya invasif dan berisiko, yaitu mengambil darah janin (kordosintesis) melalui tali pusat dengan bimbingan USG. Darah itu lalu diperiksa di laboratorium untuk mencari ada-tidak imunoglobulin (tanda infeksi) atau melakukan biakan virus. Untuk melihat keadaan fisik janin, Ibu dapat melakukan pemeriksaan USG untuk penapisan (screening) cacat bawaan, biasanya dilakukan pada usia kehamilan 18-20 minggu. Sayang sekali, tak semua cacat bawaan dapat dideteksi secara dini dengan USG. Menurut saya, yang juga jangan dilupakan adalah selalu berdoa kepada Tuhan YME agar janin yang Ibu kandung tak cacat serta sehat jasmani, rohani, dan sosial. Obat-obatan yang Ibu makan seperti CTM, Fevrin, Proviral, Amoxillin, dan obat demam dapat berpengaruh pada janin. Setiap dokter akan selalu memperhitungkan segi positif dan negatif dari setiap obat sebelum diberikan kepada pasiennya. Hanya obat-obatan yang mempunyai nilai positif besar terhadap kesehatan Ibu dan janinnya, yang akan diberikan dokter. Ibu dapat menanyakan kembali pada dokter kandungan Ibu mengenai obat-obatan yang diberikan. Bila tiba saat persalinan kelak, mohon diingatkan pada dokter spesialis anak untuk memeriksa secara khusus akan kemungkinan bayi Ibu terkena penyakit cacar air. ------------------------------------------------------------------------------------------ [EMAIL PROTECTED] wrote: Menyambung pertanyaan dari temen yang saudaranya sekarang ini lagi hamil 3 bulan (kurang lebih) terkena cacar air, khawatir terjadi hal˛ yang tidak diinginkan , kira˛ Mom and Dad di milist ini punya saran atau artikel mengenai hal tersebut ? Salam, Yuli - Syafiqa's Mom --------------------------------- Do you Yahoo!? Take Yahoo! Mail with you! Get it on your mobile phone.
