Measles is considered a "childhood" disease, and all because children, as a rule, are ill with it. Adults face this ailment at times less often than children, and even less infected with measles occurs in pregnant women. On average, this number does not exceed 0.4-0.6 per 10 thousand women in the situation. But no matter how rare this problem occurs in the life of expectant mothers, they need to beware of it and always be on the lookout. Measles during pregnancy is extremely dangerous, especially because it often occurs with complications that threaten the safe bearing of the baby, and sometimes lead to miscarriage or premature birth.
Measles: what is this disease?
Every person had to hear about this infectious disease, but many of us have already forgotten how it manifests itself and how it is treated. The culprit of the disease is a special virus. It provokes a whole bunch of disorders in the human body, the main of which is severe hyperthermia, a specific rash in the oral cavity and on the skin, as well as inflammation of the mucous membranes of the upper respiratory tract and eyes.
This virus cannot exist outside the human body, by itself, while it is extremely volatile, therefore, it “mows” everyone indiscriminately. Measles erupts in foci, it does not affect one or two people, entire families become infected, as well as all those who have contacted infected people. Infection occurs by airborne droplets, so anyone who does not have specific immunity in the body that protects him from the attack of the virus can get sick. Immunity is produced in two ways:
- if a person is ill with measles earlier;
- if he has completed the full course of vaccination.
We note immediately that a measles vaccine is not given during pregnancy. Adults are usually protected from this disease, although exceptions do occur. Therefore, gynecologists always recommend that their patients take a blood test to detect antibodies to the measles virus even before the conception of a child in order to minimize the potential risks of the disease. The fact is that this ailment is very difficult for adults to tolerate, the maternal body can not cope with it.
Symptoms of measles
The disease has three degrees of severity - mild, moderate and asymptomatic, it is also called atypical. Measles during pregnancy proceeds in the same way as in all other cases, and is characterized by the following symptoms:
- a strong increase in body temperature (40 and above degrees Celsius);
- small whitish spots on the inner surface of the cheeks (immediately opposite the molars), visually they have a granular structure; occur after the seventh day from infection;
- a rash is also sometimes observed in the sky, but not white, but bright red;
- in the early days of the disease, an infected person has a cough, conjunctivitis, severe runny nose;
- subsequently, a red rash gradually covers the whole body (it spreads from top to bottom - from the face to the neck, trunk, then to the limbs);
- acceptable abdominal pain and indigestion, loss of appetite.
Measles during pregnancy is dangerous because it is in patients from this group that it most often ends with bacterial pneumonia, especially if the woman did not seek medical help on time. Therefore, the occurrence of the above symptoms should be an occasion for an immediate visit to an infectious disease doctor.
Measles during pregnancy
We have already mentioned that there are quite few cases of measles among expectant mothers. Nevertheless, even those units of women who are not lucky to become infected with it should understand that they are at risk. Weakened by pregnancy, the body is more difficult to cope with the disease, so it faces very serious complications:
- pneumonia, bacterial pneumonia;
- laryngitis, bronchitis, pharyngotracheitis;
- meningitis;
- encephalitis.
How easily and quickly a woman recovers is influenced by whether she has been vaccinated before, and how quickly she will seek help. In case of contact with the patient, one should not wait for the symptoms of the disease to appear, but take preventive measures, and this is especially important during pregnancy. A measles vaccine cannot be given after the fact, but doctors have special protocols for managing such patients, following which all risks of the disease can be minimized.
Measles Prevention
The main method for preventing measles outbreaks is through mass immunization. Children are vaccinated without fail, while the vaccine is given free of charge, revaccination is also done at the expense of budgetary funds. Until this measure was introduced, the number of measles patients worldwide was estimated at hundreds of thousands; this infection was the main cause of infant mortality in many countries. At the moment, deaths are extremely rare, but outbreaks of the disease occur regularly, mainly because people deliberately refuse to take preventive vaccinations.
In view of this, it is quite possible to pick up measles during pregnancy, because in many places there is no collective immunity against this disease. In order to protect yourself and your child, you need to conduct a study to detect antibodies to measles in the blood. If they are not there, then you need to introduce the CCP vaccine in advance, but only if pregnancy has not yet occurred. The vaccine is done - and measles is not scary. And with it there are also such dangerous diseases as rubella and mumps.
When immunization is not possible, a pregnant woman should temporarily refuse to visit crowded places, in no case should contact with measles patients, if this was not possible to avoid, she will have to go to the hospital immediately. No less important is the strengthening of one's own immunity. To bring it back to normal, you need to eat right, often walk in the fresh air, have a good rest, take vitamin complexes prescribed by a gynecologist.
Adult measles vaccination
The full range of vaccines that protect a person from measles consists of only two injections. Vaccination for this disease is done in early childhood - 12 months, the second dose is administered at five to six years. This is enough to make the human body invulnerable to measles virus for life. Thus, adult follow-up revaccination is not necessary. The exception is some categories of the population at risk of measles, namely, medical workers and educators.
If an adult has not been vaccinated against measles in childhood, he will be able to correct this at an older age. It will be necessary to do two vaccinations, with an interval of at least one month.
Can pregnant women be vaccinated?
We have already said that measles vaccination in early pregnancy, as well as in the second and third trimester is impossible. This virus easily penetrates the placental barrier, so the child will also be infected. It is impossible to predict how this will affect its development. Help the baby in utero will not work, so doctors never risk and do not vaccinate pregnant women against measles. In order to avoid the disease, a woman needs to use other methods - to avoid contact with infected people and increase her immunity.
Pregnancy Planning and Disease
Modern standards of pregnancy planning include a comprehensive examination of the health status of future parents, the identification and elimination of problems in their organisms, and only then - the conception itself. Doctors strongly recommend that women protect themselves and their baby in advance from a number of diseases, including chickenpox, rubella, and measles. If the patient’s history does not contain evidence that she already had these diseases, she is recommended to do tests to confirm the absence of antibodies to the viruses that cause these diseases, and then vaccinate accordingly. Pregnancy after measles vaccination should not occur earlier than a month after administration of the drug.
What to do if a pregnant woman gets measles?
In case of even the slightest suspicion of an illness, you should immediately seek medical help. This is exactly the case that can be said - the faster, the better. During the first six days after contact with a person infected with measles, a pregnant woman must intramuscularly administer a single dose of immunoglobulin in the amount of 0.25 mg / kg body weight. Moreover, such an injection is done not only for the purpose of treatment, but also as a prophylaxis of measles. A week after a potential virus infection, this measure will be ineffective. A pregnant woman’s immunoglobulin is injected if she has not previously been vaccinated against measles.
In those cases when the symptoms of the disease still showed themselves, a woman needs to undergo treatment in a hospital. Outpatient measles therapy is not possible, as this disease requires quarantine.
The treatment of the disease. Management tactics for pregnant patients
Measles is a viral infection, so you need to treat it in almost the same way as any other acute viral infection:
- observe bed rest;
- drink a lot;
- Stay in a clean, cool and humid place.
Since measles affects the respiratory tract, expectorants and inhalations are additionally attributed to patients. During the disease, it is necessary to carefully monitor the body temperature - in case of a critical increase, immediately take an antipyretic. These measures will help prevent possible measles complications.
Complications after measles
If you start the disease and do not take adequate measures in time, then it will most likely proceed with very serious exacerbations. The most common among them are diseases of the lower respiratory tract, including those with attached bacterial infection. Assuming a similar situation, the pregnant woman will be forced to take medications that are undesirable in her position, including anti-inflammatory and antibacterial drugs.
Measles in early pregnancy is dangerous because it can cause a miscarriage. Unfortunately, this happens with 20% of women. In the second trimester, the situation will not be so critical and probably will not bring any risks in relation to pregnancy. But after the 36th week, measles can cause premature birth.
The effects of measles on the fetus
Doctors have been studying this question for a long time, and over the years of research they have come to the conclusion that measles in itself, if it proceeds without complications, does not pose a serious danger to the fetus. The direct relationship between this infection and the development of congenital pathologies in a child is not confirmed in any of the scientific works. Children whose mothers have the measles virus during pregnancy are usually born with a deficiency of body weight and a characteristic rash, sometimes this happens prematurely. In such cases, they are immediately given an injection of immunoglobulin immediately after birth and sent to the intensive care unit for round-the-clock monitoring. Subsequently, the disease in the womb does not affect their development.
But if the mother had measles with complications, the child is more likely to suffer. The most common cause of this is fetal hypoxia. Lack of oxygen and nutrients threatens the fetus not only underweight, but also damage to the central nervous system, blindness, deafness, delays in mental and mental development.
It is better to postpone pregnancy after measles to allow the body to recover and return to normal. A history of this disease itself does not pose any danger to the fetus. On the contrary, it is very good if the expectant mother had this infection in childhood and has already received immunity from her.