Women's Health and Education Center (WHEC)

Infectious Diseases in Pregnancy

List of Articles

  • Tuberculosis in Pregnancy
    Untreated tuberculosis (TB) disease represents a greater hazard to a pregnant woman and her fetus than does its treatment. Streptomycin in the only anti-TB drug documented to have harmful effects on the human fetus (congenital deafness) and should not be used. Pyrazinamide (PZA) can probably be used safety during pregnancy and is recommended by the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD). If PZA is not included in the initial treatment regimen, the minimum duration of therapy is 9 months. For pregnant women with multidrug resistant (MDR) TB treatment should be done in consultation with the multidrug resistant TB expert. Many of currently medications currently used for treatment of multidrug resistant TB may be harmful to the fetus. Most patients with previously untreated pulmonary TB disease can be treated with either a 6-month or a 9-month regimen, although the 6-month regimen is used for the majority of patients. All 6-month regimens must contain INH, RIF, and initially, PZA. The goal is to complete all doses within 1 year.

  • Hepatitis C Virus Infection and Pregnancy
    Hepatitis C virus (HCV) infection has been called a silent epidemic, because after infection, many individuals are unrecognized and untreated until years later. The review describes the prevalence of HCV infection during pregnancy, evaluate current risk factors associated with HCV antibody positivity, and identify novel composite risk factors for identification of groups most likely to demonstrate HCV antibody seropositivity in an obstetric population. It has been shown that infants born to HCV-positive women are more likely to have low birth-weight, be small for gestational age, be admitted to the intensive care unit, or require assisted ventilation. Universal HCV screening during the pregnancy is a fair, realistic, strategy which should be implemented in healthcare systems worldwide. In this review, we have also provided an up-to-date overview of the existing evidence on the pediatric use of direct-acting antivirals (DAAs), summarizing indications to treatment and recommendations for monitoring.

  • Novel Coronavirus (COVID-19) Disease and Pregnancy
    Novel coronavirus (COVID-19) is an emerging, rapidly evolving situation. The Women’s Health and Education Center's (WHEC's) publications in collaboration with the United Nations (UN) and the World Health Organization (WHO) will provide updated information as it becomes available. All individuals, including pregnant individuals, are encouraged to take precautions to avoid exposure to COVID-19 as the pandemic evolves. Pregnant women admitted with suspected COVID-19 or who develop symptoms suggestive of COVID-19 during admission should be prioritized for testing. Mother-to-child transmission of COVID-19 during pregnancy is unlikely, but after birth a newborn is susceptible to person-to-person spread. The mode of delivery should be individualized and based on a woman's preferences alongside obstetric indications. Cesarean sections should only be performed when medically justified. In limited studies COVID-19 has not been detected in breast milk. As the situation evolves, this document may be updated or supplemented to incorporate new data and relevant information.

  • Zika Virus Infection in Pregnancy
    Zika virus infection in humans appears to have changed in character while expanding in geographical range. Zika virus has now been clearly established as the cause of severe fetal malformations, particularly microcephaly. The risk of fetal injury appears to be greater when maternal infection occurs in the first trimester of pregnancy. Zika virus has now been established as the cause of Guillain-Barré syndrome (GBS) in adults. Although most cases of Zika virus infection are transmitted as the result of mosquito bites, patients can acquire the infection through sexual contact. Both male-to-female and female-to-male transmission have been documented. Currently, real-time reverse transcription polymerase chain reaction (rRT-PCR), immunoglobulin M (IgM), and plaque reduction neutralization (PRNT) tests are available to detect Zika infection, although each test has limitations. If a patient has had symptoms of Zika virus infection for less than 5 days, serum and urine should be obtained for rRT-PCR testing. If symptoms have been present for 5 to 14 days, urine should be tested by rRT-PCR because urine samples appear to remain positive for virus longer than serum samples do. Early-stage trials examine whether an experimental vaccine is safe and generates immune responses in vaccinated volunteers. A safe and effective, fully licensed Zika vaccine will likely not be available for several years.

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