Congenital Disorders Flashcards
How can infections be transmitted from mom to fetus?
Placenta
Amniotic fluid
Vaginal canal
What do the first trimester infections affect?
Developing organ systems
Spectrum of Presentation of Congenital Infections
Growth retardation Premature delivery CNS abnormalities Hepatosplenomegaly Bruising or petechiae Skin lesions Pneumonitis
What does TORCH stand for?
Toxoplasmosis Other (syphilis, HIV, parvovirus B-19, varicella, hepatitis, enterovirus) Rubella Cytomegalovirus Herpes simplex
Where is toxoplasmosis found?
Cat feces
Raw/undercooked meat
Contaminated soil/water
Maternal Symptoms of Toxoplasmosis
Nonspecific Fatigue Fever Headache Malaise Myalgia
Neonate Symptoms of Toxoplasmosis
Fever Maculopapular rash Hepatosplenomegaly Microcephaly Seizures Jaundice Thrombocytopenia Generalized lymphadenopathy
Classic Triad of Congenital Toxoplasmosis
Chorioretinitis
Hydrocephalus
Intracranial calcifications
Primary Focus of Infection in the Neonate is
CNS
What is the CNS sign of Toxoplasmosis?
Calcified cystic lesions dispersed within the brain
Long Term Complications of Neonate Toxoplasmosis
Seizures
Mental retardation
Spasiticity
Relapsing chorioretinitis
Diagnostics of Toxoplasmosis
IgM anti-toxoplasma antibody at 20-26 weeks (mother)
Isolation of parasite in fetal blood or amniotic fluid
Postnatal: IgM antibodies in serum
Prenatal ultrasound
Findings on the Prenatal Ultrasound in Toxoplasmosis
Symmetric ventricular dilation Intracranial calcifications Increased placental thickness Hepatomegaly Ascites
Labs for Toxoplasmosis May Show
Anemia
Thrombocytopenia
Eosinophilia
Abnormal CSF
Treatment for Toxoplasmosis
Pyrimethamine & sulfadiazine
Spiramycin
Other: HIV
Educate & address mother’s infection
Other: Enterovirus
Usually acquired around the time of birth, good prognosis
Other: Parvovirus B-19
Possible fetal hemolytic crisis associated
Other: Varicella
Perinatal exposure can be very severe
Immune globulin given if suspected
Other: Hepatitis
Type B
HBIG & vaccine if mom is positive
Other: Syphilis
Mom in primary or secondary stage transmission is nearly 100%
Syphilis Infection can Result in
Stillbirth Hydrops fetalis Prematurity & associated long-term morbidity Hepatomegaly Edema Thrombocytopenia Anemia Skeletal abnormalities, saddle nose deformity Rash (maculopapular, vesicular)
When does transmission occur during pregnancy?
Second half of pregnancy
Early Symptoms of Congenital Syphilis
Hepatosplenomegaly Skin rash Anemia Jaundice Metaphyseal dystrophy Periostitis CSF with increase protein & PMNs