Book of Medical Disorders in Pregnancy - Tintash

Poliomyelitis has also been reponed to
produce paralysis more frequently
during pregnancy. Vaccination against
smallpox and polio is therefore
mandatory, when the risk of exposure is
high, while tetanus toxoid can be given
to pregnant women, in whom immunity
has been found to have lapsed.
Cholera, typhoid, and influenza vaccines
are known to offer poor or transient
immunity. Globulins provide protection
for only a defined period of time and are
used primarily for the prophylaxis of
measles and hepatitis.
Rubella vaccine viruses, poten-tially
share the same teratogenic pro-perties as
the wild rubella virus, but they have not
been shown to produce birth defects.
However, pregnancy is a contraindication
to rubella as well as to
measles and mumps vaccination,
because a viral infection of the foetus
can occur and may damage the foetus.
Exaggerated.
Febrile responses to any vaccination
may also jeopardize the pregnancy.
Gamma globulin usually protects the
susceptible individual from measles if
given within 48 hours of exposure. Since
measles have been reported to cause
abortion in up to 50% of infected
pregnant women. The use of gamma
globulin is justified on this account.
Immunization against tetanus: Active
immunization against tetanus can be
carried out during pregnancy without
injury to the foetus. The infant can be
protected against neonatal tetanus by
vaccinating the mother. This is a matter
of great importance in rural areas, where
the incidence of neonatal tetanus may be
high as a result of infection of the
174
umbilical stump. A subcutaneous injection
of tetanus toxoid adsorbed on to
aluminium hydroxide should be given as
early in pregnancy as possible. The
second dose should follow six weeks
later and the final dose six months after
that, or earlier if labour is due before that
time. When a woman has already been
immunized in the past a booster dose of
toxoid may be given in the last trimester.
REFERENCES:
1. Grossman, J.H. Perinatal Viral
infections. Clin. Perinatol. 7:257, 1980.
2. Rossi, M. et al. Maternal rubella and
hearing impairment children. J.
Laryngol. Otol. 94:281, 1980
3. Polk, B. F., et al. An outbreak of rubella
among hospital personnel N. Engl. J.
Med. 303:541, 1980.
4. Krugman, S. Rubella Immunization.
Present status and future perspectives.
Pediatrics. 65:1174, 1980.
5. Griffiths, P.O., et al. A prospective
study of primary cytomegalovirus
infection in pregnant women. Br. J.
Obstet. Gynaecol. 87:308,1980.
6. Griffiths, P.O. et al. Persistence of high
titer antibodies to the early antigens of
cytomegalvirus in pregnant women.
Arch. Virol. 64:303,1980.
7. Gladstone, J.L., and Millan, S.J.
Rubella exposure in an obstetric clinic.
Obstet. Gynecol. 57:182,1981.