Pregnant women should receive specialised advice before travelling. The ideal time to travel is in the second trimester (between 16 and 28 weeks), when the risk of pregnancy-related problems are lowest and pregnant women generally feel at their best. During the first trimester there is a risk of miscar­riage and in the third trimester complica­tions such as premature labour and high blood pressure are possible. It's wise to travel with a companion. Always carry a

list of quality medical facilities available at your destination and ensure you continue your standard antenatal care at these facili­ties. Avoid travel in rural areas with poor transportation and medical facilities. Most of all, ensure travel insurance covers all pregnancy-related possibilities, including premature labour.

Malaria is a high-risk disease during preg­nancy. WHO recommends that pregnant women do not travel to areas with Chloro-quine-resistant malaria. None of the more effective antimalarial drugs are completely safe in pregnancy.

Traveller's diarrhoea can quickly lead to dehydration and result in inadequate blood flow to the placenta. Many of the drugs used to treat various diarrhoea bugs are not rec­ommended in pregnancy. Azithromycin is considered safe.

In the urban areas of Southeast Asia, supplies of sanitary products are read­ily available. Birth control options may be limited though so bring adequate supplies of your own form of contraception. Heat, humidity and antibiotics can all contrib­ute to thrush. Treatment is with antifungal creams and pessaries such as Clotrimazole. A practical alternative is a single tablet of Fluconazole (Diflucan). Urinary tract infec­tions can be precipitated by dehydration or long bus journeys without toilet stops; bring suitable antibiotics.