Generality
Scarlet fever in pregnancy is an infectious disease that indeed affects pregnant women.
In detail, it is an acute infectious disease triggered by group A beta-hemolytic streptococcus.
Usually the infection affects children in pediatric age, while it rarely affects adults. Unfortunately, however, in some cases, scarlet fever can also occur in the latter and in pregnant women, giving rise to many concerns, above all as regards the health of the fetus.
In the course of the article, therefore, the main characteristics of scarlet fever during pregnancy and the possible risks that can be encountered when contracted by future mothers will be described.
What is that
What is scarlet fever in pregnancy?
Scarlet fever in pregnancy is the same exanthematous disease that typically affects children between the ages of three and twelve. It is an acute infectious disease - also known as a " second disease " - which affects both female and male sex patients indifferently. Although scarlet fever in pregnancy or at least in adulthood is rarely contracted, this possibility cannot be completely ruled out.
Fortunately, scarlet fever in pregnancy - in addition to manifesting itself in quite rare cases - does not cause malformations in the fetus and, if promptly treated, should not cause damage of any kind.
Causes
What Causes Pregnancy Scarlet Fever?
Scarlet fever in pregnancy is caused by group A beta-hemolytic streptococcus, identified with the beating Streptococcus pyogenes, a Gram-positive coconut that can give rise to various types of infections. More precisely, the disease can be caused by different types of S. pyogenes . For this reason, after the first infection there is no guarantee of permanent immunity . Therefore, if a patient has contracted the disease once during her lifetime, the possibility of re-contracting scarlet fever during pregnancy cannot be excluded.
Contagion
How is scarlet fever transmitted in pregnancy?
As with most exanthematous diseases, scarlet fever - hence also scarlet fever in pregnancy - is transmitted by air . The infection, therefore, can take place directly through droplets of saliva or other secretions (for example, nasal secretions) emitted with sneezing, coughing or simply through dialogue. In this regard, it is good to remember that patients who have contracted the infection can be contagious even in the 24-48 hours before the first symptoms appear. For this reason, it may be difficult to prevent possible contact with sick people.
In addition to direct infection, it is also possible to encounter indirect infection through the manipulation of objects used by infected and sick individuals, such as crockery, glasses, toys, clothes, towels, thermometers, sheets, etc. Indirect contagion is made possible by the marked ability to survive in the external environment of S. pyogenes which can therefore favor the appearance of scarlet fever in pregnancy even if the pregnant woman does not come into direct contact with sick patients.
Symptoms
What are the symptoms of scarlet fever in pregnancy?
The symptoms caused by scarlet fever in pregnancy are very similar to those that occur when the infection affects children. However, before the onset of symptoms, there is an incubation phase lasting about 48-72 hours. After this time, scarlet fever during pregnancy can cause symptoms, such as:
- High fever;
- Headache;
- Sore throat (pharyngitis is the most common symptom of the disease);
- Hypertrophic and painful tonsils;
- Formation of a whitish patina on the tongue (white strawberry tongue) and on the tonsils;
- Abdominal pains;
- Tachycardia.
Another characteristic symptom of scarlet fever is represented by the appearance of patches of scarlet red ( scarlet exanthema, hence the name of the disease) in different body areas. Fortunately, contrary to what happens in other similar diseases (such as, for example, chickenpox), the aforementioned patches are not itchy and do not cause great discomfort to the patient.
The scarlet rash usually appears within 12-48 hours after the first symptoms appear. In this interval of time, the whitish patina covering the tongue begins to mutate and - following desquamation processes - becomes red and wrinkled and, for this reason, is defined as "raspberry tongue".
The scarlet rash lasts a few days, after which it disappears giving rise to a furfuraceous desquamation.
The symptoms induced by scarlet fever in pregnancy - as well as that of scarlet fever which occurs in other adults and in children - is rather characteristic, therefore, easily recognizable. Therefore, should the pregnant woman show any of the above symptoms, contact your doctor or gynecologist immediately.
Risks for the Fetus
Is scarlet fever in pregnancy dangerous for the fetus?
Fortunately, scarlet fever in pregnancy is not a widespread disease and, in any case, unlike other exanthematous diseases, it does not seem to constitute an excessively serious danger for the unborn child. In fact, the presence of scarlet fever in pregnancy is generally not a cause of malformations in the fetus and the eventual transmission of the infection from the mother to the child during birth is a rather rare event . In this regard, it has been estimated that children born to group A beta-hemolytic streptococcus infected mothers are infected by the same micro-organism in 1% of cases.
However, if the bacterium responsible for scarlet fever during pregnancy were to give rise to vaginal colonization, there is a real risk of suffering premature rupture of the membranes and a preterm birth with all the consequences.
Furthermore, if the bacterium is also present at vaginal level and is not adequately treated, during birth it may come into contact with the fetus and infect it. This eventuality, as we have seen, is rather rare but not impossible. For this reason, it is always good to perform a vaginal swab in order to determine the presence of S. pyogenes . This operation, however, is also useful for detecting the presence of other pathogenic microorganisms, such as S. agalactiae or group B beta-hemolytic streptococcus (for more information, read: Streptococcus in Pregnancy).
Diagnosis
How is Pregnancy Diagnosis performed?
Generally, to perform the diagnosis of scarlet fever during pregnancy, the physician is sufficient for the objective examination of the patient. However, in order to dispel any doubt, it is possible to perform a throat swab to pinpoint which pathogenic microorganism caused the symptoms.
This diagnostic test is used above all in case of uncertainty and in the presence of unclear symptoms (for example, a slight scar exanthe, absence of typical symptoms such as fever and the presence of the characteristic white patina on the tongue and tonsils, etc. .).
How to behave in the event of a certain diagnosis of scarlet fever in pregnancy?
Once a correct diagnosis of scarlet fever has been made during pregnancy, the doctor should direct the patient towards the execution of a vaginal swab to determine the possible presence of group A beta-hemolytic streptococcus also at the genital level.
Naturally, once the presence of scarlet fever has been ascertained during pregnancy - regardless of the presence or absence of the micro-organism in the vaginal environment - the doctor or possibly the gynecologist will have to institute a suitable therapy to counteract it.
Care
Pregnancy Scarlet Fever Treatment and Treatment
Since it is a disease caused by bacteria, the treatment of scarlet fever involves the use of antibiotic drugs . Obviously, the doctor will prescribe medicines based on active ingredients to which S. pyogenes is sensitive. More in detail, the antibiotics of choice used to treat the disease are represented by penicillins .
In the specific case of scarlet fever in pregnancy, the most widely used penicillin is ampicillin . This antibiotic active ingredient, in fact, can be used during gestation, provided that its administration takes place under the strict control of the doctor and only in cases of real and actual need.
However, the active ingredient to be used to fight scarlet fever during pregnancy, the way it is administered and the dosage must be established only and exclusively by the doctor or gynecologist who, on a case by case basis and on an individual basis, will evaluate which therapeutic strategy is better to undertake.
Prevention
Is Scarlet Fever in Pregnancy Prevented?
In order to avoid contagion and the consequent development of scarlet fever during pregnancy it is possible to adopt some behavioral measures. More precisely, pregnant women should:
- Avoid direct contact with infected people. However, putting this into practice could sometimes be difficult. This is because infected individuals can begin to be contagious even in the 24-48 hours before the first symptoms appear.
- Avoid the use and handling of objects used by people suffering from scarlet fever.
- Avoid attending at-risk environments during gestation (for example, elementary schools, kindergartens, etc.), especially during periods when there is a greater chance of getting infected;
- Maintain careful personal hygiene and, in particular, of the hands that must be carefully washed, especially before meals.
The aforementioned measures should also be adopted by people living with the pregnant woman, in order to avoid contracting the disease and passing it on to the future mother.
However, fortunately, scarlet fever rarely occurs during pregnancy and, following the aforementioned recommendations, the risk of contracting it is further reduced. In any case, given the possible consequences it can bring, the disease must not be underestimated in any way. Therefore, in the presence of symptoms due to scarlet fever during pregnancy, contacting the doctor and / or the gynecologist is of fundamental importance.
