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Stopped using tampon due to toxic shock. Will this create any problem in pregnancy?

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Practicing since : 1989
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My daughter had two instances of toxic shock when she was 15 years old. The first instance the doctor said was due to using a certain type of tampon and recommended she should try another brand. The following month she tried a different brand which resulted in toxic shock and she was rushed to AE again. Obviously she has never used tampons again.

Now she is 39 years old and pregnant we are very concerened as to whether toxic shock could reoccur during childbirth, and could the baby be affected coming down the birth canal? Also if she is at risk is it better to have a normal birth or caesarean?
Posted Tue, 16 Apr 2013 in Women's Health
Answered by Dr. Shanti Vennam 2 hours later

Thanks for writing to us.

Toxic shock does not necessarily recur unless the causative factor has not been eliminated. In your daughter's case, the causative factor was the tampon. The risk of recurrence of toxic shock syndrome varies between 5-40%.

There are certain precautions that need to be taken here - informing all the medical personnel attending on her about her history, managing the delivery in a well-equipped hospital with proper monitoring facilities. Provided proper precautions are taken during delivery, like strict asepsis, avoiding packs, minimizing surgical wounds and dressings, everything should be fine.

Since she did not have any further events ever since those at 15 years of age, recurrence is mostly unlikely. Please discuss elaborately with her attending gynecologist and let the specialist decide about the mode of delivery. There should be no harm to the baby with a vaginal delivery if there is no evidence of any vaginal infection and the doctor feels that a vaginal birth can be allowed. Expert monitoring during labor is mandatory. In fact, surgical wounds pose an increased risk.

Hope I have answered your query. If you need any further clarifications, please feel free to ask. I will be happy to help.

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Follow-up: Stopped using tampon due to toxic shock. Will this create any problem in pregnancy? 1 hour later
Is there any truth in small feet, she is size 4, small pelvis and as this is her first child if she is cut or tears during childbirth, could this activate the bacteria again and cause toxic shock?
Answered by Dr. Shanti Vennam 50 minutes later

Thanks for writing back.

The mode of delivery depends on the presence or absence of cephalo-pelvic disproportion, and this is more likely in a small pelvis. It is not necessary that toxic shock would be caused due to a tear or cut during delivery. Taking proper precautions as I had mentioned earlier can prevent the possible chances of infection. More often, it is caused due to retained tampons and surgical dressings.

As your daughter had the condition due to tampon use, it may not be repeated during labor. A vaginal swab may be taken after consulting the doctor to exclude colonization of bacteria that could cause the condition. Recently, during studies, probiotics have been shown to be effective in reducing the effects of the toxin.

Hope I have clarified your doubt. Please feel free to get back, if you need further clarifications. I will be ready to help.

Above answer was peer-reviewed by
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