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Chickenpox
The good news is that 90% of women of childbearing age are immune to this virus. It is especially when the future mother is infected before the 5th month of pregnancy that the consequences on the fetus can be serious. Fortunately, the risks of transmission (through the placenta) are low: of the 500 expectant mothers infected each year, 10 to 14 fetuses develop a serious malformative disease. These are mainly malformations affecting the skin, nervous system, eyes or bones. The period around childbirth – maternal chickenpox five days before childbirth and two days after – is also at risk since babies can develop neonatal chickenpox with a mortality rate of around 20 to 30%. In the mother also, more fragile at this period, a serious form of chickenpox with pneumonia can occur.
The 5th disease
Extremely rare, it is due to Parvovirus B19 and affects 0,5 to 1% of pregnancies. The major risk for the fetus is anemia by destruction of its red blood cells. This can sometimes be very important and lead to the death of the fetus. This complication is observed especially when the maternal infection occurs in the second trimester of pregnancy. In the mother, it is benign and is characterized by a small rash, a slight fever and some joint pain. Most often the signs are mild and it can go unnoticed. In case of fever, go to your doctor who will have analyzes done!
Rubella
If your vaccines are up to date, you are completely protected. Most of the time, you know whether or not you are immune from the tests you do early in your pregnancy. The risk of fetal infection depends on the age of pregnancy. Contracted by the mother before 18 weeks of amenorrhea (SA), it can be formidable for the fetus. Before 12 weeks, it causes in 80 to 100% of cases serious fetal malformations affecting the central nervous system, the eyes (cataracts), the heart or the inner ear. Between 13 and 18 weeks, a risk of deafness or growth retardation. In the 3rd trimester, the virus crosses the placenta. No malformations, but a complication: congenital rubella.
Cytomegalovirus (CMV)
Phew: more than half of expectant mothers (60%) are immune to this disease which often goes unnoticed. In affected mothers, transmission of the virus to the fetus occurs in 40% of pregnancies. Although the infection rarely affects the unborn baby, it is nevertheless serious since 5% of fetuses affected during pregnancy have a severe form of the disease: growth retardation and problems with the nervous system. Some infected babies may not show visible signs at birth, but later have hearing damage. For the vast majority (90%), the disease does not express itself.
Genital herpes
Genital herpes caused by the HSV-2 virus is harmless to the child during pregnancy, but is feared around the time of childbirth, where it can lead to serious neurological or eye abnormalities in the baby. The expectant mother may have been in contact with the virus before pregnancy, during her pregnancy, or never had herpes attacks while being infected. The fetal complications of this disease differ depending on whether it is a first infection or a maternal reinfection. A baby’s risk of developing neonatal herpes is greater and more serious if the mother is first infected with the virus in the month before giving birth. Fortunately, this case is rare: less than 50 newborns are infected per year. If the mother has a history of genital herpes, the risk of neonatal infection is estimated at 0,1%.
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Hepatitis B
Transmission of the virus to the baby occurs mainly during childbirth, when it passes through the maternal genital tract. Infected babies who are not treated quickly become chronic carriers of the virus and are at risk of serious liver complications (liver cirrhosis, liver failure or liver cancer).
HIV infection
Future HIV-positive mothers should be monitored closely because the virus can be transmitted during pregnancy or during childbirth. 65% of children are infected on the day of their birth, the others in the two months preceding childbirth. The transmission of the virus, from mother to child, depends on whether or not there is treatment. It is 16 to 20% in the absence of preventive treatment, and less than 3% with the most recent treatments. This risk increases if the mother’s viral load is high or if the mother-to-be shows signs of the disease (AIDS).
How to detect these infections?
Some infections are systematically detected during pregnancy. This is the case for rubella, the HIV virus and hepatitis B. Others may be on a case-by-case basis with a maternal rash, fever, contact with an infected person or abnormal ultrasound signs in the patient. fetus. Vaccines to be given before pregnancy exist and are recommended, mainly for rubella and hepatitis B. The vaccine against chickenpox is not yet used systematically in the general population. It may in the future be prescribed for HIV-negative women before conception.
Can we prevent these infections?
To avoid certain diseases, prevention remains the only way: future mothers with young children or in contact with them (nursery staff, hospitals, schools) must observe strict rules to reduce the risk of contamination by cytomegalovirus: do not kiss children on the mouth, do not lick their pacifiers or spoons, and wash their hands before and after changing diapers. The condom is essential for mothers having sex with a person at risk (HIV, genital herpes, hepatitis B) during pregnancy. Finally, treatments should be started during pregnancy, at the time of childbirth or after, to avoid complications in the newborn. This is the case for HIV, herpes, and hepatitis B.