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Once pregnancy is confirmed the pregnant pilot should report to the medical examiner. If declared fit, i.e.
if her pregnancy is considered a normal, uncomplicated and low-risk pregnancy and medical information
from her obstetrician, family physician and/or midwife supports this, she may continue to exercise the
privileges of her licence from the end of the 12th week until the end of the 26th week of the gestational
period. Close medical supervision must be established for the part of the pregnancy where the pilot
continues flying, and all abnormalities should be reported to the medical examiner. Provided the
puerperium is uncomplicated and full recovery takes place, she should be able to resume aviation duties
four to six weeks after confinement.
ICAO Preliminary Unedited Version — November 2009 III-7-4
Air traffic controllers and pregnancy
The provisions of Annex 1 state the following for Class 3 Medical Assessments:
6.5.2.21 Applicants who are pregnant shall be assessed as unfit unless obstetrical evaluation and
continued medical supervision indicate a low-risk uncomplicated pregnancy.
6.5.2.21.1 Recommendation.— During the gestational period, precautions should be taken for
the timely relief of an air traffic controller in the event of early onset labour or other complications.
6.5.2.21.2 Recommendation.— For applicants with a low-risk uncomplicated pregnancy,
evaluated and supervised in accordance with 6.5.2.21, the fit assessment should be limited to the
period until the end of the 34th week of gestation.
6.5.2.22 Following confinement or termination of pregnancy, the applicant shall not be permitted to
exercise the privileges of her licence until she has undergone re-evaluation in accordance with best
medical practice and it has been determined that she is able to safely exercise the privileges of her
licence and ratings.
Once pregnancy is confirmed the pregnant air traffic controller should report to the medical examiner. If
declared fit, she may continue to exercise the privileges of her licence. Some Contracting States take the
further precaution of endorsing her medical certificate as: "Subject to another similarly qualified
controller being in close proximity while the licence holder exercises the privileges of her licence" or
similar. Close medical supervision must be established for the part of the pregnancy where the air traffic
controller continues to carry out her duties, and all abnormalities should be reported to the medical
examiner. She should cease working by the end of the 34th week of the gestational period. Provided the
puerperium is uncomplicated and full recovery takes place, she should be able to resume aviation duties
four to six weeks after confinement.
Termination of pregnancy
Miscarriage (spontaneous abortion) is very common; about 15 per cent of all pregnancies are terminated
spontaneously. Observation for a few days to ensure that bleeding has stopped may be all that is needed,
but vacuum suction or dilatation and curettage to ensure completion of the abortion is frequently
performed.
Induced abortion, usually by vacuum suction or by dilatation and curettage, will in the majority of cases
entail unfitness for less than a week as these procedures are generally very safe, the rate of serious
complications is < 1% and the mortality rate is < 1 in 100 000 cases.
Complication rates increase as gestational age increases. Although uncommon, post abortion bleeding and
pelvic inflammation, peritonitis and septicaemia may occur.
The “abortion pill” (mifepristone, a progesterone-receptor blocker) is used within the first seven weeks of
pregnancy. A second drug (prostaglandin) is given two days later to start uterine contractions and
complete the abortion.
This method is very safe and unfitness is limited to a few days.
For most women, abortion has no adverse mental sequelae but for those who have a desired pregnancy
terminated for medical reasons (maternal or foetal) or who have considerable ambivalence, the mental
sequelae may be pronounced. The medical examiner should therefore pay particular attention to the
psychological effects of induced abortion before allowing return to aviation duties.
————————
ICAO Preliminary Unedited Version — November 2009
Part III
Chapter 8. MUSCULOSKELETAL SYSTEM
Page
Introduction ..................................................................................................... III-8-1
Back problems ................................................................................................. III-8-1
Cervical spine ............................................................................................. III-8-1
　
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本文鏈接地址：Manual of Civil Aviation Medicine 2(9)