RCOG releases updated guidance on air travel during pregnancy

RCOG releases updated guidance on air travel during pregnancy
Evidence suggests there is no reason why women with uncomplicated singleton pregnancies should not travel by air. The RCOG advises that these women should avoid air travel at 37 weeks of gestation as birth is usually expected at this stage. For women with uncomplicated multiple pregnancies, it is 34 weeks.

Although cabin pressure can result in dehydration, there has been concern it could also lead to a range of conditions such as preterm labour, preterm rupture of the membranes and placental abruption for women in advanced stages of pregnancy (after 32 weeks of gestation). There is no evidence that air travel can lead to these adverse pregnancy outcomes. To prevent dehydration, women should avoid caffeine and alcohol and maintain a good fluid intake during the flight.

The increase in altitude in the plane could result in some discomfort in the ears and nose. Motion sickness (made worse by morning sickness) may also be experienced.

A particular concern is deep venous thrombosis (DVT). The risk of DVT is increased during air travel because of the long periods of immobility and the cramped seating arrangements during medium to long-haul flights (four hours and more). The current advice is for women to wear properly fitted graduated elastic compression stockings during the flight to reduce the risk of DVT.

To help prevent DVT, pregnant women are encouraged to have some physical movement by walking along the aisles every 30mins where possible and by doing some light stretching to increase their blood circulation.

The common risk factors indicating that pregnant women should not travel by air or will need to take special precautions or treatment include:

Severe anaemia
Recent development of sickle cell crisis
Recent obstetric haemorrhage
Nephrotic syndrome (a kidney condition)
Wearing a cast from a recent fracture in the leg
An ear infection (otitis media) and inflammation of the sinuses (sinusitus)
Serious respiratory problems marked by breathlessness
Recent gastrointestinal surgery
Previous DVT (where treatment to prevent recurrent thrombosis is usually required)
Severe obesity
Professor Ian Greer, from The Hull York Medical School, who produced the Opinion Paper on behalf of the RCOG said “Women should be reassured that commercial air travel is not associated with specific problems in pregnancy, and that with simple precaution those with an uncomplicated singleton pregnancy can travel safely up to 37 weeks.

“Pregnant women with the particular conditions, or indeed any medical condition that concerns them, should seek specific medical advice before travelling.”

Professor Steve Thornton, Chair of the RCOG Scientific Advisory Committee, said “One of the most common questions we get from pregnant women is whether or not it is safe to fly when pregnant. This Opinion Paper addresses many of the issues and makes sensible recommendations.

“Whilst it is generally safe for women with low risk pregnancies to fly, there are increased risks of deep vein thrombosis (DVT). Women unsure about these risks or other medical conditions are advised to speak to their GP, midwife or obstetrician.”

ENDS

Notes
To speak to Professor Ian Greer or Professor Steven Thornton, please call the RCOG press office on 020 7772 6446 or 6357.

SAC Opinion Paper no. 1 Air Travel during Pregnancy (October 2008)

NICE’s guidance on air travel and pregnancy Antenatal care : routine care for healthy pregnant women (March 2008), please see section 5.14, pp. 101 – 102