Monique Rainford - HER HEALTH

A reader asked the following questions, which were printed in my article a few weeks ago.

1. My mother seems to think that I should be getting shots (immunisation) while I am pregnant to protect both myself and the baby from diseases. Is that the case or is it after I give birth that the baby actually gets the shots at six weeks? (My mother believes that I should, as she got them. This was all of 25 years ago, by the way.)

2. I am having cramps in my left leg. From my side all the way down. It pains me especially at nights when I try to turn and I often cannot walk to the bathroom as it really pains me. What could be the cause of this? The pain happens only at nights.

Dear Reader,

Unfortunately, I am not aware of the vaccine your mother might have received but I will try to provide you with some helpful information. In general, the recommended vaccines for women include the MMR for measles-mumps-rubella and tetanus-diphtheria and acellular pertussis (Tdap) or tetanus-diphtheria, Td, (every 10 years). Screening for immunity to rubella is part of the routine antenatal testing. However, a woman should not receive the MMR vaccine during pregnancy and, if she is not immuned, she should be vaccinated at least four weeks before becoming pregnant or after delivery.

She can receive the Td vaccine during pregnancy but it is recommended that she be vaccinated in the second or third trimester. There is insufficient information on the safety of Tdap in pregnancy, but certain groups of people, such as teenagers or health or child care workers, may need the vaccine. Other vaccines can be considered, based on risk factors as well. For example, if a woman is a health care worker she should be vaccinated against Hepatitis B, which can be administered safely in pregnancy. Women with certain high-risk conditions, such as sickle cell disease, may need to receive the pneumococcal polysaccharide vaccine (PPV).

Influenza vaccine

In the United States, women who are pregnant between December and March are strongly urged to be vaccinated with the trivalent inactivated influenza vaccine (TIV) to reduce their risk of influenza (the flu). Vaccinations against varicella (chicken pox), zoster and human papillomavirus should not be given in pregnancy.

After birth, the infant should receive immunisations. For example, the first course of Hepatitis B vaccine can be given to the newborn and the paediatrician will advise the parent of the schedule of vaccinations at six weeks and later in the infant's life.

Leg cramps

Leg cramps are a common problem in pregnancy and occur mainly at night. Unfortunately. the exact cause is not known. In the past, calcium was recommended to relieve the symptoms but this therapy has not been proven to be effective. Some research show that taking a supplement with the mineral magnesium, such as magnesium citrate, may help with this problem. When you experience these cramps, you could try to stretch your legs but, instead of pointing your toes, you should curl them upwards. Regular stretching at night may help to prevent the cramps.

If you have severe persistent pain or swelling in your leg, it could be a symptom of something far more serious — deep vein thrombosis (DVT). This is a blood clot deep in the veins of the leg and it requires treatment to avoid potentially life-threatening complications. Interestingly, during pregnancy, DVTs are much more likely to occur in the left leg. Therefore,you should contact your doctor or visit the hospital if you notice any of these signs.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.