Hospital's guidelines allay fears of pregnant HCWs

By Brenda Barr, RN, MS, CIC

Nurse epidemiologist

Program of Hospital Epidemiology

The University of Iowa Hospitals and Clinics

Iowa City, IA

Throughout my 14 years as a nurse epidemiologist, many pregnant health care workers have expressed to me their concerns about exposures to people with infectious diseases.

The purpose of this article is to alleviate the uncertainties that occur when the pregnant HCW is exposed to patients or other HCWs with infectious diseases. Rubella, measles, and chickenpox are risks for any non-immune HCW. Pregnancy is not an issue in these circumstances; immunity is the key. Non-immune employees should not care for patients with those infectious diseases.

The new CDC isolation guidelines assign a specific isolation category for each infectious disease. The guidelines do not provide special precautions for pregnant HCWs because, if employees follow proper precautions, the state of pregnancy is not an issue.

Parvovirus B19 infection is a possible exception. Parvoviral infection during pregnancy can cause abortion, stillbirth, and hydrops fetalis.

In light of these serious consequences, it would be prudent to reassign pregnant employees rather than have them care for individuals with parvoviral infection.

The table inserted in this issue is an informational guideline that our hospital epidemiology program developed for the department of nursing in our university hospital.

We developed it to help educate all pregnant HCWs, and to alleviate some of the fear and apprehension they may feel while caring for patients with infections. (See table of guidelines, inserted in this issue.) *