Pregnancy is a very special state of mind and body of a woman. Of course, this is both a holiday and an ordeal. From the point of view of the immune system, pregnancy is a serious shock, since a lot of new substances, antigens appear in the woman's body, information about which will be processed by all parts of the immune system. All organs and systems work differently, which also indirectly affects the immune system (for example, increased kidney function increases the loss of immunologically significant substances). In fact, pregnancy is a condition that can lead to immunosuppression.
In addition, pregnancy brings with it new risk factors for infection, such as the likelihood of infection with the hepatitis B virus during medical procedures.
What vaccinations should be done before pregnancy?
** - In Russia, vaccines against varicella, unfortunately, are not registered. As of 2005 in near abroad such vaccines (Okavax, Varilrix) are available only in some CIS countries (Ukraine, Kazakhstan) and countries.
*** - if it is not possible to start a course of vaccinations against hepatitis B (see below) 6 months in advance. before the planned pregnancy, i.e. completely complete the vaccination before it begins
***** - if the scheduled vaccination period has come up (once every 10 years, after the age of 16) or the previous vaccination was missed.
***** - if the 2nd or 3rd trimester of pregnancy coincides with the annual influenza epidemic
Rubella
It is no secret that practically any viruses whose size and properties allow them to penetrate the placental barrier are dangerous for pregnant women and their unborn children, but it stands out among them, because congenital malformations in the fetus become a consequence of infection of a non-immune pregnant woman with a 75-95% probability (t .n congenital rubella syndrome). Heart defects, hearing loss or deafness, numerous eye lesions, up to blindness, mental retardation - this is not a complete list of lesions included in the congenital rubella syndrome. Studies show that congenital rubella is responsible for about 20% of malformations and occurs in more than 2 per 1000 live births. Even in major cities In Russia, about 30% of women aged 18-30 are not immune to rubella.
If the woman did not have rubella, i.e. there is no documentary evidence of the fact of the disease, then the vaccination must be done at least 2 months before the start of the planned pregnancy. It is possible to test for rubella immunity by immunological methods, but such a test is not prerequisite for vaccination. As shown by foreign and Russian studies, vaccination given to those who initially had antibodies to rubella is safe and in the vast majority of cases can only improve the strength of immunity to infection.
All modern rubella vaccines are 95-100% effective, and the immunity created by them lasts more than 20 years. Since the vaccine is a live virus, the vaccination course consists of only one vaccination, i.e. immunity is formed immediately, without revaccinations. Another positive effect of vaccination is the transmission of antibodies against rubella with mother's milk future child.
In no case should the rubella vaccine be given during pregnancy due to the theoretical, but still, possibility of damage to the fetus by the vaccine virus.
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NB! For at least 2 months. after vaccination against rubella, it is necessary to protect yourself!
Chicken pox
Like rubella, the varicella-zoster virus also has the property of damaging the fetus when the mother is infected during the 2nd or 3rd trimester of pregnancy. The syndrome of congenital chickenpox includes gross violations of the formation and lesions of the skin, vision, skeleton and brain.
The varicella vaccine is strictly contraindicated during pregnancy due to the theoretical risk of fetal harm.
NB! For at least 1 month. after vaccination against chicken pox, it is necessary to protect yourself!
Viral hepatitis B
Strictly speaking, vaccination against viral hepatitis B is necessary for everyone, and immunity against hepatitis B is useful for a woman both before and after childbirth. Why is hepatitis B relevant for pregnant women? After all, the hepatitis B virus does not have the ability to damage the fetus, like the rubella virus.
The hepatitis B virus is transmitted through blood and other bodily fluids. Almost all pregnant women undergo injections, examinations, and manipulations. Actually, the probable transfusion of blood and its preparations - all this also represents an additional risk of infection with the hepatitis B virus.
The standard hepatitis B vaccination schedule looks like 0-1-6 months, i.e. selected day (0) - one month (1) - 6 months (3) after the first vaccination. Ideally, it is better to start vaccination in such a way as to have time to do all three vaccinations before the start of pregnancy - i.e. for 6 months This will guarantee protection in an average of 85-90% of those vaccinated.
However, when preparing for a planned pregnancy in practice (unfortunately, rarely does anyone think about vaccinations six months before pregnancy), this scheme will most likely look like this: the selected day (0) - in a month (1) - in 6-12 months (3 ) after the first. In other words, two vaccinations 1 month apart. provide immunity lasting up to 1 year, the third vaccination (done after childbirth) forms immunity lasting more than 15 years (modern vaccines have been used only since 1986, so the full duration of immunity has not been clarified). The disadvantages of this approach include the fact that a somewhat smaller (75%) number of vaccinated people can guarantee protection between 2 and 3 vaccinations.
The existing alternative scheme of immunization against hepatitis B (0-1-2-12 months) is used mainly due to emergency indications and is characterized by a more intense and reliable formation of immunity two months after the start of vaccinations. The relative disadvantages of this scheme should be recognized as its higher cost, a greater number of vaccinations and visits to the doctor.
The hepatitis B vaccine is a pure "Australian antigen", that is, only a part, or rather only one of the proteins of the virus. The effectiveness of vaccination in adults is on average 85-90%, adverse reactions are insignificant (a slight increase in temperature is possible in about 2% of those vaccinated and mild soreness at the injection site) in 5-10% of those who received the vaccine.
Polio
The third vaccine, which would be very good to do: against polio. For Russia, this is still futurism, but for European women it is more than a reality - the polio vaccine appears in all self-respecting French publications on pregnancy and childbirth. Of course, the risk of infection with naturally circulating poliomyelitis both in Europe and in Russia is negligible - the last time a "wild" virus was seen in the central regions of the Russian Federation was 10-15 years ago. But there is a more than real risk of being infected with a live vaccine virus, since Russian children, in order to eradicate polio in the country, receive OPV - a live virus vaccine - without exception. In fact, it is contraindicated for a child to receive OPV if his mother is pregnant, but in practice this contraindication is rarely observed.
The vaccine virus in OPV is intended for reproduction in the intestines of the vaccinated, including for isolating the virus into the environment in order to immunize others. Not everyone around is able to adequately respond to such immunization, especially those who are compromised in one way or another. That is why in France and a number of other countries it is recommended to be vaccinated (revaccinated) with inactivated polio vaccine (IPV) before pregnancy. One vaccination is enough to "remind" the immune system of the existence of the virus.
Why is OPV not recommended for revaccination? The fact is that in some cases, the OPV virus is able to persist in the body of the vaccinated for months and even years, so its introduction before pregnancy is risky.
diphtheria, tetanus
A diphtheria and tetanus vaccine is needed if the next vaccination is due or if you missed a previous vaccination. According to the calendar, vaccination against diphtheria and tetanus is done every 10 years after vaccination at 16 years old, that is, at 26 years old, 36 years old, etc. up to 60 years old. 90% of adults do not remember and do not know about it. And this vaccine is needed, first of all, for the unborn child, who needs to be protected from such a pathology as neonatal tetanus - an absolutely deadly infection. The child does not have its own antibodies to tetanus bacillus, and the mother's, transmitted with milk in the first days of feeding, will render the baby an invaluable service.
Flu
Pregnant women whose 2-3 trimester coincides with an influenza epidemic, in accordance with current US recommendations, should be vaccinated against influenza 2-3 months before the epidemic. These recommendations are based on evidence of a higher susceptibility of pregnant women to severe influenza complications. In addition, vaccination is especially strongly recommended for pregnant women (as well as other adults and children) with chronic diseases.
It is best to get vaccinated against influenza before a planned pregnancy, if updated vaccines are available at that time (usually, they appear in September), to protect in the current epidemic season. However, modern inactivated influenza vaccines belonging to the classes of split (split-) and subunit preparations are not contraindicated and are even recommended for use during pregnancy.
If you yourself cannot decide whether it is necessary in your case or not, then consult your doctor in antenatal clinic and a vaccination center specialist.
Vaccination during pregnancy
The risk of vaccination during pregnancy is rather theoretical. The benefits of vaccinating pregnant women generally outweigh the potential harms when: (a) there is a high likelihood of contracting the disease; b) the infection poses a particular threat to the mother or fetus, and; c) the vaccine is unlikely to cause harm.
As a rule, vaccination with live vaccines (mumps and rubella; chickenpox, polio) is contraindicated in pregnant women because of the theoretical risk of transmitting a weakened virus to the fetus. If a pregnant woman has been vaccinated or becomes pregnant within 3 months of vaccination, she should be warned about possible consequences. Nevertheless, the question of terminating a pregnancy is usually not worth it.
In particular, get vaccinated against especially dangerous infections that can cause serious harm to your unborn child. What vaccinations are necessary to protect your unborn child and yourself from the risk of infection?
Rubella
If you have not had rubella, i.e. you do not have a certificate confirming this fact - it is better not to rely on the memory of your parents, and get vaccinated at least 2 months before the planned pregnancy. If you want, you can test for rubella immunity by getting an antibody test, but it's not necessary. As shown by foreign and Russian studies, vaccination given to those who initially had antibodies to rubella is safe and improves immunity to infection.
All modern rubella vaccines are 95-100% effective, and the immunity created by them lasts for more than 20 years. Since the vaccine is a live virus, the vaccination course consists of only one vaccination, i.e. immunity is formed immediately, without revaccinations. Another positive effect of vaccination is the transfer of antibodies against rubella from mother's milk to the unborn child.
In no case should the rubella vaccine be given during pregnancy due to the theoretical, but still, possibility of damage to the fetus by the vaccine virus. That is, it is necessary to protect yourself for at least 2 months after rubella vaccination.
Hepatitis B
Although the hepatitis B virus does not have the property of damaging the fetus like the rubella virus, it is transmitted through blood and other bodily fluids. Pregnant women are subjected to injections, examinations, manipulations. Actually childbirth, probable transfusion of blood and its preparations - all this also represents an additional risk of infection of the mother and child with the hepatitis B virus.
The standard hepatitis B vaccination schedule is 0–1–6 months, i.e. selected day (0) - one month (1) - 6 months (3) after the first vaccination. Ideally, it is better to start vaccination in such a way as to have time to do all three vaccinations before the start of pregnancy - i.e. for 6 months. This will guarantee protection in an average of 85-90% of those vaccinated.
However, when preparing for a planned pregnancy in practice (unfortunately, rarely does anyone think about vaccinations six months before pregnancy), this scheme will most likely look like this: the selected day (0) - in a month (1) - in 6-12 months (3) after the first. In other words, two vaccinations 1 month apart. provide immunity lasting up to 1 year, the third vaccination (done after childbirth) forms immunity lasting more than 15 years. The disadvantages of this approach include the fact that a somewhat smaller (75%) number of vaccinated people can guarantee protection between 2 and 3 vaccinations.
The existing alternative scheme of immunization against hepatitis B (0-1-2-12 months) is used mainly due to emergency indications and is characterized by a more intensive and reliable formation of immunity two months after the start of vaccinations. The relative disadvantages of this scheme should be recognized as its higher cost, a greater number of vaccinations and visits to the doctor.
The hepatitis B vaccine is only a part, or rather only one of the proteins of the virus. The effectiveness of vaccination in adults is on average 85-90%, and adverse reactions are insignificant - a slight increase in temperature (in 2% of those vaccinated) and mild soreness at the injection site are possible.
Additional vaccinations
- The diphtheria and tetanus vaccine is recommended if the next vaccination is due or if you missed a previous vaccination. According to the calendar, vaccination against diphtheria and tetanus is done every 10 years after vaccination at 16 years old, that is, at 26 years old, 36 years old, etc. up to 60 years old. 90% of adults don't remember or don't know about it. The child does not have its own antibodies to tetanus bacillus, and the mother's, transmitted with milk in the first days of feeding, will render the baby an invaluable service.
- In some European countries, compulsory vaccination against polio is practiced for women planning a pregnancy. This is explained by the fact that there is a risk of a viral infection if there is a child next to a pregnant woman who has just been vaccinated against polio with a live polio vaccine (OPV). In Russia, this vaccine is included in the mandatory vaccination calendar. The vaccine virus multiplies in the intestines of the vaccinated and is released into the environment. That is why in France and a number of other countries it is recommended to be vaccinated (revaccinated) with inactivated polio vaccine (IPV) before pregnancy.
- Before the predicted epidemic, doctors recommend that pregnant women get vaccinated against influenza. Modern vaccines contain an inactivated (killed) influenza virus, so it is considered safe for a child. However, if you are less than 14 weeks pregnant, this vaccine should not be given. Also, keep in mind that no flu shot guarantees you won't get sick. All the same, there remains, albeit a small, but unpleasant opportunity to endure the flu, often in an erased form.
2016-04-11 17:24:28
Aliya asks:
Hello! I was vaccinated against diphtheria for 2-3 weeks. I went to the infectious disease doctor, she really couldn’t tell me anything, she said that the chances of 50-50 they say it’s better to terminate the pregnancy. The gynecologist also does not know, says he did not encounter such a problem. I don’t know where to turn anymore. Can you tell me if there can be any violations or pathology in the development of the child?
Responsible Bosyak Yulia Vasilievna:
Hello Aliya! Of course, vaccinations are contraindicated during pregnancy, but in your particular case, it is advisable to consult a geneticist, he will calculate all possible risks. You can wait until 10-12 weeks, go through the first screening - ultrasound + combined test (PAPP + hCG) and then make a final decision.
2016-04-06 18:30:12
asks Andreeeva Galina:
Tell me please, I have a delay in menstruation is not very big. But there is a possibility that I am pregnant. Tests show nothing yet. And in the middle of the month I was vaccinated against diphtheria. Will it affect pregnancy?
Answers:
Hello Galina! Vaccination against diphtheria (if indicated) is carried out even during pregnancy. So, a vaccination given during pregnancy planning is not dangerous. Take care of your health!
2016-04-02 08:41:48
Ludmila asks:
Good afternoon. I would like to know how dangerous it is to use combilipen and chondrogard at the beginning of pregnancy. What are the consequences for the fetus? And how dangerous is the diphtheria vaccine given early in pregnancy? Thank you.
Responsible Wild Nadezhda Ivanovna:
Vaccination against diphtheria during pregnancy is contraindicated, especially before 13.5 weeks. Kombilipen, chondragard - are contraindicated during pregnancy. What are the consequences? - 50 to 50 .... Needed prenatal screening at 12 weeks - Prisco I and prenatal screening of the 2nd trimester - Prisco II at 16-19 weeks. It is necessary to consult a geneticist in the CPS.
2015-08-15 19:48:07
Anna asks:
Hello. Husband 04.08 was vaccinated against diphtheria. 15.08 took ketorolac. Please tell me if it is possible to plan a pregnancy in the coming days? Thank you
Responsible Medical consultant of the portal "site":
Hello Anna! Neither the diphtheria vaccination nor a single dose of ketorolac are factors requiring a delay in conception. Plan your pregnancy and don't worry about anything. Take care of your health!
2014-01-11 17:12:34
Olga asks:
Hello, tell me, please, what should I do if I accidentally become pregnant 2-3 weeks after vaccination against diphtheria and tetanus? Can there be any concern for the fetus?
Responsible Purpura Roksolana Yosipovna:
2013-10-24 15:51:05
Laysan asks:
Hello! Is it possible to carry a healthy baby if vaccinated against diphtheria in the first week of pregnancy?
Responsible Wild Nadezhda Ivanovna:
Quote: "Anatoxins. Vaccines containing an inactivated toxin (poison) produced by bacteria. Diphtheria and tetanus vaccines can serve as an example. You can be vaccinated 1 month before the planned pregnancy."
Those. during pregnancy in short terms, vaccination against diphtheria is not carried out, but if it is carried out, then strictly according to indications, the harm of the toxoid and the disease is explained to the woman. Then a choice is made.
2013-05-30 11:22:55
Anna asks:
Good afternoon I was given a routine vaccination against diphtheria and tetanus, and a few days later I found out that I was pregnant. The gestation period is about three weeks, how will this affect the child? I don't want to terminate the pregnancy.
Responsible Medical consultant of the portal "site":
Hello Anna. All vaccinations during pregnancy, including vaccination against diphtheria and tetanus, are contraindicated. Vaccination during pregnancy can harm the fetus, so it is carried out only for serious indications. An exception, only when the potential risk of the disease is much higher than the risk of affecting the fetus. However, diphtheria vaccine refers to vaccines that can be given during pregnancy. I recommend that you still consult with your obstetrician-gynecologist on this issue and make a final decision with him - to maintain or terminate the pregnancy. Be healthy!
2013-05-13 06:44:04
Julia asks:
Good afternoon. I wanted to ask you about vaccinations against diphtheria and rubella when planning a pregnancy. As far as I know, after both it is worth protecting yourself for 3 months in order to avoid complications in the child. Can they be done at the same time? Or is there a gap between them? Thank you in advance
Responsible Medical consultant of the portal "site":
Good afternoon Julia.
Rubella vaccination can be carried out simultaneously (on the same day!) with diphtheria vaccination or not earlier than a month after the previous one. With simultaneous vaccination, the drugs are administered in different places; mixing of vaccines in one syringe is prohibited.
After the end of the vaccination course for another 2-4 months (depending on the vaccine and the manufacturer's instructions in the annotation), it will not be possible to plan a pregnancy.
Take care of your health!
As you know, during pregnancy, a woman's body undergoes a huge number of changes associated with hormonal changes, and also becomes very vulnerable to all kinds of viruses, which is easily explained by the instability of the immune system. A decrease in the reactivity of the future mother contributes to infection with dangerous infectious diseases, they can provoke miscarriages in the early stages of pregnancy or intrauterine infection of the fetus with the appearance of gross defects in organ structures during gestation. In connection with high risks For health reasons, vaccination is sometimes recommended for pregnant women to avoid complex diseases and their consequences. Is it necessary for pregnant women to be immunized? How does their body react to different types vaccines?
Rubella vaccination during pregnancy
Rubella is one of the infectious diseases, it is very dangerous for the unborn child. If during pregnancy the mother suffers this ailment, then there is a high probability of her baby developing birth defects, in particular, heart defects, deafness and mental disability. That is why doctors recommend that the fair sex planning a pregnancy 3 months before the intended conception be immunized against rubella with a live inactivated vaccine.
In most cases, doctors offer women to be vaccinated with combined vaccinations, they contribute to the development of immunity from several diseases at once, namely rubella, measles infection and. Most often, this vaccine is a live attenuated suspension of Priorix. Immunity lasts for decades, so a woman can be completely sure of the safety of her baby.
After vaccination, a woman must be protected for at least 3 months. Only in this way will antibodies to have time to develop in sufficient quantities to protect the body from the penetration of infectious agents. During pregnancy, prophylactic is strictly contraindicated, since the vaccine contains live viruses, they easily penetrate the placental barrier and, accordingly, can cause ontogeny of the disease in the fetus.
Polio vaccine
In our country, if you plan a pregnancy, then it is not necessary to be vaccinated against polio. Experts explain this fact by a very low risk of infection for a pregnant woman. But foreign experts will not agree with this, who have long insisted on the need to introduce a prophylactic suspension a few months before the planned conception.
When should vaccination not be withheld? Immunization is recommended for those women in whose family there are already children in the first years of life. The fact is that babies after three years of age are given an oral live vaccine, the viruses in which can be released into the environment, and therefore be dangerous for the environment of the immunized child. If there are pregnant women in the baby's family, then they are recommended to carry out routine vaccination by introducing an inactivated injection solution, it is not able to provoke pathological conditions in people with impaired immune function.
Tetanus toxoid and diphtheria vaccination
And tetanus is recommended to do every 10 years. To do this, use a vaccine or DPT, if you need to vaccinate a person also. These vaccinations are contraindicated for pregnant women, since these vaccines at the beginning of pregnancy can cause a miscarriage, and in the second half of it, the fetus will die, after which it is necessary to induce artificial labor. In addition, tetanus toxoid also has a pronounced teratogenic effect, and therefore they act as the culprits for the occurrence of ontogenesis defects in the unborn child.
Experts advise planning pregnancy for women with a pre-vaccinated against tetanus, as well as immunized against diphtheria. Why is this happening? It is known that both viruses are extremely dangerous for normal human life, and tetanus is generally among the incurable pathologies. Diphtheria is easily transmitted from an infected person to a healthy one, which contributes to its rapid spread in communities where pregnant women may also be. It is for this category of patients that the disease is of particular danger and often leads to death.
Tetanus vaccination is prescribed according to the vaccination plan for the immunization of the population. It is done no later than a month before the probable conception. The injection of the solution should be carried out in a special room, which will guarantee its safety and minimize the risks of post-vaccination complications.
The flu vaccine and pregnancy
flu is serious viral disease, which annually provokes outbreaks of seasonal epidemics throughout the country. For this reason, doctors constantly remind their patients of the importance of vaccination against this disease, which allows them to create protection against a dangerous virus. This makes it possible not only to eliminate the risk of infection, but also to maintain their working capacity without interrupting the labor process.
Since pregnancy is a special period when the body of the expectant mother is extremely susceptible to viral agents, it is this category of the population that should take care of itself and think about immunization during the planning period for the child. You can get vaccinated at every clinic. To do this, use a vaccine called, which is recommended to be given a month before the expected pregnancy.
Is it possible to inject the influenza vaccine in women who have already begun pregnancy? If the patient has no general contraindications to vaccination, then there are no restrictions for her to be vaccinated against influenza during pregnancy. After vaccination, the expectant mother is not only reliably protected from the influenza virus, but is also able to transfer antibodies from it to her newborn child, thereby creating protection for him in infancy. These women are injected with a vaccine for children, known as "".
Many women are not even aware of the existence of such a serious disease as hepatitis B. And there is nothing strange in this. The fact is that the danger of contracting hepatitis appears in people who need surgical procedures, frequent injection of liquids, blood transfusion, since the pathogen is transmitted exclusively through the blood. It is known that women who are registered in the antenatal clinic for pregnancy are forced to constantly take tests, undergo examinations, and undergo medical manipulations. This increases the likelihood of both the mother and her unborn child becoming infected with hepatitis.
It is forbidden to vaccinate all girls "in position", since its effect on the embryo has not been studied. Vaccination is possible only in exceptional situations, when the risk of catching an infection is very high. When planning a baby, they prefer to administer the vaccine three times six months before deciding to give birth. This will provide decent immunity and allow him to form immunity, lasting 15-20 years.
You can also get vaccinated three months before pregnancy, but then you will need to revaccinate once, about a month later. Although such actions will help protect yourself from the penetration of hepatitis B viruses, such protection will be short-term and last only 1-1.5 years. The third injection will allow you to create long-term post-vaccination immunity, which should be done after the birth of the crumbs, if she feels good.
Chickenpox vaccine during pregnancy
Usually seen in children preschool age. Most people get it in early childhood, but there are always those who are bypassed by the virus. Such patients are at risk of contracting a disease during their lifetime, which is much more difficult in adulthood. In addition, during pregnancy, the disease provokes a violation of the formation of organs in the fetus, the appearance of soil for the development of mental or physical retardation. The only way to protect yourself from the disease is to get the vaccine recommended by your doctor.
Girls who are thinking about conception are advised to use the vaccine 3 months before pregnancy. During all this time, they are strongly advised to protect themselves with the help of various contraceptives. For immunization, they take proven Okavax and Varilrix vaccines, after which complications are almost never diagnosed.
What should a future mother do if she does not have protection against chickenpox, if for some reason she was in contact with the patient? Can such a patient be immunized? According to legislative acts, in our country, any vaccinations are prohibited for pregnant women, if the composition includes live pathogens, and refers to their list. Upon contact with a patient during pregnancy, a potentially infected girl is given an injection of immunoglobulin containing ready-made antibodies against the disease. This allows you to prevent the development of the pathological process and ensures the preservation of the health of the fetus.
Vaccination of a future mother against rabies and its effect on the body
In our country, it is assigned only to those who are directly related to this infection, that is, workers in virological laboratories, foresters, farmers, and the like. But anyone can get sick with an incurable disease if he is bitten by an infected animal. Therefore, pregnant girls constantly risk their health, as it can be bitten, for example, by a rabid stray dog. What to do in this case?
During pregnancy, it is forbidden to enter. But this only applies preventive measures. If the injured person was bitten by a wild animal, then vaccination is indicated for health reasons, since in any case the disease is fatal. It is possible to vaccinate by injection of an inactivated suspension, the effect on the baby remains unknown. Naturally, this is a big risk, but there are no other treatment options. In addition to the girl, anti-rabies immunoglobulin was shown.
When put according to the plan a month before pregnancy. It is made to such categories of girls:
- laboratory workers associated with the rabies virus;
- any person who wishes;
- ladies planning a trip to countries with increased level disease incidence.
Tick-borne encephalitis vaccine
Vaccination against this disease is included in the preventive plan for vaccinating women before pregnancy only in endemic foci of infection, that is, in areas where many ticks live. The vaccination should be applied in a course 1.5-2 months before conception. If pregnancy occurs during immunization, then the next injection should be postponed until delivery.
Vaccination is prohibited during pregnancy. What if the girl did it first, and only then found out that she was pregnant? Are such actions dangerous for the baby? Studies on the teratogenicity caused by a tick bite have not been conducted, respectively, there is no confirmation that he is the culprit of a pregnancy complication. Female representatives who find themselves in an ambiguous situation need to be patient, regularly see a gynecologist and visit an experienced immunologist who can determine the possible negative consequences of vaccination for the fetus.
Rh negative vaccine
All preventive measures in the management of pregnant women with negative Rh factor are aimed at preventing sensitization, that is, they are designed to prevent the development in the mother's body of antibodies to fetal erythrocyte cells that have entered the girl's circulatory system. The process of formation of protective complexes can be suppressed by introducing an anti-Rhesus immunoglobulin or a sufficient dose of ready-made antibodies to a problem patient.
Vaccination at risk of Rhesus conflict is a specific human immunoglobulin. It is assigned to negative girls who carry a child with a positive Rh under their hearts. In addition, the drug is used in women with negative factor in the following cases:
- natural abortion or artificial termination of pregnancy;
- when there is a threat of losing a child at any stage of pregnancy;
- ectopic pregnancy;
- after the amniocentesis procedure, when there is a possibility of mixing of maternal and child blood.
As a rule, the solution is administered intramuscularly in the doses prescribed by the doctor. If vaccination was not carried out before the baby was born, then the suspension is administered 72 hours after birth. In the case of immunization of a pregnant patient, after delivery, the drug is prescribed to her in a single dose after three days. It is forbidden to infuse intravenously. Before the procedure, the liquid should be heated to 20 0 C. Patients whose husbands are also Rh-negative do not need an injection.
To prevent conflict, the following steps should be taken:
- a potentially sick girl in a state of pregnancy, regardless of her husband's Rh, should be tested for antibodies between 12 and 19 weeks of pregnancy;
- with a titer of one to four, it is mandatory to pass a second analysis at the 28th week;
- if abnormalities in the development of the fetus are detected, monitoring of the amount of antibodies is prescribed earlier than the above period;
- the level of immunoglobulin should be determined every 6-8 weeks;
- if up to 20 weeks the titer exceeds the permissible ratio, then an additional study is carried out every half a month and the dynamics of such growth is observed;
- the presence of immunoglobulin requires constant ultrasound monitoring of the baby's condition (if gross violations are detected, delivery or intrauterine blood transfusion is recommended to save the baby's life).
After the use of immunoglobulin, adverse reactions are possible in the form of local and general pathological manifestations after an injection. Most often, patients complain of the development of hyperemia, fever, digestive disorders. Naturally, all these changes pass quickly and, unlike dangerous antibodies, do not lead to irreparable impairment of life. In rare cases, doctors diagnose an allergy to a vaccine, and even anaphylactic shock after its administration.
It is important to remember that the achievements of modern medicine allow us to hope for a successful solution to the problem and the prevention of complications associated with Rh-conflict pregnancy. Fortunately, today doctors have everything necessary for the successful bearing of conflict children. The main thing that is needed is the timely response of the woman herself and a thorough examination of her in a consultation.
Preparing for the birth of an heir is an important step towards a happy motherhood. That's why modern women make every effort to prevent unwanted manifestations before the birth of the child. After all, it is always easier to prevent possible problems than to deal with their consequences later. The health of the unborn child largely depends on premature vaccination, since immunity can be transmitted to the baby not only through the blood, but also with breast milk his mother.
It is no secret that for a favorable course of pregnancy, good, competent preparation for it is important, which must be started at least 6 months in advance. An important point Such training is the prevention of a number of dangerous diseases that can adversely affect the development of the fetus and the course of pregnancy. From the point of view of the immune system, pregnancy is a serious shock: a fetus that combines maternal and paternal genetic traits is half foreign to the mother's body. So that the woman’s immune system does not reject the baby and the pregnancy develops safely, the body must always reduce its defenses. Therefore, pregnancy is always a decrease in immunity. In this state, the body of the expectant mother is easily susceptible to various infectious diseases. It is necessary to take care in advance to protect yourself and your unborn baby from the most common and dangerous infections - to make all the necessary vaccinations.
But how do you decide which vaccinations are needed? After all, a woman may not know if she had this infection in childhood and whether she had previously been vaccinated. Or maybe she suffered a disease in a latent form and neither she nor her relatives remember this. To clarify the situation, before vaccination, the doctor will suggest a test for the presence of antibodies to infections in the blood, such as rubella, measles and chickenpox - “chickenpox”. At the same time, immunoglobulins of classes G and M are determined in the blood. These are special proteins that store information about contact with a particular virus or bacterium. Class G immunoglobulins indicate that a woman once suffered from this disease and she retains immunity to it.
Immunoglobulins M are proteins that indicate an acute process, that is, that at the time of the study in the woman's body, the disease has an acute, current character. If class G antibodies to any infection are detected during blood tests, then you should not be afraid of it and there is no need to vaccinate. If there are no such antibodies, then vaccination will protect the woman from the disease in the future.
In addition, there are infections for which vaccination is carried out in childhood(e.g. poliomyelitis, diphtheria). However, every 10 years, the immune system needs to be "reminded" of these diseases, because the protection against them gradually weakens.
Vaccinations before pregnancy: rubella
The most dangerous for the baby in the period prenatal development is the rubella virus. It is known that it can cross the placenta to the fetus and cause serious malformations. Most often, rubella affects children. The virus spreads by airborne droplets. The incubation, or latent, period is 2-3 weeks. If a woman becomes infected with this disease during pregnancy, especially for periods up to 16 weeks, the consequences can be sad: the likelihood of congenital malformations is very high, the rubella virus causes hearing loss and deafness, numerous eye lesions, blindness, heart defects, brain malformations, mental backwardness.
If infection occurs in the 1st or 2nd trimester, this is an indication for termination of pregnancy. In this case, doctors tell the woman about the possible consequences and leave her the right to decide what to do next. If the disease develops for more than later dates when the formation of all organs and systems has already been completed, the risk to the child will be minimal, since during this period the rubella virus is no longer capable of causing serious malformations.
You can check for immunity to rubella by determining antibodies to this infection in the blood. However, such a check is not a prerequisite for vaccination. If it is not possible to donate blood for rubella immunoglobulins, you can be vaccinated if there are already antibodies in the blood: the vaccine will only strengthen the body's defenses.
The vaccination course consists of only one vaccination, it provides protection against infection for at least 20-25 years.
Rubella vaccination is carried out 3-6 months before the intended conception. Since a live vaccine is used for vaccination, a weakened virus can continue to live and develop in a woman's body for some time without causing disease, but has the potential to infect the fetus. Therefore, at least 3 months after vaccination, it is necessary to protect yourself from pregnancy.
Vaccinations before pregnancy: chickenpox
Chickenpox, or chicken pox, is a disease caused by a virus. It most commonly affects children between the ages of 6 months and 7–8 years. At this age, the disease is mild. In adults, chickenpox happens infrequently, but they endure it extremely hard. The disease is transmitted by airborne droplets. Her period hidden development is from 7 to 21 days.
Infection with chickenpox while waiting for a baby does not entail such negative consequences as rubella, however, in a small percentage of cases, women who become infected in the first 4 months of pregnancy give birth to children with congenital chickenpox syndrome: they have malformations of the limbs, brain , eye damage and pneumonia.
In order to find out if a woman has immunity to chickenpox, you can also donate blood for IgG immunoglobulins to this virus. If the expectant mother did not have chickenpox, it is worth getting vaccinated. Vaccination is carried out twice with an interval of introductions from 6 to 10 weeks. Since the vaccine is live and the varicella-zoster virus can live in the body for up to a month, it is necessary to prevent pregnancy after the second injection within a month.
Vaccinations before pregnancy: mumps and measles
Measles- an infectious disease caused by a virus. It is transmitted by airborne droplets from a sick person. The incubation period is from 8 to 14 days. A measles rash appears on the 4-5th day of illness, first on the face, neck, behind the ears, the next day on the trunk, and on the 3rd day the rash covers the folds on the arms and popliteal areas.
In adults, measles is very severe, often with measles pneumonia - inflammation of the lungs - and various complications.
When a pregnant woman is infected with measles in the early stages of pregnancy, spontaneous abortion often occurs. Fetal malformations may occur - damage to the nervous system, decreased intelligence, dementia. To prevent the negative consequences of this disease, before planning a pregnancy, a woman should be tested for antibodies to measles and, if necessary, be vaccinated against measles.
Parotitis- an acute viral infection transmitted by airborne droplets and affecting the parotid and submandibular salivary glands. Its incubation period is 11 to 23 days. The disease is dangerous for its complications: the virus can affect the membranes or tissue of the brain, causing inflammation - meningitis and encephalitis. Also, the causative agent of the disease affects the tissue of the pancreas, joints, and in adults - on the ovaries and testicles, which can lead to infertility.
When infected with mumps in the first trimester of pregnancy, spontaneous miscarriage is possible.
Pregnant women do not often get sick with mumps, which is colloquially called "mumps". Unlike measles, chickenpox or rubella, mumps is much less contagious, so even direct contact with the patient does not give one hundred percent chance that a pregnant woman will also get sick.
If it is not known whether a woman has previously had measles and mumps, then either a blood test for measles IgG and tests for antibodies to mumps should be taken, or re-vaccinated. If antibodies are not found in the blood, vaccination against measles is carried out twice with an interval of 1 month. The measles vaccine is also considered live, therefore, within 3 months after vaccination, it is necessary to protect against pregnancy.
Vaccination against mumps is carried out once. After it, contraception is required for 3 months.
The advantage of vaccination is also that antibodies to measles and mumps are transmitted from mother to newborn child and during the first year of life protect him from infection. When vaccinating, you need to know that there are monocomponent vaccines that contain only attenuated measles viruses or mumps virus, two-component vaccines that simultaneously contain measles and mumps viruses, and three-component vaccines that also include rubella. Multicomponent vaccines are administered once.
Vaccinations before pregnancy: Hepatitis B
The causative agent of the disease is the hepatitis B virus, which is extremely resistant in the environment. The virus persists for a long time during drying, freezing, boiling. Hepatitis B is transmitted through the blood: during medical manipulations - injections, through dental, manicure instruments, transfusion of blood and its components, as well as drugs produced on the basis of blood, and sexually. There is a risk of transmission of the virus from mother to child during pregnancy and childbirth.
Hepatitis B is much more contagious than HIV. It can take 2 to 6 months from the time of infection to the onset of symptoms. Vaccination against hepatitis B is indicated not only before pregnancy - the virus is dangerous for any person, therefore vaccination is desirable for everyone. During pregnancy, the frequency of medical manipulations increases, and therefore the risk of infection.
The hepatitis B vaccine does not contain a live virus - it is artificially created using genetic engineering and includes only the coat protein of the viral particle (HBs antigen). According to the standard scheme, vaccination against hepatitis B is carried out three times: the second - a month after the first, and the third - 6 months after the first. Ideally, it is better to start vaccination in such a way as to have time to do all three vaccinations before the start of pregnancy - i.e. 7 months before the intended conception. If it is not possible to wait six months, there are accelerated vaccination schedules, when the third vaccination is given 1 or 2 months after the second. In this case, to create a stronger immunity, it is advisable to do the fourth vaccination - a year after the first. If only 2 vaccinations were carried out before pregnancy, then the third vaccination is transferred to the postpartum period and is done 12 months after the first.
Pregnancy is possible one month after vaccination against hepatitis B.
Vaccinations before pregnancy: influenza
It is an acute infectious disease of the respiratory tract caused by the influenza virus. This disease affects people of all ages. The source of infection is a sick person with an obvious or erased form of the disease, who excretes the virus with coughing, sneezing. The incubation period can range from a few hours to 3 days, usually 1-2 days.
During pregnancy, the flu is dangerous for its complications. It may lead to spontaneous miscarriages and premature birth. In addition, there is the possibility of infection of the child.
It is better to get vaccinated against influenza a month before the planned pregnancy, if vaccines adapted for the current season and containing an updated composition of antigens are available at that time: they usually appear in September.
Vaccinations before pregnancy: diphtheria, tetanus, polio
Almost everyone was vaccinated against these infections in childhood. However, if every 10 years the body is not reminded of these diseases, immunity is rapidly weakening.
Polio is a viral disease that affects nervous system, in particular the spinal cord, and leading to paralysis. Transmission of the virus occurs by the fecal-oral route, that is, the pathogen enters the body of another person from the patient's intestines through the soil, unwashed hands and food through the mouth, causing the disease. Airborne transmission of the disease is also possible. In Russia, poliomyelitis was last registered more than 10 years ago, however, given the high contagiousness of this disease and its severe consequences, it is better to carry out repeated vaccination before pregnancy.
There are live and inactivated vaccines against polio. Since the virus can remain in the intestine for a long time with the introduction of a live vaccine and there is a potential risk of infection of the fetus with the formation of malformations, it is not recommended to use such a vaccine before a planned pregnancy. At least one month before pregnancy, vaccination with an inactivated polio vaccine is carried out. One vaccination is enough to "remind" the immune system of the existence of the virus.
Diphtheria- This is a dangerous infectious disease caused by a bacterium - diphtheria bacillus. The infection is transmitted by airborne droplets. The disease is most often manifested by inflammation of the mucous membranes of the oropharynx and nasopharynx, as well as symptoms of general intoxication, damage to the cardiovascular, nervous and excretory systems.
During pregnancy, diphtheria can cause serious complications, provoke premature birth or miscarriage.
Tetanus- an acute infectious disease, the causative agents of which are the bacteria Clostridium. The disease is transmitted by contact and causes damage to the nervous system with the development of seizures. The causative agent forms tetanus toxin - one of the strongest bacterial poisons, inferior in strength only to botulinum toxin. Tetanus toxins cross the placenta and can affect the fetus, most often the nervous system. In a child born with tetanus in the mother, convulsions are sometimes noted in the first day of life. With neonatal tetanus, the mortality rate reaches almost 100?%.
Revaccination against diphtheria and tetanus is carried out with the ADS-M vaccine, which consists of purified diphtheria and tetanus toxins. The vaccination is repeated every 10 years.
Vaccination is carried out no later than one month before pregnancy. In order to take care of the health of the baby in advance, expectant mother during pregnancy planning, it is worth contacting a gynecologist, as well as specialists from the vaccination center about the necessary and desirable vaccinations. Doctors will help right choice, which means to conceive, endure and give birth to a healthy baby.
