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OB > ch 7 + 35, substance abuse and infection > Flashcards

ch 7 + 35, substance abuse and infection Flashcards

1
Q

examples transplacental organism infections

A

-HIV
-CMV
-rubella

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2
Q

examples organisms ascending into vagina to cause infection

A

-GBS
-E coli

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3
Q

examples organisms that cause infection from direct contact at birth

A

-herpes

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4
Q

perinatal infections risk factors

A

-h/o multiple sex partners
-previous h/x of STI or vaginal infections
-employment with high exposure to children

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5
Q

general S+S STI

A

*flu like S+S for mom, plus:
-vaginal discharge
-genital lesions
-dysuria
-painful intercourse

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6
Q

lab studies perinatal infections

A

-antibody titers
-TORCH
-VDRL
-RPR
-gonorrhea
-vaginal wet mount

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7
Q

which maternal immunoglobulin passes through the placenta? which does not?

A

passes: IgG
doesn’t: IgM

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8
Q

possible consequences of all infections

A

-abortion
-IUGR
-premature labor
-severe neonatal sepsis
-long-term carrier status

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9
Q

what is screened for on TORCH

A

Toxoplasmosis
Other (syphilis, gonorrhea, hepatitis, varicella, HIV)
Rubella
CMV
Herpes simplex

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10
Q

how is toxoplasmosis acquired

A

raw meat
unpasteurized milk
exposure to cat feces

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11
Q

classic triad in neonate presentation of toxoplasmosis

A

-hydrocephalus
-chorioretinitis (blindness)
-cerebral calcifications

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12
Q

possible maternal effects of syphilis

A

-chancere
-late abortion
-positive abx screen (VDRL, RPR)

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13
Q

possible fetal effects of syphilis

A

-stillbirth
-hydrocephaly
-cataracts
-**copper colored rash
-cracks around mouth
-hypothermia

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14
Q

Tx syphilis

A

-penicillin G
-erythromycin before 16 weeks

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15
Q

screens for syphilis

A

VDRL
RPR

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16
Q

S+S congenital rubella (severe anomalies if infection before 12 weeks EGA)

A

-blueberry muffin rash
-IUGR
-cardiac defects
-cataracts/glaucoma
-hearing loss

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17
Q

possible neonatal consequences of CMV

A

-IUGR
-microcephaly
-jaundice
-anemia
-deaf
-mental retardation
-rash
-hepatosplenomegaly
-cerebral palsy

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18
Q

possible consequence untreated hep b

A

preterm birth

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19
Q

what baby receives immunoglobulin for hep b after birth

A

mom had hep b surface antigen positive

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20
Q

possible consequences for fetus if mom has varicella zoster (chicken pox) before 20 weeks EGA (early transplacental transmission)

A

-limb atrophy
-neurologic anomalies
-IUGR
-eye abnormalities

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21
Q

high risk exposure time for fetus with varicella zoster? what can happen?

A

-last 3 weeks pregnancy (close to birth)
-neonatal varicella
-increased infant mortality rate

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22
Q

if women are exposed to varicella zoster when should they receive immunoglobulin (Vzig)? what about baby?

A

within 72 hrs

baby: 5 days before - 2 days after birth

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23
Q

S+S HPV

A

small or large wart like growths on vulva, vagina, cervix, or rectum

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24
Q

possible fetal effects of HPV

A

possible chronic resp papillomatosis

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25
Q

can herpes simplex virus be transmitted transplacentally

A

very rare
usually contracted during birth from lesions

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26
Q

optimal mode of delivery if mom has active lesions from herpes simplex virus

A

C/S

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27
Q

possible consequences for babies born with congenital herpes simplex virus

A

-neonatal viral sepsis
-herpetic lesions on eyes, skin
-pneumonia
-herpes enchephalitis
-neurological abnormality
-possible death

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28
Q

Tx babies born with congenital herpes simplex virus

A

acyclovir

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29
Q

maternal effects of gonorrhea

A

-dysuria
-purulent vaginal discharge
-PID

30
Q

fetal effects of gonorrhea

A

-ophthalmia neonatorum (blindness)
-sepsis

31
Q

Tx gonorrhea

A

-penicillin and/or erythromycin and ceftriaxone

32
Q

Tx to avoid perinatal transmission of HIV

A

-antiretroviral meds
-C/S (can have vaginal birth if viral load <1000 at 36 weeks EGA)
-no breastfeeding
-no FSE or fetal scalp blood sampling
-avoid forceps and vaccuum

33
Q

what must be done for fetus after birth (born to HIV+ mom) before he can receive shots

A

bath

34
Q

maternal effects chlamydia trachomatis

A

-mucopurulent vaginal discharge
-dysuria
-acute salpingitis (inflammation of fallopian tubes)
-PID
-sterility/infertility

35
Q

fetal effects chlamydia trachomatis

A

-still birth/neonatal death
-preterm birth
-blindness
-pneumonia

36
Q

Tx chlamydia

A

erythromycin

37
Q

maternal effects bacterial vaginosis

A

-milklike discharge with fishy odor
-itching, burning, pain
-risk for PROM
-risk for PP endometritis

38
Q

fetal effects bacterial vaginosis

A

-neonatal sepsis
-death

39
Q

Tx bacterial vaginosis

A

-clindamycin
-ampicillin
-metronidazole

40
Q

what med used to treat bacterial vaginosis (and some other vaginal infections) is contraindicated in the 1st (and sometimes 2nd) trimester of pregnancy because of its effects on the fetus

A

metronidazole (flagyl)

41
Q

maternal effects yeast infections

A

-odorless, thick vaginal discharge
-cheesy appearance
-severe vaginal itching
-painful intercourse

42
Q

fetal effects yeast infection (contracted at birth)

A

-oral yeast infection (thrush)
-perineal rash

43
Q

what women are yeast infections more common in

A

-diabetics
-taking longterm antibiotics

44
Q

Tx yeast infections

A

-miconazole nitrite cream or nystatin cream during pregnancy
-wear cotton underwear
-no sex until cured

45
Q

Tx baby thrush/oral candidiasis

A

-topical application nystatin to mouth 4x/day for 14-21 days
-if breastfeeding: mom rubs some on nipples too

46
Q

maternal effects trichomoniasis vaginalis

A

-profuse, frothy yellow discharge
-irritation
-itching
-dysuria
-painful intercourse

47
Q

fetal effects trichomoniasis

A

none

48
Q

Tx trichomoniasis

A

-vaginal suppositories to reduce S+S during 1st and 2nd tris

49
Q

fetal effects GBS

A

-neonatal sepsis
-resp distress

50
Q

risk factors transmission GBS

A

-PPROM
-preterm labor
-preterm birth
-chorio

51
Q

when do pregnant women get rectovaginal culture to test for GBS

A

35-37 weeks EGA

52
Q

prophylactic Tx pregnant woman with GBS

A

-intrapartum Tx ABX

53
Q

what moms that are not tested for GBS would receive antibiotics for GBS intrapartum

A

-preterm labor
-h/x of preterm birth
-h/x of neonate with GBS
-prolonged ROM
-S+S GBS
-if untested, assumed +

54
Q

neonatal Tx GBS

A

-ABX (ampicillin, penicillin, aminoglycoside)

55
Q

2 categories neonatal sepsis

A

early onset: first 7 days life
late onset: day 7-30

56
Q

risk factors early onset neonatal sepsis

A

-prematurity
-ROM >18hrs
-invasive procedures during L&D (FSE)
-resuscitation after birth
-maternal fever
-maternal GBS+

57
Q

2 most common organisms causing early onset neonatal sepsis

A

-GBS
-E coli

58
Q

S+S early onset neonatal sepsis

A

-lethargy
-poor feeding
-temperature instability
-subtle color changes (mottling, duskiness)
-resp distress, apnea

59
Q

labs for babies at risk for early onset neonatal sepsis

A

-blood
-CSF
-urine

60
Q

Tx neonatal sepsis

A

-ABX
-IV fluids
-encourage mother to breastfeed or pump
-emotional support (for mom

61
Q

mom w/ untreated syphyilis: can baby room in and breastfeed

A

no rooming in
no breastfeeding
*until receives Tx

62
Q

mom w/ untreated gonorrhea: can baby room in and breastfeed

A

no rooming in
no breastfeeding
*until receives Tx

63
Q

mom w/ HIV/AIDS: can baby room in and breastfeed

A

can room in (strict handwashing)
no breastfeeding

64
Q

mom w/ acute CMV: can baby room in and breastfeed

A

can room in
no breastfeeding

65
Q

why is 1st tri sonogram helpful when mom has substance addiction

A

helps screen for fetal anomalies, measure growth

66
Q

mom w/ chlamydia: can baby room in and breastfeed

A

yes breastfeeding
yes room in?

67
Q

mom w/ gonorrhea treated for 24 hrs: can baby room in and breastfeed

A

yes breastfeeding
room in?

68
Q

mom w/ hepatitis: can baby room in and breastfeed

A

yes breastfeeding
room in?

69
Q

mom w/ herpes: can baby room in and breastfeed

A

yes breastfeeding unless lesion on breast/nipple
yes room in?

70
Q

mom w/ syphilis treated for 24 hrs: can baby room in and breastfeed

A

yes breastfeeding after Tx unless lesion on breast/nipple
yes room in?

OB (21 decks)

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