Pinworms in pregnancy.

The intestinal parasite that family physicians are most likely to see in the office is the pinworm, Enterobius vermicularis. 1 Prevalence in the United States is estimated to be 20 to 42 million cases, with the greatest rate of infestation in children between the ages of 5 and 14 years. I Parents and other siblings will likely be infected if one child in the family becomes infected. Pinworms commonly spread from the contaminated hands of infected children (60 percent of infested children have Enterobius embryos under their fingernails).2 Pinworms can also spread from infested bedclothes, bedding, dust, food, and eating utensils. Prevalence of pinworm infestation remains high in spite of greater knowledge of the parasite and its relation to humans. Enterobius vermicularis is a parasite that usually lives in the human gastrointestinal tract. The female worm migrates to the anus or rectum at night to lay eggs. The eggs can disperse ~ro~gh­ out the general surroundings and remaIn vIable in the intestinal tract for up to 20 days.3 The larvae develop within a few hours in the ova, th~n migrate to the large bowel, where they mature In 15 to 28 days.4 Involvement of the genital tract is less common, but cases have been reported in the medicalliterature.5,6 Pregnant worms often migrate to the patient's anus to lay eggs at night, but they can enter the vagina a~d travel ~e len~.of the genital tract to the pentoneum. The abIlIty of the parasite to migrate to several areas of ~e body and through various organ systems led HIPpocrates to call it the "hopper."2 Cases of vulvovaginitis in children and women have been :eported. Ova have been discovered on routme Papanicolaou smears, and a case was reported with pinworm infestation of a st~llborn.8-~o ~o reports of pinworms causing cervIcal bleedIng In pregnancy, however, were found in a search of the current medical literature.