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INTERNATIONAL MEDICAL INSURANCE AND HEALTH INSURANCE FOR OVERSEAS |
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INTERNATIONAL MEDICAL INSURANCE AND HEALTH INSURANCE FOR OVERSEAS |
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- add to favoritesGLOBAL COVERAGE, INTERNATIONAL HEALTH INSURANCE |
Although international medical insurance is important it is also important to be so prepared in order to avoid health problems overseas.
EXPATRIATE HEALTH
PREGNANT EXPATRIATE
(For most up-to-date
advice go to www.pregnanttraveler.com)
All expatriate workers should recognize that going overseas and having a baby in a developing country will certainly not be the same as in the U.S. There are some unpredictable health problems in which a child can be lost.
Many of the countries in which people serve have maternal/mortality rates still in the ranges of what the U.S. had in the late 1800’s in terms of pregnancy losses. If a pregnant patient can AVOID TRAVELING in the first 12 weeks, that is best since the first trimester is the time of organogenesis (fetal formation) and no medicines can be declared as having no effect on the formation. Airlines vary in their rules regarding transporting pregnant patients, but none of them willingly do it past 36 weeks’ gestation. Most organizations such as the U.S. military recommend return to the U.S. by 32 weeks in most situations.
Routine immunization should NOT be done in the first 12 weeks of pregnancy.
Diphtheria and tetanus vaccine can be given after the first trimester
Measles, mumps and rubella vaccinations should NOT be given in pregnancy.
Polio vaccination can be given in the second trimester if the patient has never been immunized because there is a tendency for pregnant patients to get polio. Oral polio is no longer recommended in the U.S. because of gastrointestinal transmission of the virus to immune-compromised patients. They should be dosed at 0 and 30 days prior to travel.
Hepatitis B & A vaccinations may be given in the second trimester.
Pulmonary influenza vaccine should be given to the pregnant traveler prone to chronic respiratory disease.
Yellow fever should NOT be given to a pregnant woman unless travel to an endemic area is ABSOLUTELY unavoidable. Preferable when needed in the 2nd trimester. If at all possible travel in those areas should be avoided until after delivery. Breastfeeding, however, is not contraindicated. Yellow fever vaccination is generally NOT recommended in children under 2 years because of complications of encephalitis.
Typhoid (oral vaccine) is not generally given to pregnant patients because of febrile reactions with adverse effects. It is not recommended in the patient unless the risk of typhoid in a MUST-travel area is unavoidable. Babies’ vaccine should be able to be given.
Japanese encephalitis vaccine is not recommended in pregnancy at all. Avoiding travel in infected areas should be considered.
Malaria-endemic areas require personal protective measures since no prophylaxis is 100% effective. So, remain indoors between dusk and dawn. Wear light-colored clothing with long sleeves, pantlegs, shoes and socks.
Permethrin-impregnated bed nets and electrical citronella coils should be used. Chloroquine and Progauonil have been used for decades by the British with no documented birth defects. First trimester is still a concern FOR ANY MEDICATIONS. Mefloquine has been given in the second trimester with no adverse effects. Breastfeeding mothers should take anti-malarials. Doxycyline SHOULD NOT BE USED IN PREGNANCY except in a mother with acute malaria. Graying of teeth of the baby is the only known problem. Apparently graying of the bone also takes place but causes no proneness to fracture.
Air travel during pregnancy
As previously mentioned, those with a history of thrombophlebitis, (blood clot and vascular inflammation of the great vessels of the legs), sickle cell trait and severe anemias should probably avoid flying during pregnancy. Where it is unavoidable, oxygen should be ordered in advance for severe forms of sickle cell and anemia. Aisle seats at the bulkhead should be requested ahead of time. Pregnant women should walk every half hour during flight, flexing and extending ankles. Avoid dehydration.
Women should avoid air travel with newborns for the first 6 weeks because alveoli (air sacules in the lungs)are not completely functional yet.
Infants are prone to pain with the collapse of the Eustachian tube with air pressure changes. Breastfeeding during this time relieves that, or a bottle as well as Benadryl or a decongestant.
Travel Medical Kit in Pregnancy – avoid medications if possible
Talcum powder - Oral Rehydration packets - Anti-fungal for yeast infections
Thermometer - Multi-vitamins - Acetamenophine (Tylenol)
Mosquito Repellent with > 15% Deet - Blood pressure cuff in 3rd trimester
Urine dip sticks - Anti-malarial for self-treatment - Anti-diarrheal
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