Worms and Parasites

Intestinal parasites are not a fun topic to think about at any time, much less when you are pregnant.  Nonetheless, if you will be traveling to undeveloped areas and living and eating in places of questionable hygiene, infestation with these creatures becomes a real possibility.

Most intestinal parasites are acquired by eating raw or undercooked food.  Just as food preparation is essential for diarrhea prevention, therefore, it is vital to preventing parasitic disease.

In general, intestinal worms are rarely a severe enough health problem to warrant treatment during pregnancy.  Most parasitic diseases, in fact, can safely be addressed simply with symptomatic treatment until the pregnancy is over. 

An exception to this general rule may be infections with giardia, ameba and cryptosporidia.  As these may cause significant weight loss and diarrhea, and because the medicines used to treat them are generally harmless, treatment during pregnancy is probably a good idea.  Some medicines used to treat these include metronidazole, tinidazole and paromomycin.  Your physician may find references regarding these medicines in the "Providers" section of this web site.

There are a few types of tapeworm that can end up in the liver, lungs, brain and other areas of the body.  These are rare but may cause enough problems during pregnancy to warrant treatment.  The medicines for these - medicines such as ivermectin, albendazole, mebendazole and thiabendazole - are also discussed in the "Providers" section.

Other parasites, rather than being spread through food, are injected by insects or can even enter directly through the skin.  If you live in the tropics for very long, words like “onchocerciasis”, “schistosomiasis” and “filariasis” become part of your vocabulary if not part of your medical history.  Infestation with these parasites can be quite dangerous in the long run, but usually there are few immediate effects.  Once again, therefore, treatment is usually postponed until after pregnancy.

Then, of course, there are the "ectoparasites", like mites, scabies, lice, bedbugs and fleas.  Prevention and treatment of these is best handled by the methods mentioned in the chapter on insect repellents.  We discourage the use of lindane during pregnancy, but probably Permethrin® is safe.  Ivermectin and other antiparasitic medicines have been used for severe cases.