ch 7 + 35, substance abuse and infection Flashcards by McKenna Michael

examples transplacental organism infections

-HIV
-CMV
-rubella

How well did you know this?

Not at all

Perfectly

examples organisms ascending into vagina to cause infection

-GBS
-E coli

How well did you know this?

Not at all

Perfectly

examples organisms that cause infection from direct contact at birth

-herpes

How well did you know this?

Not at all

Perfectly

perinatal infections risk factors

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

How well did you know this?

Not at all

Perfectly

general S+S STI

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

How well did you know this?

Not at all

Perfectly

lab studies perinatal infections

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

How well did you know this?

Not at all

Perfectly

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

passes: IgG
doesn’t: IgM

How well did you know this?

Not at all

Perfectly

possible consequences of all infections

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

How well did you know this?

Not at all

Perfectly

what is screened for on TORCH

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

How well did you know this?

Not at all

Perfectly

how is toxoplasmosis acquired

raw meat
unpasteurized milk
exposure to cat feces

How well did you know this?

Not at all

Perfectly

classic triad in neonate presentation of toxoplasmosis

-hydrocephalus
-chorioretinitis (blindness)
-cerebral calcifications

How well did you know this?

Not at all

Perfectly

possible maternal effects of syphilis

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

How well did you know this?

Not at all

Perfectly

possible fetal effects of syphilis

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

How well did you know this?

Not at all

Perfectly

Tx syphilis

-penicillin G
-erythromycin before 16 weeks

How well did you know this?

Not at all

Perfectly

screens for syphilis

VDRL
RPR

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

possible neonatal consequences of CMV

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

How well did you know this?

Not at all

Perfectly

possible consequence untreated hep b

preterm birth

How well did you know this?

Not at all

Perfectly

what baby receives immunoglobulin for hep b after birth

mom had hep b surface antigen positive

How well did you know this?

Not at all

Perfectly

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

-limb atrophy
-neurologic anomalies
-IUGR
-eye abnormalities

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

within 72 hrs

baby: 5 days before - 2 days after birth

How well did you know this?

Not at all

Perfectly

S+S HPV

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

How well did you know this?

Not at all

Perfectly

possible fetal effects of HPV

possible chronic resp papillomatosis

How well did you know this?

Not at all

Perfectly

can herpes simplex virus be transmitted transplacentally

very rare usually contracted during birth from lesions

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

C/S

possible consequences for babies born with congenital herpes simplex virus

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

Tx babies born with congenital herpes simplex virus

acyclovir

maternal effects of gonorrhea

-dysuria -purulent vaginal discharge -PID

fetal effects of gonorrhea

-ophthalmia neonatorum (blindness) -sepsis

Tx gonorrhea

-penicillin and/or erythromycin and ceftriaxone

Tx to avoid perinatal transmission of HIV

-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

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

bath

maternal effects chlamydia trachomatis

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

fetal effects chlamydia trachomatis

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

Tx chlamydia

erythromycin

maternal effects bacterial vaginosis

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

fetal effects bacterial vaginosis

-neonatal sepsis -death

Tx bacterial vaginosis

-clindamycin -ampicillin -metronidazole

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

metronidazole (flagyl)

maternal effects yeast infections

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

fetal effects yeast infection (contracted at birth)

-oral yeast infection (thrush) -perineal rash

what women are yeast infections more common in

-diabetics -taking longterm antibiotics

Tx yeast infections

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

Tx baby thrush/oral candidiasis

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

maternal effects trichomoniasis vaginalis

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

fetal effects trichomoniasis

none

Tx trichomoniasis

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

fetal effects GBS

-neonatal sepsis -resp distress

risk factors transmission GBS

-PPROM -preterm labor -preterm birth -chorio

when do pregnant women get rectovaginal culture to test for GBS

35-37 weeks EGA

prophylactic Tx pregnant woman with GBS

-intrapartum Tx ABX

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

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

neonatal Tx GBS

-ABX (ampicillin, penicillin, aminoglycoside)

2 categories neonatal sepsis

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

risk factors early onset neonatal sepsis

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

2 most common organisms causing early onset neonatal sepsis

-GBS -E coli

S+S early onset neonatal sepsis

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

labs for babies at risk for early onset neonatal sepsis

-blood -CSF -urine

Tx neonatal sepsis

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

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

no rooming in no breastfeeding *until receives Tx

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

no rooming in no breastfeeding *until receives Tx

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

can room in (strict handwashing) no breastfeeding

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

can room in no breastfeeding

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

helps screen for fetal anomalies, measure growth

mom w/ chlamydia: can baby room in and breastfeed

yes breastfeeding yes room in?

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

yes breastfeeding room in?

mom w/ hepatitis: can baby room in and breastfeed

yes breastfeeding room in?

mom w/ herpes: can baby room in and breastfeed

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

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

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

ch 7 + 35, substance abuse and infection Flashcards

(70 cards)