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
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 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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