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Infections are caused by viruses or bacteria. Chickenpox, rubella (German measles), and herpes are caused by viruses. They cannot be treated by antibiotics. Bacteria are live organisms that can infect your body by multiplying in tissue and in the bloodstream. Serious bacterial infections include toxoplasmosis and listeriosis. Unlike viruses, these can be treated with antibiotics. Although it is unusual for bacteria or viruses to cross the placenta and affect the baby, the exceptions to this rule are rubella , toxoplasmosis, and listeriosis. The baby may also be indirectly affected by an infection (for example, a kidney infection) that causes premature labour.

Urinary tract infections
A urinary tract infection can affect any part of the urinary tract , including the bladder and kidneys. Symptoms include a constant need to urinate , irritation, or a burning sensation when urinating, low abdominal pain and, if untreated, blood in the urine, and fever. If you have any of these symptoms , you will need antibiotics. Delay in treatment may result in a kidney infection, causing severe illness and possibly miscarriage or premature labour.

Thrush
This is a common and usually harmless vaginal infection caused by a fungus. Its main symptoms are vaginal soreness and itching, and a white discharge. Treatment in pregnancy involves a course of cream, and vaginal suppositories.

Toxoplasmosis
If you think you have been in contact with this infection (seep. 106), your blood will be tested for antibodies, which your body produces to fight the infection. If present, you r baby may need treatment, and his or her growth will be checked by frequent scans. If the infection is missed , there is a risk of miscarriage or stillbirth , or your baby might be born mentally handicapped or blind.

Listeriosis
This bacteria is found in soft cheeses, pates, and pre-cooked foods (see p. 106). If the result s of a blood test show that you have been infected, you will be treated with antibiotics and your baby may need to be delivered early. Listeriosis can cause premature labour, miscarriage, or stillbirth. If your baby has to be delivered, he or she may be very ill and will need antibiotics to prevent septicaemia (blood poisoning) and meningitis.

Rubella (German measles)
This virus is now rarely contracted in pregnancy because most young adults have been vaccinated against rubella at school. Rubella can cause your baby heart and brain defects, deafness, and cataracts and, if you are infected with rubella in the first three months, there is a more than 50 per cent chance of your baby being affected; this risk reduces thereafter. Chickenpox (varicella zoster)
This can cause a severe lung infection or pneumonia in the mother if contracted in pregnancy, bur there is only a very small chance that this will harm your baby. If you have been in contact with anyone with chickenpox and are not immune , you will be injected with immunoglobulins to reduce any risk.

Herpes
This virus can cause painful blister s in and around the vagina. The risk of passing this on to your baby at birth , even with recurrent herpes, is low. However, if your first attack is in pregnancy and you have ulcers at the time of delivery, you may be offered a Caesarean section because there is a risk of your baby being infected, which may cause brain damage.

Cytomegalovirus
Cytomegalovirus (CMV) is one of the herpes group of viruses. It is one of the major congenital causes of deafness, blindness, and mental impairment; a fact made even more shocking because so few pregnant women have heard about it. The good news is that many women (40 to 80 per cent in Europe) are immune to it through previous infection . The bad news is that if you're not immune, and catch it in pregnancy, there is a 50/50 chance of passing it to the baby.

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