From the Research
Typhoid fever in pregnant women typically presents with high fever, headache, malaise, and abdominal pain, and requires prompt treatment with appropriate antibiotics to prevent maternal and fetal complications. The clinical presentation of typhoid fever in pregnant women may include constipation initially, followed by diarrhea with pea-soup-like stools, as well as weakness, fatigue, dry cough, and relative bradycardia (slow heart rate despite fever) 1. A rose-colored rash (rose spots) may appear on the trunk, though this is less common. Pregnant women are at higher risk for complications including intestinal perforation, gastrointestinal bleeding, and miscarriage.
Diagnosis and Treatment
Diagnosis requires blood cultures, and treatment must begin promptly with appropriate antibiotics. Ceftriaxone (1-2g IV daily for 10-14 days) is the preferred treatment during pregnancy, as fluoroquinolones and chloramphenicol are contraindicated 2. Azithromycin (1g on day one, followed by 500mg daily for 6 days) is an alternative for uncomplicated cases. Supportive care with hydration, fever management, and close monitoring is essential.
Prevention and Complications
Typhoid vaccination is not recommended during pregnancy, so prevention through safe food and water practices is crucial 3. Early treatment is vital to prevent maternal and fetal complications, including preterm labor, intrauterine growth restriction, and transplacental infection. The relationship between typhoid fever and pregnancy outcome has been studied, and while pregnancy is a risk factor for and affects typhoid disease expression, typhoid fever does not appear to affect pregnancy outcome 1. However, proper diagnosis and early treatment with ampicillin or ceftriaxone are associated with an improved outcome of the pregnant women complicated with typhoid fever 4.