Pregnancy and risk of infection during travel in the tropics and subtropics

Each year 5-7 million Germans travel to tropical and subtropical areas. Pre gnant women should be discouraged from traveling to countries with low stan dards of medical care or hygiene. Each year 500,000 pregnant women die, 99% of them in developing countries. The high maternal mortality in developing countries is due to infections, hypertension, bleeding, anemia, ectopic pr egnancy, miscarriage, abortion, and obstructed labor. This reflects the poo r medical standard in these countries to which pregnant women will be expos ed. Every pregnant traveler to tropical areas should be vaccinated against teta nus, diphtheria, polio myelitis, measles, mumps, rubella, varicella, and he patitis A. Depending on the local endemic situation, prophylaxis or vaccina tion for malaria, yellow fever, typhoid fever, hepatitis B, meningococcal m eningitis, Japanese encephalitis, rabies, and cholera are recommended. High -risk infections for pregnant women and their unborn children include hepat itis A, B, C, E, and Plasmodium falciparum malaria before delivery and sept icemia, tetanus, or HIV after delivery or abortion.