Relative Contraindications for Travel during Pregnancy

Travel should be delayed until after delivery in these categories if possible. If travel is unavoidable, preventa-tive measures should be delineated to decrease risk as much as possible, as outlined below.

Pregnant women should carry a copy of their medical

Table 24.7 Relative contraindications for travel during pregnancy

Medical risk factors

Congenital or acquired heart disease (especially valvular disease or congestive heart failure) History of thromboembolic disease

Medical disease requiring ongoing assessment and medication Severe anemia

Chronic lung disease, including asthma

Obstetric risk factors History of miscarriage

Threatened abortion or vaginal bleeding during present pregnancy

Incompetent cervix

Premature labor, premature rupture of membranes, or placental abruption or seperation with prior pregnancy

History of ectopic pregnancy (should be ruled out prior to travel, using ultrasound)

History of or present placental abnormalities

Multiple gestation in present pregnancy

History of toxemia, hypertension, diabetes with any pregnancy

History of infertility or difficulty becoming pregnant

Primigravida over 35 or under 15 years old

Travel to destination that may be hazardous High altitude Scuba diving

Areas endemic for, or where epidemics are occurring of, life-threatening food- or insect-borne infections Areas where chloroquine-resistant Plasmodium falciparum is endemic

Areas where live vaccines are required and recommended

Adapted from the CDC Health Information for International Travel 1999-2000.

record with them in case of an emergency and/or to get general advice in transit or at the destination. This should include a recent evaluation by the women's health clinician. The following should be included: gestational age, presence of an intrauterine pregnancy on ultrasound, fetal growth performance, and appropriate medical and obstetric history. Laboratory data should include blood type and Rh factor. Serology for toxoplasmosis, rubella, measles, chickenpox, cytomegalovirus and hepatitis B should also be considered, if not done previously.

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