7: Pregnancy Infections

Question 1

What is the difference between primary and recurrent Varicella-Zoster?

Answer 1

Primary is known as chickenpox and recurrent infections are known as shingles.

Question 2

How is GBS transmitted to the fetus?

Answer 2

This bacterium is transmitted to the newborn vertically through contact with a GBS-colonized vagina during vaginal birth.

Question 3

How is Varicella-Zoster transmitted to the fetus?

Answer 3

Transplacentally

Question 4

How is chlamydia transmitted to the newborn?

Answer 4

Exposure to the cervix during birth

Question 5

T/F Not only should you avoid the Rubella vaccine in pregnancy, but you should not become pregnant within 4 weeks of getting the vaccine.

Answer 5

True

Question 6

How is gonorrhea transmitted to the newborn?

Answer 6

Exposure to the cervix during birth

Question 7

Which virus causes German measles?

Answer 7

Rubella

Question 8

When is a test of cure needed for gonorrhea?

Answer 8

Test-of-cure is not needed for persons who receive a diagnosis of uncomplicated urogenital or rectal gonorrhea who are treated with any of the recommended or alternative regimens; however, any person with pharyngeal gonorrhea who is treated with an alternative regimen should return 14 days after treatment for a test-of-cure.

Question 9

What parasite causes an infection via foodborne transmission or animal-to-human (usually cat feces)?

Answer 9

Toxoplasma gondii

Question 10

This virus, like chickenpox, is a member of the herpes family and can cause congenital complications.

Answer 10

Cytomegalovirus (CMV)

Question 11

How is CMV transmitted to the fetus/newborn?

Answer 11

1. Transplacentally
2. Maternal body fluids during birth
3. Breastfeeding

Question 12

This virus causes chickenpox.

Answer 12

Varicella-Zoster

Question 13

How is Rubella transmitted to the fetus?

Answer 13

Transplacentally and the most risk is during the first 12 weeks of pregnancy.

Question 14

How is syphilis transmitted to the fetus?

Answer 14

Transplacentally

Question 15

How is Hep B transmitted to the fetus/newborn?

Answer 15

1. Vaginal fluid
2. Amniotic fluid
3. Blood
4. Saliva
5. Breastmilk (most likely)

Question 16

A gram + bacteria that can cause sepsis and infections of the lungs, brain, or spinal cord in newborns.

Answer 16

Group B Streptococcus (GBS)

Question 17

When is a test-of-cure needed for chlamydia?

Answer 17

A test of cure should be done 3 to 4 weeks following treatment and again within 3 months.

Question 18

Which virus causes fifth disease?

Answer 18

Parvovirus B19

Question 19

How is HIV transmitted to the fetus/newborn?

Answer 19

1. Maternal circulation during the 1st trimester.
2. Maternal and fetal blood exchange at birth.
3. Lactation

Question 20

How is Toxoplasmosis transmitted to the fetus?

Answer 20

Transplacentally and risk increases with advancing gestation, though the most damage occurs if exposed in the 1st trimester.

Question 21

How is parvovirus B19 transmitted?

Answer 21

Transplacentally

Question 22

Which STIs should the NP routinely screen for in pregnant patients?

Answer 22

Trich
HIV
Hep B
Syphilis
Gonorrhea
Chlamydia
Herpes
HPV (if timing is appropriate)

Question 23

Which STIs need a test-of-cure in pregnant women?

Answer 23

1. Gonorrhea: Pharyngeal gonorrhea who is treated with alternative regimen needs test-of-cure in 14 days.
2. Chlamydia: Test-of-cure in 3-4 weeks and again in 3 months for reinfection.

Question 24

What is treatment of gonorrhea in pregnancy?

Answer 24

250 mg Ceftriaxone IM x 1 + 1 gm Azithromycin PO x 1 (same as nonpregnant)

Question 25

What is treatment of Chlamydia in pregnancy?

Answer 25

Azithromycin 1 gm PO x 1. Doxy is contraindicated in pregnancy.