Immunizations

There is no evidence of fetal risk from inactivated virus vaccines, bacterial vaccines, toxoids, or tetanus immunoglobulin, and they should be administered as appropriate. Safe vaccines:

■ Diphtheria

Three immunizations should be avoided during pregnancy:

Viral vaccinations may be safely given to the children of pregnant women.

Immune globulin is recommended for pregnant women exposed to measles, hepatitis A and B, tetanus, chickenpox, or rabies.

WHEN TO CALL THE PHYSICIAN

Vaginal bleeding

Leakage of fluid from the vagina

Rhythmic abdominal cramping of > 6/hr

Vaccines safe in pregnancy:

• Diphtheria

Vaccines unsafe in pregnancy:

Give immune gloublin in pregnancy for exposure to:

• Chickenpox

■ Progressive and prolonged abdominal pain

■ Fever and chills

■ Prolonged vomiting with inability to hold down liquids or solids for > 24 hours

■ Progressive, severe headache, visual changes, or generalized edema

■ Pronounced decrease in frequency or intensity of fetal movements

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