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OB
CMECNE

Is Air Travel Safe in Pregnancy?

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Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. Explain when a pregnant patient should avoid flying
2. Recall the measures a pregnant woman should take while in flight

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.

Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from 12/31/2017 through 1/25/2023, participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

CLINICAL ACTIONS:

Occasional air travel during pregnancy is generally safe but is not recommended for women who have medical or obstetric conditions that may be exacerbated by flight or that could require emergency care. If a pregnant patient does opt to fly, consider the following discussion points:

  • Use a seat belt continuously while seated to avoid turbulence-induced trauma
    • Ensure that the belt sits low on the hip bones between the protuberant abdomen and the pelvis
  • Avoid gas-producing food or drink before flying to decrease general discomfort as entrapped gasses will expand at higher altitudes
  • Consider preventive antiemetic medication especially for those women experiencing nausea
  • Noise and vibration are a negligible risk
  • Cosmic radiation is a negligible risk
    • National Council on Radiation Protection and Measurements and the International Commission on Radiological Protection recommend a maximum annual radiation exposure limit of 1 millisievert (mSv) (100 rem) for general public and 1 mSv over the course of a 40-week pregnancy
    • The longest intercontinental flight will not exceed 15% of this limit
  • Check with the individual carrier for specific airline requirements as policies may vary
  • Pregnant civilian and military air crew members should check with their specific agencies for regulations and/or restrictions on their flying duties

Note: ACOG has updated guidance regarding aircrew and frequent flyers and provides the following statement

The Federal Aviation Administration and the International Commission on Radiological Protection consider aircrew to be occupationally exposed to ionizing radiation and recommend that they be informed about radiation exposure and health risks

  • The Federal Aviation Administration (FAA) has a document (see ‘Learn More – Primary Sources’ below) that provides tables and links to websites to aid in the calculation of effective dose of galactic cosmic radiation by a crewmember while inflight
    • The document also includes tables that provide risks for severe genetics defects
  • The CDC also has a site with a section for aircrew (see ‘Primary Sources – Learn More’ below)

SYNOPSIS:

Most commercial airlines allow pregnant women to fly up to 36 weeks of gestation. However, some airlines restrict pregnant women from international flights earlier in gestation and some require documentation of gestational age.  Changes in vital signs (increased maternal heart rate, increased blood pressure, decreased aerobic capacity) may result due to cabin pressure and humidity levels alterations.

KEY POINTS:

  • The following preventative measures can be used to minimize the risk of lower extremity edema and venous thromboembolic events
    • Support stockings
    • Periodic movement of the lower extremities
    • Occasional ambulation during flight
    • Avoiding restrictive clothing
    • Ensuring adequate hydration

Learn More – Primary Sources:

ACOG Committee opinion 746: Air Travel During Pregnancy

FAA: What Aircrews Should Know About Their Occupational Exposure to Ionizing Radiation

US Department of Transportation Advisory Circular: In-Flight Radiation Exposure

CDC: Cosmic Ionizing Radiation

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Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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