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Should travel be restricted during pregnancy?

Most of the newest guidelines revolve around the patient’s individual risks and the likelihood of acute problems during the travel segment. The second trimester is considered the safest time to travel. Prolonged sitting in pregnancy is more restrictive because the gravid uterus contributes to risk of thrombosis and can cause lower extremity venous stasis and ambulation, particularly at 2-hour intervals. Air travel can additionally increase travel risk because of low oxygen tension, low humidity, and recirculated air, which contribute to dehydration.

Being pregnant has been estimated to increase the risk of thrombosis about 10 times, to a rate of about 10:100,000; air travel further increases this rate between 2-4 times. Most planes are pressurized to around 8000 feet, so altitude is not an issue.

With respect to radiation exposure, the ACOG has estimated that overall radiation levels of 50 mSv are safe. Daily radiation is about 2.2 mSv per year cumulative dose and travel is about 0.05 mSv.

Maternal adaptions to altitude itself vary but could include elevated blood pressure, increased maternal heart rate, and lower oxygen saturation. A fetus can physiologically adapt to these conditions and is typically protected during these flights.

Drinking water and avoiding alcohol and caffeine is important to avoid dehydration. Additional risks may be due to communicable diseases, but those typically depend on to the destination. Travelers diarrhea is common; pregnant women have an increased risk because of slower gastric and intestinal transit times. Pregnant women should be informed of travel risks and told to wear compression stockings.

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