Chapter 10 Infectious Diseases in Pregnancy Flashcards
asymptomatic bacteriuria is >___ colonies on culture
100,000
in early pregnancy, 20-30 fold increased risk of developing
acute pyelonephritis
ASB in pregnancy further associated with ___, and ___
preterm birth
low birth weight infants
during pregnancy, _____ effects of ____ decrease bladder tone and cause ureteral and renal pelvic dilation, as well as decreased ureteral peristalsis resulting in physiologic hydronephrosis of pregnancy
smooth muscle relaxation,
progesterone
UA may be positive for
leukocyte esterase, nitrates, or hematuria. urine sediment will have elevated WBCs and bacteria.
treatment of asymptomatic bacteriuria
amoxicillin,
nitrofurantoin (macrobid)
trimethoprim/sulfamethoxazole (Bactrim)
cephalexin
ASB may persist a test of cure should be obtained how long?
1-2 weeks.
in addition to treating infection, patients with dysuria / bladder pain may find __ beneficial, acts as a local anesthetic to reduce the pain.
pyridium.
will cause urine to turn bright orange.
diagnosis of acute pyelonephritis characterized by
fever, chills, flank pain, dysuria, urgency, frequency. CVA tenderness. Lab abnormalities: pyuria, bacteriuria, elevated WB count. WBC CASTS are highly associated with pyelonephritis and diagnosis can be confirmed on urine culture.
Approximately 50-80% of PTs have serologic evidence of past cmv infection. However, presence of antibodies is not perfectly protective against either reinfecion or vertical transmission of infection from mother to fetus.
True
Diagnosis of cmv usually confirmed by serologic testing serum samples collected 3-4 wks apart tested in parallel for anti cmv igG essential for Dx.
From neg to pos or a significant increase greater than 4 fold ex 1:4 to 1:16 in anti cmv igG is evidence o infection.
Presence of cmv igM useful but not completely reliable indication of primary infection
Principal sono findings suggestive of fetal injury are
Microcephaly, ventriculomegaly, intervertebral calcification, fetal hydrops, growth restriction, oligohydramnios
Treatment or prophylaxis for cmv
None.
Rubella widely disseminated nonpuritic, erythematous maculopapular rash, arthritis, arthralgias, lymphadenopathy, lasts 3-5 days
True
4 most common anomalies associated with congenital rubella syndrome (crs)
Deafness, eye defects such as cataracts or retinopathy, Cns defects, cardiac malformations
PTs advised to avoid pregnancy for —- after mmr
1 month
Gonococcal infections associated with
Pid preterm delivery pprom chorioamnionitis, neonatal sepsis, maternal postpartum sepsis
Treatment of gonorrhoeae
Im ceftriaxone, oral cefixime, or im spec tinomycim
Untreated chlamydial infections can cause
Neonatal conjunctivitis or pneumonia
Treatment of chlamydia durin pregnancy
Azithromycin, amoxicillin, or erythromycin. 1 gram dose azithromycin . Test of cure in 3 weeks
All PTs screened for hepatitis b surface antigen (hbsag). Those + are likely to have chronic disease and at risk for transmission to fetus. How to confirm active hep b infection?
Hepatitis b core antibody and hepatitis b surface antibody igM and igG should also be checked.
PTs with acute hepatitis b are pos for
Hbsag and igM antibody to the core antigen.
PTs with chronic hepatitis b are pos for .
surface antigen and pos for igG antibody to the core antigen
Syphillis can cross placenta (treponema pallidum) as early as 6 weeks
True
All regnant wen should be tested usin nonspecific antibody tests including either
Veneral disease research laboratory vdrl
Or rapid plasma reagin rpr
All positive rpr or vdrl must be confirmed with fta-abs fluorescent treponemal antibody test and the t pallidum particle agglutination. Once reactive, specific treponemal tests usually remain positive for life.
True
Treatment for treating maternal infection preventing maternal syphillis transmission to fetus and for treating fetal infection
Penicillin
If pt has primary syphillis trtment
One dose of penicillin 2.4 million units benzathene penicillin g
If pt has secondary or
Tertiary syphillis will need
Weekly treatments of 2.4 million units of
Benzathene penicillin g for 3 weeks
Toxoplasma Gondi is a common protozoan. Organism is dependent on
Wild and domestic cats which are the only known host for the oocyst
Bv treatment in pregnancy
Metronidazole 7d
Gbs has been leading cause of
Neonatal sepsis
Diagnosis of parovirus
IgM igG parovirus
Most common fetal/neonatal complication of this infection during pregnancy
Fetal anemia and hydrops
What is the
Mechanism by which parovirus interaction causes fetal anemia
Parovirus b19 causes fetal anemia by bone marrow suppression. Virus is cytotoxic to rbc precursors leading to decreased production.
