Causes & Signs Of Hand, Foot, And Mouth Disease In Pregnancy

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Like several other viral infections, it is possible to contract hand, foot, and mouth disease during pregnancy (HFMD), albeit rare. HFMD typically affects infants, children, the elderly, and those with a weakened immune system. It is caused by coxsackievirus, a type of enterovirus that is highly contagious.

A mother’s immunity is naturally suppressed during pregnancy to prevent fetal rejection; hence, it is possible to contract HFMD, especially in the later stages of gestation (1).

Read on to learn about the symptoms, treatments, and prevention of HFMD during pregnancy.

Symptoms Of Hand, Foot, And Mouth Disease

Some pregnant women may have mild symptoms, while many are asymptomatic. The symptoms begin to appear after a few days of exposure to the virus. However, the symptoms of this infection in pregnancy are similar to signs in a non-pregnant state and include the following (2) (3).

  • Low-grade fever
  • Mouth or throat pain (sore throat)
  • Ulcers in the mouth and on the tongue
  • Malaise and uneasiness
  • Loss of appetite
  • Small blister-like rashes or lesions on hands, fingers, soles, and genitals

Complications Of Hand, Foot, And Mouth Disease In Pregnancy

There is no clear evidence of hand, foot, and mouth disease complications in pregnant women, the fetus, or newborns. A pregnant mother could pass the virus to the baby, but there is no evidence to demonstrate the involvement of the virus in causing birth defects (4). Also, few studies state that having this infection in pregnancy may expose your newborn to mild to severe infection. However, in rare cases, having a fever during the first months of pregnancy, such as due to HFMD, may lead to miscarriage (5).

A few research studies also suggest that this infection in pregnancy rarely increases the risk of complications such as spontaneous abortions, intrauterine death, myocarditis, respiratory failures, and neurodevelopmental delays in infants (6) (7). However, there is conflicting data in this regard, and literature supporting the causal relationship and adverse effects of this viral illness on fetuses is limited.

Transmission Of Hand, Foot, And Mouth Disease

Hand, foot, and mouth disease can occur anytime, but more frequently during the summer and fall months (4). The regular mode of transmission is through the fecal-oral route. The disease is communicable and also occurs due to (8):

  • Consumption of contaminated water
  • Inhalation of respiratory droplets from an infected person (cough or sneeze)
  • Direct contact with an infected person (hand to hand) and touching nose, eyes, or mouth (close contact, kissing, hugging, or sharing utensils)
  • Contact with contaminated mouth or throat secretions (including saliva, sputum, or nasal mucus) or fluids from blisters

Young children exposed to the virus at daycare may spread it to their pregnant mothers. The postnatal transmission of this virus from a pregnant mother to her baby is common and may occur through respiratory secretions, blood, and maternal secretions during vaginal delivery. The intrauterine transmission route is seen with a little frequency and is not well-documented (9).

Diagnosis Of Hand, Foot, And Mouth Disease

The diagnosis of hand, foot, and mouth disease is based on the clinical features and symptoms. Additional laboratory tests are usually not needed. However, stool or blister samples or throat swabs might be taken for analysis in some cases (10).

Treatment For Hand, Foot, And Mouth Disease In Pregnancy

There is no specific treatment for HFMD. Most people reportedly see a spontaneous improvement in their symptoms within a week or two without any medical intervention. However, if you feel you have contracted the virus in pregnancy and need treatment, contact your doctor, who may suggest the following treatments (3).

  • Acetaminophen or ibuprofen to relieve pain or soreness
  • Gels, sprays, or mouthwashes for mouth ulcers

Additionally, you might be advised to stay hydrated and avoid certain foods and drinks, such as spicy or acidic foods, to avoid irritation in the ulcers and recover faster.

Prevention Of Hand, Foot, And Mouth Disease In Pregnancy

The best way to prevent hand, foot, and mouth disease during pregnancy is to maintain good hygiene throughout your gestation period. You may observe the following good hygiene practices (11).

  • Wash your hands thoroughly with soap after using the toilet, changing diapers, wiping your nose, coughing and sneezing, before and after caring for a sick person, and before eating (if you don’t have soap and water available, you can use an alcohol-based hand sanitizer)
  • Avoid sharing utensils, personal care items, such as towels, and clothes with any family member, including your children, during pregnancy.
  • Make sure to disinfect any soiled items and contaminated surfaces periodically (e.g., toys and doorknobs).
  • Cough or sneeze into your elbow or a tissue, and discard the tissue in a bin. Wash your hands immediately. You may wear a face mask when outdoors.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with anyone who is infected with the illness.
  • Drink plenty of water and take proper diet and rest to maintain good overall health and immunity.

Hand, foot, and mouth disease in pregnancy seldom causes severe symptoms. It rarely leads to complications for the mother or the baby. Nevertheless, it is essential to follow all the safety measures to prevent the infection. Make sure to contact your healthcare provider if you notice any symptoms to ensure a healthy pregnancy and safe delivery.

Key Pointers

  • Hand-foot-and-mouth disease in pregnancy manifests itself as a mild fever, sore throat, weariness, mouth and tongue ulcers, and skin lesions on the hands and soles.
  • Hand, foot, and mouth disease is transferred via contaminated food or water, respiratory droplets, and direct contact with an infected individual.
  • There is no specific cure, and the symptoms can be managed with fever medications, pain relievers, and drugs to reduce skin rashes and irritation.

References:

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  1. Priyia Pusparajah, et al., (2020); Hand foot and mouth disease in late 3rd trimester of pregnancy: A case report.
    https://www.researchgate.net/publication/339891012_Hand_foot_and_mouth_disease_in_late_3rd_trimester_of_pregnancy_A_case_report
  2. Hand, Foot and Mouth Disease.
    https://my.clevelandclinic.org/health/diseases/11129-hand-foot-and-mouth-disease
  3. Amanda M. Guerra, et al., Hand Foot And Mouth Disease.
    https://www.ncbi.nlm.nih.gov/books/NBK431082/
  4. Dealing With Infections During Pregnancy.
    https://www.womens-health-center.org/obstetrics/pregnancy/infections/
  5. Hand, foot and mouth disease.
    https://www.nhs.uk/conditions/hand-foot-mouth-disease/
  6. Weiming Yu, et al., (2015); CoxsackieVirus A16 Infection of Placenta with Massive Perivillous Fibrin Deposition Leading to Intrauterine Fetal Demise at 36 Weeks Gestation.
    https://pubmed.ncbi.nlm.nih.gov/25826430/
  7. E Euscher, et al., (2001); Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn.
    https://pubmed.ncbi.nlm.nih.gov/11755547/
  8. Z. Khediri, et al., (2018); Adverse effects of maternal enterovirus infection on the pregnancy outcome: a prospective and retrospective pilot study.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902830/pdf/12985_2018_Article_978.pdf
  9. J F Modlin, (1988); Perinatal echovirus and group B coxsackievirus infections.
    https://pubmed.ncbi.nlm.nih.gov/2837356/
  10. Hand, foot and mouth disease.
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hand-foot-and-mouth-disease#diagnosis-of-hand-foot-and-mouth-disease
  11. Hand, foot and mouth disease fact sheet.
    https://www.health.nsw.gov.au/Infectious/factsheets/Pages/handfootmouth.aspx
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Dr. Miguel Ángel Guagnelli Martínez

(MD)
Dr. Miguel Ángel Guagnelli obtained an MD from Universidad Nacional Autónoma de México (UNAM) and specialized in Pediatrics at “La Raza” National Medical Center. He has a Master´s Degree in Pediatric Endocrinology from Universitat Autònoma de Barcelonaand a Master´s Degree in Clinical Epidemiologý from UNAM. He is currently working on a PhD project. Dr. Guagnelli teaches Clinical Epidemiology in the... more

Vidya Tadapatri

Vidya did her post-graduation in Biotechnology from Osmania University, Hyderabad. Her interest in scientific research and writing made her pursue a career in writing, in which she now has over four years of experience. She has done certified biotechnology-related training programs under renowned organizations such as Centre For Cellular & Molecular Biology and Department of Biotechnology. Vidya writes health-based articles... more