Pregnancylosses may be related to the host environment. Congenital or acquired cervical
and uterine abnormalities, infections, maternal endocrinopathies and a
hypercoagulable state are some factors that have been implicated in the
occurrence of spontaneous abortion.
1)
Congenital or acquired uterine abnormalities
can interfere with implantation and growth. In a recent review of the
literature regarding fibroids and their effect on reproductive performance, the
authors suggested that the best available evidence indicates that sub mucous
myomas decrease fertility and increase the spontaneous abortion rate.
Myomectomy is likely to be of value. This may be true for intramural myomas as
well.
2)
Acute maternal infection could lead to
abortion due to fetal or placental involvement. Infections are an accepted
cause of late fetal demise; therefore, it is logical that they are responsible
for early fetal losses as well. A large number of organisms have been reported
to be associated with spontaneous abortions including, among others, Listeria
monocytogenes, Parvovirus B19, Rubella, Herpes simplex, Toxoplasma gondii,
Mycoplasma hominis, Chlamydia trachomatis, and Urea plasma urealyticum.
However, evidence of this relation has not been extensively conformed.
3)
Maternal endocrinopathies such as poorly
controlled diabetes mellitus and thyroid dysfunction can contribute to a
sub-optimal host environment. Luteal phase defect is another condition that has
been suggested to be associated with spontaneous miscarriage. A successful
pregnancy is dependent on sufficient progesterone support. Before the placenta
takes over progesterone production, the progesterone production by the corpus
luteum provides the necessary support of early pregnancy. A defect in corpus
luteum function is associated not only with implantation failure but with
miscarriage. However,the association between corpus luteum defects and
miscarriage is controversial.
4)
Hypercoagulable state due to inherited or
acquired thrombophilia and abnormalities of the immune system may lead to
immunological rejection or placental damage and are accepted causes of
miscarriage.
5)
Additional factors that are considered
possible causes of spontaneous abortion include trauma; alloimmune disease;
exposure to drugs, substance use, and environmental contaminants; some maternal
illnesses; and psychological factors.
When
the etiology of abortion in chromosomally and structurally normal embryos of
women that are apparently healthy remains unclear, it is considered
unexplained.
When
the etiology of abortion in chromosomally and structurally normal embryos of
women that are apparently healthy remains unclear, it is considered
unexplained.
Pregnancy
and food poisoning
Food poisoning is an unpleasant experience but most people recover without any ill
effects. But there are particular risks for pregnant women. These range from
dehydration caused by vomiting and/or diarrhoea through to birth defects and
miscarriage.
The
main risk is that of damage to the unborn baby caused by bacteria which are
responsible for food poisoning. The worst case scenario is premature birth,
stillbirth or miscarriage.
What
causes food poisoning
Bacteria,
viruses or parasites cause food poisoning but there are a few which are
particularly problematic for pregnant women. These include e coli, salmonella,
campylobacter and listeria.
These
can all spread to the unborn baby via the placenta where they will cause a
range of health problems at birth which include meningitis. In some cases they
may lead to a stillbirth.
But
the worst is listeria. This is one type of bacteria which pregnant women need
to be aware of as it is can cause both the mother and baby to become seriously
ill. It is also responsible for a series of complications which can result in
long term health problems in the baby. These can range from plain nasty through
to fatal.
The
effect of food poisoning on your pregnancy
If
you are pregnant and you develop food poisoning then in most cases, it will not
cause any long term problems for both you and your baby; however, you can
expect it to be more unpleasant than usual due to the fact that your body is
already under pressure as a result of your pregnancy.
So,
look at reducing your risk of food poisoning as much as possible. That means
taking notice of food safety and hygiene and being careful about the types of
foods that you eat. Avoid those foods which are a known risk for listeria.
Basically,
the healthier you are the better that is for your unborn baby.
The
issue here is that the effects of food poisoning are more likely to cause
problems for your unborn baby than for you. Your unborn baby is a greater risk
due to it having an underdeveloped immune system which makes it vulnerable to
all types of infections. This includes bacterial food poisoning.
Find
out more in our preventing food poisoning section.
Listeria
and pregnancy
Listeria
food poisoning or listeriosis is caused by the consumption of foods which
contain these bacteria. Examples of these include soft cheese such as Camembert
or Brie; blue cheese; butter, pates; cooked meats such as ham or salami; and
ready meals which are found in the chiller cabinet in supermarkets.
Unwashed
fruit, vegetables and salads are also a factor as is unpasteurised milk.
Undercooked meat and fish are also a danger.
If
you are pregnant then you will have been advised to avoid these foods due to
these risks. Choose hard cheeses such as Cheddar, pasteurised milk, yoghurts
and cottage cheese. Make sure that you wash all salads, fruit and vegetables
before you eat them.
Pregnant
women are at greater risk of listeriosis which may be due to a lowering of
their immunity plus changes to their metabolism. A weakened immune system is
one of the risk factors for food poisoning and other illnesses as it is less
able to fight the bacteria which cause these.
If
you eat food which has been contaminated by the listeria bacteria then these
will pass into your intestine via digestion. Once there they release toxins
into the lining of the intestine which results in an infection.
This
infection causes symptoms such as nausea, stomach pains, vomiting and
diarrhoea.
Complications
include blood poisoning (septicaemia), confusion, seizures and stillbirth or
miscarriage in pregnant women.
Listeria
and the unborn baby
If a
pregnant women contracts listeriosis in the 14th week or onwards of her
pregnancy then this is likely to affect the health of the baby. This can only
be detected via a blood test or an ultrasound scan.
Unfortunately,
babies can become infected with listeriosis during birth if the bacteria are
present within the mother’s vagina. These symptoms may not be apparent at birth
but can develop later on. These can cause:
Jaundice
Pneumonia
Meningitis
What
also needs to be taken into account is that any infection, even if it is relatively
mild, will deprive the unborn baby of essential nutrients which are vital for
its development.
One
example of this is toxoplasmosis which is spread via contact with infected cats
(or their litter). If this spreads to the unborn baby then it is likely to
cause birth defects or even a miscarriage.
This
is why it is advisable for pregnant women to avoid any contact with cat litter
or an infected animal during their pregnancy.
Treatment
for food poisoning during pregnancy
If
you are pregnant and suspect that you developed food poisoning then ask your
midwife or GP for advice. Do this if you think your illness is caused by
listeria bacteria as these can be dangerous during pregnancy.
Your
GP is required by law to notify the authorities about any case of food
poisoning.
You
will need to rest during this time, drink plenty of fluids and take an oral
re-hydration powder if necessary. This powder contains electrolytes which are
vitamins, minerals and sugars, essential for the everyday functioning of the body.
These
powders are available as sachets from your local chemist.
Your
GP will perform a blood test and if this shows that you have bacterial food
poisoning then you will be prescribed antibiotics to treat this. He or she will
check that these are safe for you to take during your pregnancy.
Preventing
food poisoning during pregnancy
There
are a few steps you can take to reduce your risk of food poisoning. These
include only eating foods which are safe to eat during pregnancy; washing your
hands every time you handle food; checking that food is cooked properly and
using food before its ‘use by’date.
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