Infectious Disease Book

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Travel in Pregnancy

Aka: Travel in Pregnancy, Obstetric Related Air Travel Restrictions
  1. Precautions: Airline travel
    1. Safe until 36 weeks gestation (32 weeks if Multiple Gestation)
      1. Carry documented ED+C (due date) with travel papers
    2. Relative Contraindications to Air Travel
      1. Airline travel after 36 weeks (after 32 weeks if Multiple Gestation)
      2. Severe Anemia or Sickle Cell Anemia
      3. Thrombophlebitis
    3. Prevention of Deep Vein Thrombosis
      1. See DVT Prevention in Travelers
      2. Consider Compression Stockings
      3. Walk every half hour during flight
      4. Perform Isometric Exercises (e.g. flex and extend ankles) frequently while sitting
      5. Stay hydrated
    4. Cesarean Delivery
      1. Air travel safe 1-2 weeks after procedure
    5. Newborns
      1. Avoid travel for first 1-2 weeks (at least >48 hours) after delivery
      2. Consult pediatric pulmonology before air travel in children with chronic lung disease
    6. Radiation Exposure
      1. Background radiation
        1. Does not appear to increase Teratogenicity in pregnancy
        2. However, pregnant frequent flyers, pilots, and flight attendants may be exposed to higher radiation doses
      2. Body image scanners for security screening
        1. Appear to be safe in pregnancy
  2. Precautions: International Travel
    1. See First Aid Travel Kit
    2. Avoid contaminated food and water
      1. See Prevention of Foodborne Illness
      2. Hepatitis E is particularly dangerous in pregnancy
    3. Travel to areas with Malaria
      1. Avoid this travel during pregnancy if possible
      2. See Prevention of Vector-borne Infection
      3. Malaria Prophylaxis as directed by CDC
        1. Chloroquine and Mefloquine are used in pregnancy
    4. Update important Immunizations based on CDC guidelines
      1. See Immunization in Pregnancy
  3. Precautions: Activities in pregnancy
    1. See Exercise in Pregnancy
    2. Scuba Diving is contraindicated
    3. Avoid travel to altitude >13,000 feet or 4000 meters
  4. Resources
    1. CDC Yellow Book: Pregnancy, Lactation and Travel
      1. http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-8-advising-travelers-with-specific-needs/pregnant-travelers
  5. References
    1. (2018) Obstet Gynecol 132(2):e64-e66 [PubMed]

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