In healthy pregnant women, sexual intercourse usually is not harmul. Whenever miscarriage, placenta previa, or preterm labor threatens, however, coitus is avoided. Nearly 10,000 women enrolled in a prospective investigation by the Vaginal Infection and Prematurity Study Group were interviewed regarding sexual activity (Read, 1993). hey reported a decreased frequency of coitus with advancing gestation. By 36 weeks, 72 percent had intercourse less than once weekly. The decline is attributed to lower desire and fear of harming the pregnancy (Bartellas, 2000; Staruch, 2016).
Intercourse speciically late in pregnancy is not harmful. Grudzinskas and coworkers (1979) noted no association between gestational age at delivery and coital frequency during the last 4 weeks of pregnancy. Sayle and colleagues (2001) reported no increased-and actually a decreased-risk of delivery within 2 weeks of intercourse. Tan and associates (2007) studied women scheduled for non urgent labor induction and found that spontaneous labor ensued at equal rates in groups either participating in or abstaining from intercourse.
Oral-vaginal intercourse is occasionally hazardous. Aronson and Nelson (1967) described a fatal air embolism late in pregnancy as a result of air blown into the vagina during cunnilingus. Other near-fatal cases have been described (Bernhardt, 1988).
Examination of the teeth is included in the prenatal examination, and good dental hygiene is encouraged. Indeed, periodontal disease has been linked to preterm labor. Unfortunately, although its treatment improves dental health, it does not prevent preterm birth (Michalowicz, 2006). Dental caries are not aggravated by pregnancy. Importantly, pregnancy is not a contraindication to dental treatment including dental radiographs (Giglio, 2009) .
Current recommendations for immunization during pregnancy are summarized in Table 9-7. Well-publicized concerns regarding a causal link between childhood exposure to the thimerosal preservative in some vaccines and neuropsychological disorders have led to some parents to vaccine prohibition. Although controversy continues, these associations have proven groundless (Sugarman, 2007; Thompson, 2007; Tozzi, 2009). Thus, many vaccines may be used in pregnancy. The American College of Obstetricians and Gynecologists (20 16b) stresses the importance of integrating an efective vaccine strategy into the care of both obstetrical and gynecological patients. The College further emphasizes that information on the safety of vaccines given during pregnancy is subject to change, and recommendations can be found on the CDC website at ww.cdc.gov/vaccines.