Pregnancy is an altered state of health that requires special considerations. With careful preparation, however, most pregnant women are able to travel safely.
The pre-travel evaluation of a pregnant traveler (Box 8-01) should begin with a careful medical and obstetric history, with particular attention to gestational age and evaluation for high-risk conditions. A visit with an obstetrician should be a part of the pre-travel assessment, which should include an ultrasound—to establish the gestational age of the pregnancy and identify any potential problems—and evaluation of the mother’s blood type and Rh status. The traveler should be provided with a copy of her prenatal records and physician’s contact information. Checking for immunity to various infectious diseases may obviate the need for some vaccines.
A review of the pregnant woman’s travel itinerary, including destinations, types of accommodation, and planned activities, should guide pre-travel health advice. Preparation includes educating the pregnant woman regarding avoidance of travel-associated risks, the management of minor pregnancy discomforts, and recognition of more serious complications. Bleeding, severe pelvic or abdominal pain, contractions or premature labor, premature rupture of the membranes, symptoms of preeclampsia (unusual swelling, severe headaches, nausea and vomiting, vision changes), severe vomiting, diarrhea, dehydration, and symptoms of potential deep vein thrombosis (unusual swelling of leg with pain in calf or thigh) or pulmonary embolism (unusual shortness of breath) are conditions that require urgent medical attention.
Pregnant travelers should pack a travel health kit that includes all prescription medications, hemorrhoid cream, antiemetic drugs, antacids, prenatal vitamins, medication for vaginitis or yeast infection, and support hose, in addition to the items recommended for all travelers.