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Whether it's your first pregnancy or your fifth, you'll be screened for the hepatitis B surface antigen as early as possible. Knowing that you have the antigen lets your health care provider know whether he or she needs to be ready to administer a hepatitis B virus (HBV) vaccine as soon as your baby is born. This vaccine keeps a potentially infected baby from becoming a chronic carrier, which can lead to chronic cirrhosis and liver cancer within just a few short years. The vaccine prevents these scary outcomes in up to 95 percent of infants who are chronic carriers. And if you don't have the antigen, your baby won't need any type of HBV treatment.
Although not the standard of practice in all settings, some care providers recommend thyroid testing before conception or in early pregnancy. During pregnancy especially, thyroid hormone levels need to be just right or complications can develop.
Expectant moms in a hypothyroid state may develop anemia, preeclampsia, placental abruption, postpartum hemorrhage, cardiac dysfunction or miscarriage. Their babies are at risk for prematurity, low birth weight, congenital anomalies, stillbirths and retarded mental development. But again, much of this can be prevented. If you're experiencing hypothyroidism, your doctor will prescribe a synthetic thyroid supplement medication.
Expectant moms in hyperthyroid state are at increased risk of pregnancy loss, infection, preeclampsia, preterm delivery, congestive heart failure, thyroid storm and placental abruption. Their babies are at risk of prematurity, size that is small for gestational age, intrauterine fetal death and fetal or neonatal thyrotoxicosis. Your doctor will recommend a course of treatment to combat these risks as well.
Postpartum depression is strongly related to thyroid dysfunction after birth. Anxiety, fatigue, jitteriness and hair loss may all be related to thyroid problems in the postpartum period. Ask your health care provider if you experience these symptoms after you have your baby.
Rubella Immunity Testing
If this is the beginning of your first pregnancy, you'll probably be tested for rubella immunity. If you've had rubella or are immune to it '- either you know you were vaccinated or have had a positive immunity test '- you'll be immune throughout your life, so your shouldn't need to be retested in the future. Those who test low positive, mid positive or high positive are considered immune. Those who test negative are not immune. Those with equivocal tests should be retested.
This test is so important because rubella infection during pregnancy is very dangerous. Congenital rubella infection may lead to a range of problems for an unborn baby, including deafness, mental retardation, cardiac malformations, cataracts, retinopathy, microphthalmia and intrauterine growth restriction. Luckily, rubella has become fairly rare since mass immunization started in 1969. In 1996, for instance, only 220 cases of rubella were reported in the United States. But just because you've never had it does not mean you're immune. It is estimated that up to 20 percent of reproductive-age women in the United States are not immune to rubella. It's best to have the rubella vaccine at least one month before you become pregnant, but if it's too late for that, you can still do a few things to protect your baby. Find out whether or not you are immune, avoid situations in which you might be exposed to rubella (don't visit a friend's sick child, for example) and report any possible exposure to your health care provider immediately so that immune globulin treatments can be started right away.