Inactivated virus vaccine during pregnancy

Inactivated or assembled virus vaccine

Inactivated virus vaccines are the vaccines which contain dead viruses or the viral particles. Therefore inactivated virus vaccines do not have the drawbacks of live attenuated virus vaccines. Because of this reason inactivated virus vaccines are not contraindicated during pregnancy, instead they are very useful during pregnancy. Useful inactivated virus vaccines during pregnancy are the vaccines against influenza, hepatitis A and hepatitis B.

Attenuated virus vaccine during pregnancy

An Attenuated virus vaccine is a vaccine which contains viable or live viruses but virulence of those viruses are diminished. Commonly used Attenuated virus vaccines are the vaccines against measles, mumps, poliomyelitis, rubella, yellow fever, and varicella. These attenuated virus vaccines are contraindicated during pregnancy. Because the attenuated vaccines containing viruses can cause the relevant disease, particularly in immunocompromised patients. But no cases of fetal damaged were reported yet. MMR vaccine is safe during lactation.

Immunization during pregnancy

Immunization or vaccination during pregnancy is one of the very important aspects of an immunization or vaccination program. Though immunization during pregnancy is a routine practice, there are several vaccines are valuable during pregnancy. What is meant by immunization during pregnancy? It is the administration of vaccine during pregnancy period. Routine practice is the administration of required vaccine during pre-conception period or postpartum period. Most of the developed countries and some developing countries like Sri Lanka have a well organized vaccination program therefore risk for an unvaccinated pregnant women to develop of an infection (rubella, measles, and mumps) is a rare event. But immunization during pregnancy can be essential in some instances. One must remember that the vaccination with live virus or bacteria is contraindicated in pregnancy. Risk to a developing fetus from vaccination of the mother during pregnancy is primarily theoretical. No evidence exists of risk from vaccinating pregnant women with inactivated virus or bacterial vaccines or toxoids. Live vaccines pose a theoretical risk to the fetus.

Followings are the different types of vaccines available and their implications during pregnancy.

1. Attenuated virus vaccine
2. Inactivated or assembled virus vaccine
3. Live attenuated bacterial vaccine
4. Inactivated bacterial vaccine
5. Toxoids containig vaccines
6. Immune globulins containing vaccines

How to perform urine hCG test to diagnose pregnancy

This is a very easy test to perform. You can perform urine hCG test at home and diagnose the pregnancy. What you need to perform urine hCG test are a sample of urine (about 10ml), test tube or a cup and urine hCG strip or urine hCG kit. Collect a sample of urine of the patient to a test tube (preferably) or to a cup. Then you have to dip the correct side (mentioned with an arrow) of the kit or the strip into the urine sample. Don’t dip whole strip but up to the mentioned level. Then keep it in urine for 3-5 minutes. If there is a single stained line, the pregnancy will be negative whereas two stained line indicates positive test.

urine hCG strip


positive urine hCG strip

Serum hCG test for diagnosis of pregnancy

Serum beta hCG test is the most sensitive and specific test for diagnosis of the pregnancy. Beta hCG will be present in the maternal blood by 8-9 days after the conception. Most of the tests methods can detect serum beta hCG at this time. The most popular test to detect serum beta hCG is the enzyme-linked immunosorbent assay (ELISA) and it determine the total beta hCG level in the blood. Radioimmunoassay (RIA) is the other test which used to detect beta hCG in the maternal blood. The hCG level doubles approximately every 2 days in early pregnancy. However, it should be noted that even increases of only 33% can be consistent with healthy pregnancies. These values increase until about 60-70 days and then decrease to very low levels by about 100-130 days and never decrease any further until the pregnancy is over

Urine hCG test for diagnosis of pregnancy

Urine hCG test for diagnosis of pregnancy is one of the frequently used urine tests. Beta hCG is specific for the pregnancy. Usually beta hCG is present in urine by 8-9 days after the conception. But most of the kits will give positive result by 3-4 weeks after the conception. The kits available for urine hCG tests are very accurate. If urine beta hCG level is more than 20 mIU/mL (usually 3-4 weeks after the conception), the kit will give a positive result. It takes 3-5 minutes to perform the test. hydatidiform molar pregnancy or other placental abnormalities may give false positive results whereas incorrect test preparation will result false negative result. Urine hCG test will remain positive for longer period after miscarriage.

Urine hCG strip


positive urine hCG strip

What is the most accurate pregnancy test to use?

There are several pregnancy tests available to diagnose or to confirm the pregnancy. One is the ultra sound scan of the abdomen and other one is the detection of pregnancy related enzyme. Among these two tests, detection of pregnancy related enzyme is easy and accurate.

hCG (human chorionic gonadotropin), estrogen and progesterone are the pregnancy related enzymes. But hCG has a diagnostic value than that of others. hCG enzyme is composed of two sub units; alpha and beta. Beta hCG is specific for the pregnancy and it is produced by the syncytiotrophoblast beginning on the day of implantation. Level of beta hCG starts to rise in the maternal blood and the maternal urine early in the pregnancy. Therefore beta hCG can be detected in both maternal blood and urine by about 8-9 days after conception.

The serum hCG test is the most sensitive and specific. The urine beta hCG tests differ in their sensitivity and specificity depending on the cut off hCG unit value, usually 2-5 mIU/mL. the test can be performed quantitatively or qualitatively.

1. urine hCG test
2. serum hCG test
3. other urine tests for pregnancy

definition of normal labour/ labor

definition of normal labour/ labor

Normal labour/labor is defined as spontaneous onset of labour with a singleton cephalic presentation (a single fetus with head presentation; head is pointing towards the vagina) after 37 weeks of pregnancy. The liquor (amniotic fluid) is clear, the fetal heart rate is within 120-160 beats per minute and the cervix dilates at 1 cm or more in every hour with progressive descent of head. mother should not have post partum (after delivery) complications as well.