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Pregnancy (Expert Forum)
Giardia and weight loss in first trimester
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
This forum is for questions and support regarding pregnancy issues such as: Alcohol/Drugs, Bleeding, Caesarean Section, Childbirth, Diabetes, Depression, Fetal Monitoring, Genetic Testing, Hormonal Changes, Labor, Lamaze, Morning Sickness, Nutrition, Parenting, Prenatal Care, Weight gain.
Giardia and weight loss in first trimester
by Arabinda, Feb 03, 2008 04:52PM
My wife is 12 weeks pregnant and has been diagnosed with giardia. Her weight at conception was 145 lbs and is now 135 lbs. Our doctor wants to delay treatment of the giardia due to the risk of complications to the fetus for another month. We are however worried about the effects of the lack of nutrients to the fetus due to malabsorption. Can you please advise us on the risks and anything we can do to treat giardia or at least mitigate the risks.
Doctor's Answer
by Keith Downing, MD, Feb 07, 2008 01:20PM
, Feb 07, 2008 01:20PM
Hello,
Treatment of giardiasis in pregnancy can be difficult. Metronidazole is often avoided based upon old reports of teratogenic effects in rats, although human studies have not documented such risks. If symptoms of giardiasis are minimal, therapy can be withheld until after delivery. If symptoms are bothersome, paromomycin (25 to 35 mg/kg per day PO in three divided doses for seven days) can be used. Paromomycin, a nonabsorbable aminoglycoside, eliminates cysts in only 60 to 70 percent of patients, but it may provide symptomatic relief. If giardiasis in pregnancy is associated with dehydration, malabsorption, or severe symptoms, therapy with metronidazole is warranted. And at 12 weeks organ development is mostly complete, making its use less worrisome. Malabsorptive symptoms may persist in any patient receiving antiparasitic therapy since regeneration of functioning intestinal mucosa requires time.
Best regards,
Dr. Downing
Treatment of giardiasis in pregnancy can be difficult. Metronidazole is often avoided based upon old reports of teratogenic effects in rats, although human studies have not documented such risks. If symptoms of giardiasis are minimal, therapy can be withheld until after delivery. If symptoms are bothersome, paromomycin (25 to 35 mg/kg per day PO in three divided doses for seven days) can be used. Paromomycin, a nonabsorbable aminoglycoside, eliminates cysts in only 60 to 70 percent of patients, but it may provide symptomatic relief. If giardiasis in pregnancy is associated with dehydration, malabsorption, or severe symptoms, therapy with metronidazole is warranted. And at 12 weeks organ development is mostly complete, making its use less worrisome. Malabsorptive symptoms may persist in any patient receiving antiparasitic therapy since regeneration of functioning intestinal mucosa requires time.
Best regards,
Dr. Downing
