Pregnancy and air travel. Can you fly while pregnant? Favorable and unfavorable periods for air travel, contraindications and possible negative consequences Flight rules for pregnant women with airlines

Hello! According to the recommendations, the safest time to travel is during the second trimester (18-24 weeks), when a woman feels better, and the likelihood of spontaneous abortion or premature birth least. In the III trimester, pregnant women are not recommended to move away from home more than 500 km, so that in case of possible problems (hypertension, phlebitis or premature birth), medical care is territorially available. Before making a decision to travel, a woman should always consult with her doctor. When deciding on a trip, a number of controversial issues should be resolved: 1. Before starting any trip, the presence of an intrauterine pregnancy must be confirmed by a doctor and ectopic pregnancy excluded. 2. Medical insurance must be valid abroad and in case of pregnancy. Additionally, the insurance must include a transport insurance policy and a prepaid medical care, although most insurances may not cover pregnancy-related costs. 3. The availability of adequate medical support at the destination must be confirmed. For women in the last trimester of pregnancy, it is mandatory to have qualified medical personnel and appropriate equipment for the management of pregnancy complications, late toxicosis of pregnant women and caesarean section. 4. It is advisable to determine in advance the situations in which prenatal care (assistance to the unborn child before birth) may be needed and who will provide it. A pregnant woman going on a trip should regularly visit a doctor at the required time, and not miss the scheduled visits. 5. You should first find out if blood is tested for HIV in the area and. A pregnant woman, going on a trip, should know her blood group and Rh, and persons with negative Rh factor prophylactically should receive anti-D at 28 weeks of gestation. In the event that the newborn has an Rh-positive blood factor, the woman after childbirth should be re-introduced with anti-D immunoglobulin. There are certain contraindications to international travel during pregnancy. Obstetric risk factors include: - history. - Isthmic-cervical insufficiency. -Ectopic pregnancy history. -Premature birth or a history of premature rupture of membranes. - Anomalies of the placenta during the current pregnancy or in history. - Threatened abortion or vaginal bleeding during this pregnancy - Multiple pregnancy. - Anomalies in the development of the fetus. - Toxicosis of pregnancy, hypertension or diabetes in the background or not related to pregnancy. Primigravida older than 35 or 15 years. General medical risk factors: - History of thromboembolism. - Pulmonary hypertension. - with other chronic lung diseases. - Pathology of the valvular apparatus of the heart (III or IV degree of heart failure according to NYHA). - Cardiomyopathy. - Hypertension. - Diabetes. - . - Different kinds anemia or hemoglobinopathies. - Chronic dysfunction of body systems requiring frequent medical attention. Travel to potentially dangerous places: - Highlands. - Regions endemic for life-threatening intestinal or transmissible diseases (from Latin transmissio - transfer to others; contagious human diseases, the pathogens of which are transmitted by blood-sucking arthropods - insects and ticks). Such diseases include, for example, typhus, malaria, tularemia, and the like. - Territories where malaria caused by P. falciparum resistant to chloroquine is common. - The area, stay in which requires mandatory vaccination with live viruses. If we talk about general recommendations regarding travel, then a traveling mother-to-be should have at least one accompanying person. The most common problems that pregnant women experience while traveling are fatigue, heartburn, indigestion, constipation, vaginal discomfort, leg cramps, increased frequency of urination and hemorrhoids. During the trip, if possible, a woman should exclude foods and drinks that contribute to increased gas formation from the diet, especially before flying (the resulting gases at altitude can expand and stretch the walls of the gastrointestinal tract). During the flight, it is advisable to periodically move the legs (contract the muscles of the legs in isometric and isotonic modes) to reduce venous stasis; be sure to wear a seat belt as air turbulence is unpredictable and can cause serious injury. Medical observation is required by the patient if the following signs and symptoms appear: vaginal bleeding, (especially cramping), convulsions, premature rupture of the membranes, pain or severe swelling of the lower extremities, headache, or other visible problems. There are certain recommendations for pregnant women who are going to fly by air. Commercial flights do not pose any risk to a healthy woman or fetus. According to ACOG (American College of Obstetricians and Gynecologists) regulations, a healthy woman with a singleton pregnancy can safely fly on airplanes up to 36 weeks of pregnancy. A decrease in atmospheric pressure in the aircraft cabin has a minimal effect on fetal oxygenation (oxygen supply) due to the increased affinity of fetal hemoglobin for oxygen. If necessary, with appropriate medical indications, additional oxygen inhalation of the pregnant woman during the flight should be organized. Various types of anemia and past thrombophlebitis may be relative contraindications to flying. Pregnant women with placental abnormalities or risk of preterm birth should avoid air travel. Each airline has its own rules (requirements) regarding flying during pregnancy. It is considered safest to be in control when ordering tickets, as this requires the completion of relevant medical forms. Flights within the country for pregnant women are usually allowed up to 36 weeks of gestation, and international flights - up to 32-35 weeks, depending on the particular airline. At the same time, women must necessarily have documents with them with the expected date of birth. Today, the airport security system (when passing control) has a minimal radiation effect on pregnant women, not associated with an increase in undesirable consequences for the fetus. Considering that some research results have indicated a possible link between radiation exposure to security systems during pregnancy and an increased risk of developing childhood leukemia and cancer, it is possible to request (require) manual screening or control with a sensor when passing the control instead of the conventional one that causes radiation exposure. The largest amount of free space and comfort in the aircraft is provided by seats near the aisle behind the partition. At the same time, in the seats located in the middle of the aircraft, a quieter flight is possible. Pregnant women are advised to walk every half hour during the flight, often bend and unbend their knees to prevent the development of phlebitis. The seat belt must always be fastened at pelvic level. Dehydration caused by air conditioning during flight can lead to reduced placental blood flow and haemoconcentration (blood clotting), increasing the risk of thrombosis. Therefore, during the flight, a woman should receive plenty of fluids. If the crew member or pilot is a woman who is about to become a mother, she can continue to work in the air until the 20th week of gestation. All the best!

IN modern world where travel is the norm, air travel is one of the most sought-after modes of transportation. In anticipation of your baby, you can safely travel by air, without any problems from your well-being, during the 1st and 2nd trimesters up to 7-8 months of pregnancy. At the same time, the most favorable period for air and not only travel is 14-27 weeks of pregnancy. This rule applies to women whose pregnancy is absolutely normal, and there are no bans on flights imposed by a doctor.

Flying in the first weeks of pregnancy

In some cases, doctors recommend not flying in the first trimester of pregnancy, because. at this time, hormonal changes occur in the woman's body. During the flight, the likelihood of feeling unwell and fatigue increases, nausea and headache often occur. According to many gynecologists, air travel during the first trimester can be one of the factors that can cause spontaneous abortion. Long hours of flight can worsen the condition, and pressure drops during takeoff and landing can negatively affect the fetus, and experts believe that it is better to refrain from them. However, there are no conclusive studies on the dangers of air travel during this period.

The maximum safe period for pregnant women allowed during the flight.

It was considered that at normal course pregnancy, without complications, traveling by plane is safe up to 33-34 weeks (up to 32 weeks in case of multiple pregnancy), if this does not contradict the rules of the chosen airline.

Recent studies have shown that flying is safe at any stage of an uncomplicated pregnancy, provided that general precautions are followed and recommendations are followed: the woman avoids immobility and tight clothes drinking enough fluids.

Starting from the third trimester of pregnancy, a number of airlines provide restrictions for expectant mothers. It is better to know about them in advance, and timely adjust your current and long-term plans.

In order not to put yourself in an extremely risky position, it is better to refuse air travel in the last month of pregnancy. Even if the pregnancy proceeds without problems, and the woman feels well, flying in the 9th month is highly discouraged, because of the threat of giving birth ahead of schedule and right on the plane.

That is why many airlines will not allow a woman to board an airliner if there are less than 7-30 days left before the expected date of delivery (depending on the specific airline). Therefore, when going on a flight, take care in advance of a certificate from a medical institution, which will indicate the expected date of future birth. In this regard, do not forget about the date of return from the trip.

What you should pay attention to when planning an air flight - or modern myths and reality when flying for a pregnant woman:

1. Heavy bags.

If you plan to take a lot of things with you, you should take care of a suitcase on wheels with comfortable handle so that you can roll it without tilting the body. Even better, if you can be escorted to the plane and met at the airport, eliminating the need to lift weights. Such a precaution will not interfere at any stage of pregnancy.

2. Inability to receive urgent qualified medical assistance during the flight.

This is the main reason why most airlines are reluctant to take pregnant passengers on board.

There is currently no scientific evidence that air travel during pregnancy increases the risk of preterm birth. Flight-induced stress can be considered a risk factor, since stress is associated with increased release of corticotropin-releasing hormone.

It should be remembered that preterm births are quite common, and patients should be aware of the lack of facilities for resuscitation of newborns on board the aircraft. As a result, some airlines have developed special rules prohibiting flights for pregnant women with a high risk of preterm birth (for example, with multiple pregnancies), as well as for full-term pregnancies.

According to the internal rules of many airlines, a woman after 30 weeks at check-in for a flight may be asked to present an exchange card and a certificate from a doctor on satisfactory health indicating the duration of pregnancy. She may also be asked to sign a warranty statement stating that the airline is not responsible for possible adverse consequences.

The fears are understandable: although flight attendants are trained in obstetrics, they will not be able to provide full-fledged resuscitation assistance to the child or his mother in the event of an emergency. It is clear that it is impossible to deploy an operating room for a caesarean section or a blood transfusion unit on board a passenger liner. So during pregnancy, you need to think very carefully about the possibility of flying, especially if you plan to deliver by caesarean section.

There are cases of successful births during the flight. If childbirth begins when the flight comes to an end, the crew contacts the dispatcher of the city of arrival, and immediately from the gangway the woman is taken to the maternity hospital.

If future mom constantly takes any medications, you need to take them with you to the cabin. You can supplement the first aid kit with a remedy for heartburn, activated charcoal in case of bloating, mints against nausea, a nasal spray with sea or mineral water.

3. Checking on a metal detector during registration before the flight.

The metal detectors used by security services at airports are not a source of ionizing radiation (their work is based on a weak magnetic field), therefore, they do not pose any danger to the fetus at any stage of pregnancy. X-ray radiation is used only when checking baggage.

4. Vibration and shaking during flight.

In the first trimester of pregnancy, this can cause nausea and vomiting, especially in expectant mothers prone to motion sickness. For this reason, it is forbidden to fly if there is a threat of preterm labor, spotting or preeclampsia.

Getting into turbulent air currents is inevitable. Therefore, it is necessary to choose modern models of air liners and not sit in the tail of the aircraft, where the shaking is felt more strongly.

5. Changes in atmospheric pressure.

The higher the plane soars into the sky, the lower the atmospheric pressure and the partial tension of oxygen in the inhaled air. Pregnant women are already sensitive to a lack of oxygen, and during an air flight this condition has to be endured for several hours. This explains the possible deterioration of well-being: a feeling of lack of air, increasing weakness, headache and dizziness.

Specialists studying the effect of relative hypoxia on the body of healthy pregnant women in real conditions during the flight did not reveal any serious differences in the blood gas composition or compensatory reactions. When monitoring the state of the fetus during the flight, there were also no signs of fetal respiratory distress, i.e. tachy- and bradycardia and pathological types of heart rate variability in cardiotocography. It is believed that a slight decrease in PaO2 in the mother's blood during air travel, as a rule, does not lead to the development of severe fetal hypoxia, because. The affinity for oxygen in fetal hemoglobin is much greater than that of adult hemoglobin. Thus, relative hypoxia is easily tolerated by both mother and fetus.

Opinion about the increased risk of occurrence congenital anomalies fetal development due to hypoxia during air travel at altitude<2500 метров в настоящее время считается необоснованным.

But in some pathological conditions, such as severe anemia (Hb<80 г/л), снижение PaO2 в крови может достигать критических значений. Поэтому авиаперелеты противопоказаны беременным с анемией тяжелой степени, но могут допускаться при возможности дополнительной оксигенации.

6. Solar radiation.

At the flight altitude of modern passenger airliners, the intensity of cosmic radiation is several hundred times higher than at sea level.

Of course, we are talking about the so-called "small" doses of radiation, which do not have any effect on the health of ordinary passengers. However, it should be emphasized that the biological effects of "small" ionizing radiation on the human body, especially during prenatal development, have not yet been sufficiently studied. In this regard, doctors recommend refraining from frequent and long travel by plane only in the first trimester of pregnancy. For example, flight attendants are offered temporary ground jobs.

It is currently believed that infrequent long-term air travel (i.e. as a passenger), regardless of the gestational age, does not adversely affect the intrauterine development of the unborn child, since the equivalent dose received in this case is several times less than the maximum permissible level adopted for the population (t .e.< 1 миллизиверта).

So, for example, during a transatlantic flight, the equivalent dose is 50 microsieverts, which is 2.5 times less than with chest X-ray with shielding of the pelvic area.

7. Prolonged immobility anddeep vein thrombosis and pulmonary embolism.

The reasons for the increased risk of venous thrombosis during pregnancy are venous stasis in the lower extremities. There is no evidence to quantify the risk of air travel-related thrombosis, but an increase in pregnancy is evident. Therefore, preventive recommendations for passengers with an increased risk of thrombotic complications during long flights are quite acceptable for pregnant women.

A long flight is considered to be a flight lasting more than 3 hours. All patients (pregnancy of any period and 6 weeks postpartum period) during the flight must be prevented from venous congestion in the lower extremities, including isometric tension of the calf muscles and movement around the aircraft cabin for 5-10 minutes per hour, when possible. With a tendency to hypercoagulation of blood (that is, with a tendency to thrombosis), as prescribed by a doctor, on the day of the flight and the next day, an injection of low molecular weight heparin is given, which reduces blood clotting.

It is necessary to sit in a chair not strictly straight, but slightly leaning back on the seat - this way the vessels of the legs are less squeezed and the back is relaxed.

For all pregnant women on a long flight, it is advisable to use compression stockings.

8. Dehydration.

During the flight, dry air is supplied to the aircraft cabin. In addition, people drink liquids less than usual, and from drinks they prefer diuretic tea, coffee, sugar-rich pops. Therefore, it is important to drink pure and mineral water, without fear of frequent trips to the toilet. Moreover, this is another reason to move.

9. Increased swelling of the nose.

It's not the pregnancy hormones that are to blame, but the dry air in the cabin. Doctors recommend regularly spraying the nasal passages with mineral water from a personal first-aid kit.

10. Excessive anxiety and fatigue due to jet lag

Sometimes a woman's well-being can worsen due to nervousness: tension can cause an increased tone of the uterus, headaches. It is better to be careful when choosing a flight: the schedule of regular flights is more predictable than charter flights; they are less likely to be canceled or rescheduled. When checking in for a flight, you can ask for a seat in the front row or next to the emergency exits, where it is more spacious. There is more turbulence at the end of the cabin, and this too should not be overlooked. It is better to avoid large crowds of people, it is recommended to get on the plane closer to the end of the announced landing. If you are tormented by nausea before the flight, it is better not to read on the way, but to sleep. Eat small meals, but often. For heartburn, high blood pressure and stomach problems, individual meals can be ordered in advance. It is necessary to have dark chocolate with you in your purse to prevent attacks of nausea that occur due to carbohydrate hunger.

Do not worry in vain: the baby feels everything. Keep all your medical records and a notebook with the contact numbers of close relatives or friends nearby. Buckle up at the request of the flight attendant, but make sure that the belt is located under the tummy.

When it is contraindicated for pregnant women to fly on an airplane

Common sense should make you refuse to fly on an airplane if a pregnant woman:

• the threat of abortion or premature birth;
• partial detachment of the placenta;
• anemia iron deficiency 3 degrees or sickle cell;
• the day before there were blood-stained discharge from the genital tract;
• complete or partial placenta previa with intermittent spotting spotting;
• preeclampsia;
• acute otitis or sinusitis, diseases of the lungs and heart, accompanied by a feeling of lack of air.

All other contraindications are relative. This means that in special cases, the doctor may allow the flight, but the risk of complications for the mother and her child is very high. Such contraindications include exacerbation of any chronic or acute diseases of the pregnant woman, severe nausea and vomiting, conception as a result of the use of obstetric technologies, multiple pregnancy (after 24 weeks), incorrect position of the fetus in the second half of the third trimester, a scar on the uterus, invasive procedures, anemia 2 degrees.

Airline rules for pregnant women

Naturally, air carriers are trying by all means to avoid problems associated with health problems in pregnant women during the flight and premature birth, because. they do not have the opportunity to provide the necessary assistance on board the aircraft.

Each airline has its own rules for the carriage of pregnant passengers; more details can be found in the table. If you are purchasing a packaged tour, it is the responsibility of the travel agency to provide information about the requirements of the airline you are flying with. But if you are planning a vacation on your own, it is better to find out this question in advance. On the websites of all airlines, in the sections on the rules for carrying passengers, there is information regarding pregnant women. Do not be too lazy to get acquainted with it carefully before buying tickets, and if necessary, call the office of the air carrier.

Most airline policies depends on gestational age.

• In the period up to 27-28 weeks, flights at this period are allowed, but airline employees have the right to demand a certificate from a doctor, which indicates the expected date of delivery; this is due to the fact that it is visually difficult to determine the gestational age, and if your stomach is large and there is no certificate, this is the basis for not being allowed on board the aircraft.
• In the period from 28 to 36 weeks - a certificate will definitely be needed, and it should clearly indicate that "there are no obstacles to flying." You may also need to sign a paper stating that you are aware of the risk and take responsibility - this is how air carriers insure themselves.
• Some flights involving long hours of travel may not let you in even if you are 28 weeks pregnant.
• After 36 weeks, almost all airlines refuse to carry pregnant passengers.

The certificate must be as recent as possible, issued no more than 7 days before the expected date of departure. Consider also the date of your return flight, and make sure that it falls within the time allowed by the airline. If you are expecting twins or triplets, then the flight restrictions are more stringent. Often, in addition to a certificate from your doctor, you must obtain a certificate from the airline's doctor.

Table: features of the conditions for accepting pregnant passengers on board the aircraft of various airlines

In general, the likelihood of occurrence of conditions that threaten the life of the mother and fetus during air travel is low. But, since there is no possibility of providing specialized medical care on board the aircraft, even an emergency managed from the point of view of modern medicine can have a dramatic outcome. Therefore, when counseling a pregnant woman before a flight, it is necessary to take into account the possibility of certain complications from the standpoint of individual risk.

Happy flight and vacation!

Tomsk--2014

In contact with

Are flights dangerous during pregnancy, what month is it better to organize a trip, the rules for "transporting" the belly, and other useful answers to disturbing questions.

Pregnancy is shrouded in many different prejudices. Grandmother says that you can’t have a haircut, mom says that you can’t buy a dowry for a baby in advance; we reject thousands of nonsense instructions and continue to lead our usual busy lives, continue to work, go to beauty salons and travel ... But are all trips suitable for pregnant women? The most doubtful thing is the aircraft. Are the dangers of flying a grandmother's prejudice or does the threat really exist? Doctors have not come to a consensus about flying: most will neatly say that this is an "undesirable risk" for pregnant women.

What can scare?

1. Pressure drops. preterm birth

It is known that pregnant women are extremely sensitive to pressure drops, an inevitable phenomenon during the flight, especially noticeable during takeoff and landing. It is impossible to say with absolute certainty how a woman will endure this. There is an opinion that a strong drop in atmospheric pressure can cause premature birth. However, there is no scientific evidence for it. Of course, premature births are not uncommon, they can occur on earth. But it is in the air that there will be no resuscitation for children, a team of doctors and the opportunity to provide qualified assistance.

And the Royal College of Obstetricians and Gynecologists of Great Britain consider preeclampsia, severe anemia as absolute contraindications for flying. Relative contraindications include the risk of premature birth and premature detachment of a normally located placenta; moderate anemia, low placentation (from gestation), the presence of bloody discharge from the genital tract at any stage of pregnancy, invasive procedures, multiple pregnancy (after), and abnormal position of the fetus in the second half).

Airline requirements for pregnant women

Before traveling, you should find out what rules the airline you have chosen adheres to in relation to pregnant women. They have different requirements. For example, on the Aeroflot website there is such information: "Pregnant women whose birth is expected within the next four weeks must provide a written consent of the doctor for the flight. A medical examination must be issued no earlier than 7 days before the start of the flight."

And Transaero reports: “Flight of pregnant women is allowed provided that it is carried out no later than four weeks before the expected date of birth and that there is no risk of premature birth. Information about the condition of a pregnant woman, confirmed by a medical report and an exchange card, must be provided airlines.

The flight of pregnant women is possible provided that a guarantee obligation is signed before the flight, which stipulates that the airline does not bear any responsibility for the adverse consequences that may arise for the pregnant woman and the fetus during the flight and as a result of the flight.

AirFrance does not require any paperwork at all: "Pregnant women are allowed on Air France flights without a doctor's note. Despite this, we still recommend that you consult a doctor before traveling."

In any case, it is better to clarify such information immediately before the flight, because it happens that airlines change their rules.

Rules for a successful flight

1. Buying a ticket is better, of course, in business class: the seats are wider and generally more comfortable. In economy class, you can ask to take a seat in the front row, where you can stretch your legs without resting your knees on the front seat. In addition, the air flow in the plane from nose to tail - it will be easier to breathe in the front seat. You should not choose a window seat, you should be able to get up often and go out into the aisle.
2. Flight clothing should be comfortable, loose-fitting and breathable. In the cabin, you can grab a few pillows - under the neck and somewhere else to ensure maximum comfort.
3. To avoid dehydration, drink plenty of water and avoid diuretics (coffee, sodas).
4. The seat belt must be fastened; skip it should be under the stomach.
5. Take off your shoes before flying. Do not sit cross-legged, this makes it difficult for blood circulation in the legs. From time to time it makes sense to strain the calf muscles and walk around the salon.
6. To be able to freshen up, take a seawater nasal spray and thermal water spray with you.
7. Always keep with you, as well as a note indicating your blood type and the phone number of a loved one (if you are flying alone or only with children).

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Due to the increased vigilance of a pregnant woman regarding her own condition, on which the normal development of the fetus depends, she wonders about the safety of almost any ordinary activity, including air travel. Consider the possible impact of air travel on the condition of a pregnant woman and answer the question: "is it possible to fly with pregnancy by plane?"

Flying while pregnant

In general, the degree of safety of air travel for each individual pregnant woman depends on her state of health. That is, in fact, the safety of a flight during pregnancy is the same as for the same, but not a pregnant woman.

The currently known potential hazards and possible negative effects of air travel on the human body concern not so much the growth and development of the fetus in the womb, but any adult or child undertaking travel by aircraft. This means that all the risks and dangers of air travel for pregnant women are exactly the same as for non-pregnant women, men and children. Thus, the main risks of air travel are considered to be the "syndrome of economy class travelers", an increased risk of thromboembolism, overdrying of the mucous membranes of the ENT organs, infection with airborne infections due to the accumulation of a large number of people in the cabin, etc.

However, all existing relative risks of air travel can be reduced to almost zero by following simple rules of conduct throughout the flight, which we will consider separately.

Thus, it can be concluded that a healthy woman whose pregnancy is proceeding normally (without complications) can safely fly an airplane, following simple rules aimed at minimizing risks, when necessary, since air travel is safe for her and the unborn child. If a woman has any complications of pregnancy, then they should first be eliminated, after which, upon reaching a stable improvement, you can fly by air, also following simple rules that minimize the risks and negative impact of flying on an airplane.

Contraindications for flying during pregnancy

• Singleton pregnancy over 36 weeks;
• Multiple pregnancy over 32 weeks;
• The first seven days after childbirth;
• Complicated course of pregnancy (for example, the threat of miscarriage, gestosis, severe toxicosis, etc.).

More clear contraindications to air travel during pregnancy are given by obstetrician-gynecologists from developed countries in Europe and the USA. So, absolute contraindications to air travel during pregnancy are the following conditions in a woman:

• Placenta previa (complete);
• preeclampsia;
• Anemia III severity (hemoglobin level below 70 g/l).

In addition to absolute, there are relative contraindications to air travel for pregnant women. In the presence of such relative contraindications, a woman can fly an airplane with caution, but doctors strongly recommend in such cases to refuse air travel. So, relative contraindications to air travel during pregnancy include the following conditions and diseases:

• The threat of premature birth;
• Risk of miscarriage;
• Suspicion of placental abruption;
• Anemia of the II degree of severity (hemoglobin level below 90 g / l, but above 70 g / l);
• Low location of the placenta (only taken into account from the 20th week of pregnancy);
• Abnormal structure of the placenta;
• Bloody discharge from the vagina at any stage of pregnancy that occurred 1-2 days before the planned flight;
• Incorrect position of the fetus in the III trimester of pregnancy (from 28 to 40 weeks inclusive);
• Multiple pregnancy in the period of more than 24 weeks of gestation;
• Carrying out invasive procedures (for example, amniocentesis, choriocentesis, etc.) within 7 - 10 days before the planned air flight;
• preeclampsia;
• Severe toxicosis;
• excessive vomiting;
• Thrombophlebitis transferred in the past;
• uncontrolled diabetes mellitus;
• Uncontrolled hypertension;
• Isthmic-cervical insufficiency;
• Exacerbation of chronic diseases (for example, herpetic, cytomegalovirus infections, etc.);
• Acute infectious diseases (including colds, flu, etc.);
• Pregnancy resulting from IVF;
• Scar on the uterus.

These relative contraindications can also become absolute, but only in each specific case, if a woman has a really high risk of pregnancy loss due to any of the indicated conditions or diseases. However, in general, if there are relative contraindications, air travel can be made, but this should be done only in case of urgent need.

Possible negative effects of air travel during pregnancy

• High risk of preterm birth due to pressure drops;
• Risk of deep vein thrombosis or pulmonary embolism (PE);
• The action of cosmic radiation;
• hypoxia;
• Harm from passing through the metal detector at registration;
• Vibration and shaking in flight;
• Dehydration;
• Swelling of the nose and the appearance of rhinitis, sore throat and other signs of a cold;
• Risk of contracting respiratory infections;
• Risk of sudden obstetric complications.

Risk of preterm birth due to pressure drops during takeoff, landing and getting into turbulence

However, long-term practical observations of the flights of pregnant women at different stages of pregnancy have shown that the frequency of premature births in the air is the same as on the ground. And pressure drops in no way affect the contractile activity of the uterus. In other words, air travel does not increase the risk of preterm birth, so this is nothing to be afraid of. And even if a woman already has a risk of miscarriage or premature birth, then air travel will not increase it. Thus, this opinion is a myth.

To determine the risk of preterm birth, you can use transvaginal ultrasound to measure the length of the cervix. If the cervix is ​​longer than 14 cm, then the risk of preterm birth is almost zero and you can safely take an air flight. If the cervix is ​​shorter than 14 cm, then there is a risk of premature birth, the degree of which must be assessed by the doctor and decide whether this woman can fly on an airplane.

Many women are not convinced by the results of many years of practical observations, because they believe that if flights did not increase the risk of premature birth and did not negatively affect pregnancy, then airlines would not restrict them in flight permits, requiring a certificate from a gynecologist, which indicates that this woman can fly on an airplane. However, airline policy has nothing to do with the impact of flying on pregnancy, so this conclusion is fundamentally wrong.

It should be understood that such a policy of airlines is not due to the negative impact of flights on pregnancy, but the desire to minimize the likelihood of stress for the crew of the liner, which they will receive if a passenger begins to give birth in the cabin. After all, neither pilots nor flight attendants are gynecologists, and they do not particularly want to be in a situation where you need to help a woman in labor. Although flight attendants are trained in birthing skills, they are not doctors or midwives, and therefore a woman giving birth is an emergency for them. And no one wants to be in a stressful emergency, so airlines are simply insuring themselves, preferring not to deal with such incidents. To do this is very simple - to limit the admission to air travel for pregnant women, which is what we see from the airlines.

Deep vein thrombosis or pulmonary embolism (PE)

It must be remembered that the risk of thrombosis and pulmonary embolism during air travel is associated with low oxygen concentration and excessive dryness of the cabin air, alcohol, coffee and soda, as well as prolonged immobility. All these factors cause stagnation of blood in the vessels of the legs and dehydration, which leads to the formation of blood clots.

However, these increased risks of thrombosis and PE in pregnant women can be minimized by proper flight behavior (walking every 45-50 minutes, moving legs frequently while sitting, wearing compression stockings, etc.). If a pregnant woman follows these rules of conduct in flight, the risk of thrombosis will be significantly reduced. At present, the Society of Obstetricians and Gynecologists of Britain has developed the following recommendations for pregnant women, the implementation of which will reduce the risk of thrombosis:

• For 5 - 10 minutes every hour, strain the muscles of the lower leg;
• Every 45 - 50 minutes walk around the cabin for 10 - 15 minutes;
• Drink 500 ml of liquid per hour (juice, still water);
• Do not drink coffee, tea, alcohol;
• Wear compression stockings with a preventive degree of squeezing for flight.

If for some reason it is impossible to administer low molecular weight heparin preparations, then they can be replaced by taking Aspirin 75 mg once a day the day before and on the day of the flight. However, Aspirin for the prevention of venous thrombosis and PE is less effective than low molecular weight heparins.

The action of cosmic radiation

However, one should not panic, since this effect of solar radiation is completely safe for all people of any gender and age, including pregnant women. The safety of solar radiation to which a pregnant woman is exposed during air travel is due to the fact that the received dose of radiation is very low. Thus, the dose of solar radiation received during a transatlantic flight is 2.5 times lower than with an X-ray of the chest organs. Therefore, during infrequent air travel, a pregnant woman is exposed to small doses of radiation that are not dangerous either for her or for the fetus.

hypoxia

So, in the course of studying the effect of low oxygen concentration in the air during air travel on the body of pregnant women, it was found that there are no signs of hypoxia in the fetus (according to CTG). That is, a slight decrease in the concentration of oxygen in the air and blood of a woman during the flight does not lead to hypoxia of the fetus, and, therefore, does not adversely affect its condition. Therefore, the widespread belief that the fetus experiences oxygen starvation during air travel is a myth.

The only situation in which the fetus may be in a state of hypoxia during air travel is the presence of grade III anemia in a pregnant woman. In this case, compensatory mechanisms are not enough to eliminate hypoxia due to the lack of the required amount of hemoglobin.

Metal detector frame at check-in

Vibration and shaking in flight

Dehydration

Swelling of the nose and the appearance of rhinitis, sore throat and other signs of a cold

Risk of contracting respiratory infections

Sudden obstetric complications

Rules of conduct for pregnant women during air travel

• For the flight, put on comfortable clothes that do not restrict movement and do not squeeze tissues;
• For the duration of the flight, you should wear compression stockings or stockings with a preventive degree of pressure;
• For the duration of the flight, you should wear a gauze or synthetic mask covering your nose and mouth;
• Be one of the last to board the plane;
• Wear shoes that can be removed without bending down and also put on;
• Do not sit cross-legged, as this impedes blood circulation and increases swelling;
• Get up every 45-50 minutes and walk down the aisle for 10-15 minutes;
• For 5 - 10 minutes every hour, strain the muscles of the legs and perform the simplest movements with the ankle in a sitting position (for example, pull the sock on and away from you, etc.);
• If the shoes begin to put pressure on the foot or be felt on it, then it is necessary to remove it;
• Fasten the belt under the belly;
• Drink every hour 500 ml of non-carbonated pure water or juice;
• Choose places in the nose of the aircraft, because, firstly, the air goes from the cockpit to the tail and it will be easier to breathe, and secondly, it shakes less in this part;
• If possible, it is recommended to buy business class tickets, since it has more comfortable and wider seats, as well as relatively large aisles that allow you to stretch your legs and take the most comfortable position;
• Choose a place near the aisle so that you can get up and walk along the aisle;
• Take a few small pillows into the salon to put them under the neck, lower back, etc. in order to ensure maximum comfort;
• To refresh your face, take with you and, if necessary, use thermal or mineral non-carbonated water;
• To wash the nose and mouth in order to eliminate the dryness of the mucous membranes, take with you and use salt solutions (Aqua-Maris, Humer, Dolphin, etc.);
• To reduce the effect of stuffy ears and motion sickness, you need to take sour candy and bitter chocolate, and use them as needed;
• To eliminate the symptoms of motion sickness, take with you and use, if necessary, homeopathic preparations that are safe for pregnant women, such as Vertigoheel or Avia-Sea;
• Do not drink coffee, tea, alcohol and sugary carbonated drinks;
• Put in a conspicuous place an exchange card and a note indicating the blood type and phone number of a loved one.

The most favorable periods of pregnancy for air travel

In addition to favorable, there are also unfavorable periods for air travel, during which the flight is most dangerous for a pregnant woman. Such unfavorable periods for air travel, and indeed for any other active actions, include the following:

• From 3 to 7 weeks of pregnancy;
• From 9 to 12 weeks of pregnancy;
• From 18 to 22 weeks of pregnancy;
• Each term of the next menstruation, which would have come if there had been no pregnancy.

Flights at different stages of pregnancy

Early flight (1, 2, 3 and 4 weeks of pregnancy)

Flight during the 1st trimester (5th, 6th, 7th, 8th, 9th, 10th, 11th, 12th weeks of pregnancy)

Flight during the 2nd trimester (13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 weeks of pregnancy)

Flight during the 3rd trimester (28, 29, 30, 31, 32, 33, 34, 35, 36 weeks of pregnancy)

Rules of various airlines for the carriage of pregnant women

• Up to 28 weeks pregnant women are allowed on board without any certificates and special documents;
• 29 to 36 weeks pregnant women to board the plane must provide a certificate from a gynecologist that the flight is allowed;
• From 36 weeks air travel is prohibited.

These rules are general and most common, but not universal. Many airlines use different rules for the carriage of pregnant women, which can be both stricter and, on the contrary, loyal. For example, some airlines take women on board even after 36 weeks of pregnancy with a certificate from a gynecologist that the flight is allowed. Therefore, when buying plane tickets, you need to find out the rules of the airline that operates the flight.

Most major airlines have the following rules for pregnant women:

• KLM - up to 36 weeks free, after which the passenger will not be allowed on board in any case;
• BRITISH AIRWAYS - up to 28 weeks free, and from 28 weeks until delivery only with a certificate from a gynecologist, which indicates that there are no contraindications to flying and with a completed application that the woman is aware of all the risks and does not place the blame on the airline;
• LUFTHANSA - up to 34 weeks free, from 35 weeks until delivery only with a certificate from a gynecologist who works in a special center of the airline;
• Aeroflot and S7 - a certificate from a doctor at any stage of pregnancy;
• UTair, Air Berlin, Air Astana - up to 36 weeks with a certificate from a gynecologist, and from 36 weeks - a flight is prohibited;
• Air France - free at any stage of pregnancy up to childbirth;
• Alitalia - up to 36 weeks free, and after with a certificate from a doctor.