Viral Infections - Infections caused by viruses are hard to treat and threaten potentially serious problems to the baby.

Rubella (German measles). A fairly innocuous illness in itself, rubella during pregnancy can cause serious harm to a developing baby. If rubella occurs during the first 8 to 12 weeks of pregnancy, there's a 50 to 80 percent chance that the baby will have such serious birth defects as mental retardation, blindness, hearing loss, and heart disease. Miscarriage or stillbirth are other possibilities.Almost a third of those babies whose mothers had rubella during pregnancy die within 4 months after birth. Termination of the pregnancy is often considered by expectant mothers who develop rubella. Vaccinations prompted by widespread awareness of this serious danger have dramatically lowered the number of babies affected by the disease while still in the uterus. If you have a rash, low fever, swollen glands, and symptoms of the common cold, you could be suffering from rubella. A blood test will tell you whether you have had the disease and whether the infection was recent. Immune globulin will lessen the effects of the virus if you decide to continue the pregnancy. Any woman who has never had rubella or been immunized against it a group that includes about 10 to 15 percent of women of childbearing age in the United States should receive the vaccine at least a few months before she tries to become pregnant.

Chickenpox. Chickenpox may play a role in preterm labor and birth defects. If you are pregnant and have never had chicken pox, you should get an injection of chickenpox immune globulin. If you contract the disease during late pregnancy and have it during labor, when it can be fatal to your baby, the doctor can give an injection of the globulin to the fetus through the placenta.

Sexually Transmitted Diseases If you develop a sexually transmitted disease (STD) during pregnancy, you must get treatment immediately. Should you notice even the slightest evidence of an STD before conception, see your doctor right away, to prevent any risk to a future baby.

Syphilis. An untreated mother can pass syphilis on to a developing baby for up to 4 years after she contracted it. The baby may develop serious deformities and irreversible brain damage, and may even die from the disease. Fortunately syphilis responds well to penicillin and other antibiotics.

Chlamydia. Vaginal infection, pain during intercourse, and a general run down feeling suggest infection with chlamydia. When present during pregnancy, chlamydia makes premature birth, miscarriage, or stillbirth 10 times more likely to occur. A baby delivered vaginally may contract the virus and develop eye disease (conjunctivitis) a few days later; doctors successfully treat this infection with antibiotic eye ointment. Erythromycin is the safest antibiotic treatment for chlamydia during pregnancy.

Gonorrhea. A woman with gonorrhea during pregnancy may go into labor before her due date; her baby may not grow properly and may develop conjunctivitis 2 to 7 days after birth. Penicillin or antibiotics will help prevent these problems.

Cytomegalovirus (CMV). In the United States, CMV is the most common viral infection of the uterus. Symptoms are similar to those of mononucleosis: sluggishness and general exhaustion. If contracted early in pregnancy, CMV can cause bleeding and liver disease in the mother, and may be a reason to opt for termination of the pregnancy. Symptoms of the virus in the baby may not appear immediately. A child with CMV might have hearing difficulties, learning disabilities, and a tendency to contract infections during the first 2 years of life.

Genital Herpes. Babies born to mothers with active herpes lesions around the vagina can contract the disease directly from the sores. If laboratory tests confirm the infection, the mother can use acyclovir (Zovirax) to reduce the chance of fetal infection. Infection with herpes during pregnancy increases the risk of miscarriage and premature delivery. A child born to an infected mother may grow slowly or may even die. Doctors sometimes recommend cesarean section to keep the baby away from the sores. While there is no known cure for herpes, it can disappear for long periods of time. If you know you have had herpes, or think you might have, be sure to tell your doctor so that he or she can test you, especially toward the end of your pregnancy.

HIV infection and AIDS. Babies of women who are positive for human immunodeficiency virus (HIV), which causes AIDS, have a 25 to 30 percent chance of acquiring the infection during pregnancy. Extreme illness and early death are usually inevitable, although azidothymidine (AZT) has recently shown promise for protecting newborns against their mothers' HIV infection.

Nonviral Infections Bacterial infections are easier to treat than viral infections.

Urinary tract infections. Two to 10 percent of pregnant women have urinary tract infections (UTIs). Most don't even realize it until the laboratory report comes in. One reason doctors routinely ask pregnant patients for urine specimens starting with the first appointment is their interest in treating a UTI as soon as possible. Bladder infections (cystitis), the most common type of UTI, occur in a great many women (and in some men and children, too). The likelihood of developing cystitis increases during pregnancy and is especially strong in women who have had UTIs before. Changes in the immune system during pregnancy may be one reason for this increased risk. Also, the growing baby can cause the uterus to press against the bladder, preventing it from emptying completely and creating a breeding ground for bacteria.
Infection can spread from the bladder up through the ureters to the kidney. Dangerous and painful in themselves, kidney infections can lead to premature birth. Doctors treat pregnant women with penicillin, usually ampicillin or amoxicillin, and the cephalosporins. Although the baby can't "catch" a UTI from its mother, a tendency for such infections may be hereditary.

Toxoplasmosis. Babies who contract this parasitic disease between conception and the twenty-fourth week tend to be born small and run the risk of developing liver disease, convulsions,blindness, brain abnormalities, and mental retardation. Since toxoplasmosis organisms live in raw or incompletely cooked meat and are carried in cat feces, pregnant women should eat only well-done meat and should avoid changing cat litter.

Hepatitis (inflammation of the liver). The risk to the baby is serious when the mother has chronic hepatitis B or C. Hepatitis A, which also requires treatment, has fewer dangerous side effects during pregnancy. To prevent neonatal hepatitis the doctor will give the baby hepatitis B immune globulin and vaccine immediately after birth. All male and female healthcare workers should get a vaccination before starting a child. The mother is also tested for hepatitis B during her pregnancy.

Group B Strep-Group B Strep (GBS) has gained a lot of attention recently. Many doctors and midwives are routinely testing all populations for these bacteria. Testing is done at some point during pregnancy, this varies from clinician to clinician, although the recommended is 35 - 37 weeks gestation, by taking cultures. This is a swab done of the vagina and rectum. Some offices may use a urine screen instead. It is estimated that between 15-40% of women are colonized (carrying) GBS at some point during pregnancy.

98-99% of all babies born to infected mothers will not become infected. Of those who become infected few will have any problems with the infection. There are two types of infections: early and late.
Early infections tend to occur usually within the first six hours after birth, and most by the seventh day of life. This infection can cause inflammation of the baby's lungs, spinal cord or brain. About 15% of these babies will die from the infection.
The other infection, late infection, occur after the first seven days of life. Half of these late infections are not from the mother but from other sources of infection, such as contact with other carriers of GBS, including hospital personnel. Meningitis is the main risk from late infection, which has long term problems associated with the baby's nervous system. However, babies with late infections are less likely to die than those with early infections.

There are two treatments that are in common use: Oral antibiotics and IV antibiotics during labor.
Oral antibiotics have not been recommended by any of the professional organizations. However, they may still be offered to reduce the number of colonies in the body. This is usually done at the end of pregnancy. Although they have not been found to be effective in eliminating colonization or in preventing GBS in the newborn.
IV antibiotic treatment during labor is the standard practice and has been shown to decrease the 70-85% of the cases of early onset GBS in newborns. You will normally receive a bolus of antibiotics and then another dose every four hours. For those women who had not wished to have an IV in labor, there is still an option. You can have your cake and eat it too. Simply receive the IV antibiotics through a heparin/saline lock and then when the medication is done the tubing can be removed,leaving the catheter in place. If you require another dose during labor the lock is still in place and you do not need to have another needle inserted,but you will retain your mobility during the rest of your labor.