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Infektionsgefährdung: Mutterschutz im Krankenhaus

The Maternity Protection Act and supplementary decrees guarantee the protection of employed pregnant and nursing women. Occupationally acquired infectious diseases are a wellknown problem for employees in the health sector. As a result, great importance is attached to the risk of infection for pregnant and nursing women. Before taking up work, instruction should be given on modes of infection (aerosol, faecal-oral, contact, parenteral), direct or indirect sources of infection, the extent of risk of infection with respect to the workplace and the corresponding hygienic measures to be taken. Vaccination, re-vaccination and the determination of immune status for infections relevant to pregnancy are also to be offered. Of the most important viral infections with consequences for the foetus and child, rubella, varicella and hepatitis B are all preventable by vaccination. The risk of infection with cytomegalo-virus in a hospital setting is low, provided hygienic measures are adequately followed. The infection with hepatitis C virus and human immunodeficiency virus (HIV) in healthcare personnel is primarily acquired via needlepoint injuries during blood sampling and can be considered low. Pregnant employees are not at higher risk of infection in the workplace than non-pregnant women or male personnel. During the increased occurrence of infectious erythema (parvovirus B19 infection), temporary leave for sero-negative pregnant women can be considered (mainly between 9 to 20 weeks of pregnancy). In the case of herpes simplex virus infections in hospitals, the so-called iatrogenic risk of neonatal herpes in the newborn via postnatal exposure is higher than the potential risk to pregnant medical personnel. However, for all these infections it must be mentioned that case reports are lacking in which occupational exposure was indisputably the source of the maternal infection that resulted in abortion or foetal death. Nevertheless, for the known infections with proven consequences for the foetus or newborn (and also infections for which consequences are as yet unknown, such as imported infections), the possibilities offered by rapid diagnosis, adequate isolation and therapeutic measures should be realised and the outcome of pregnancy monitored.