Am J Perinatol 2004; 21(4): 173-182
DOI: 10.1055/s-2004-828605
REVIEW ARTICLE

Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Tetanus in Pregnancy

Jeanne S. Sheffield1 , Susan M. Ramin2
  • 1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
  • 2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, Houston, Texas
Further Information

Publication History

Publication Date:
28 May 2004 (online)

Tetanus remains a leading cause of maternal and neonatal morbidity and mortality in developing countries. It is caused by the release of two toxins produced by Clostridium tetani, a noninvasive gram-positive anaerobic bacillus. Tetanospasmin is taken up by the neuronal end plates and prevents neurotransmitter release at the synaptic junction. This leads to spasms and is irreversible. Recovery requires the formation of new neurons and may take months. Generalized muscle spasm, respiratory compromise, and autonomic dysfunction are all common clinical manifestations. Diagnosis is based mainly on history and clinical examination. The management of the pregnant woman is similar to the nonpregnant individual. The main objectives are prompt prevention of further toxin absorption, wound debridement, antibiotic therapy, and aggressive supportive care. Primary and secondary prevention protocols are important worldwide because tetanus is a preventable disease. The tetanus toxoid vaccine can be given in pregnancy.

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Jeanne S SheffieldM.D. 

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center

5323 Harry Hines Boulevard, Dallas, TX 75390-9032