Congenital & Perinatal Infections Flashcards
When is?
Prenatal
Perinatal
postnatal/partum
Prenatal: before delivery
Perinatal: around time of delivery
postnatal/partum: after delivery
eg. of perinatal infection?
group B strep
What is vertical transmission?
mother to fetus via placenta
mother to baby via milk (CMV)
What is horizontal transmission?
baby or person to another baby
what is a non-specific effect of maternal infection? 2:
fetal death
premature delivery
what is a specific effect of maternal infection? 3
benign: parvo
end-organ damage: rubella
chronic infection: hep B/C HIV
VZV?
varicella zoster virus
varicella zoster virus spread?
resp and direct contact
complications of varicella: 3 main:
- secondary bacterial infection
- pneumonitis
- acute cerebellar ataxia
What is pupura fulminans?
varicella with Group A strep infection
When is varicella in adults most severe?
pregnancy d/t immunosuppression
when do most maternal deaths from varicella occur?
3rd trimester
congenital varicella zoster virus syndrome?
baby can have shingles in utero, get scarring, short limbs etc.
Perinatal Varicella dangerous to neonate?
25-30% mortality due to disseminated infection
how to treat preg mom if she gets Varicella? 2 things
VZIG
Varicella Zoster immunoglobulin
Acyclovir
cytomegalovirus microscopy?
multinucleate giant cells
why cytomegalovirus latent infection?
can hide in our WBCs
when does cytomegalovirus shed more?
primary infection
when do people get cytomegalovirus in western vs. developing?
more as adults: developed
more as children: developing
danger of toddlers getting cytomegalovirus?
Mom isn’t immune, could bring it home and infect her and cause problems with baby #2
cytomegalovirus infected lymphocytes look?
reactive lymphocytes: enlarged darker cytoplasm/chromatin
post-partum cytomegalovirus syndrome?
sepsis-like:
hepatomegaly
resp distress
atypical lymphocytosis
when is more dangerous to fetus with mom’s cytomegalovirus? primary or reactivation
primary because 20-50% chance of fetal infection
reactivation happens in 10-30% but only 1-3% fetal infection
3 ways to look for cytomegalovirus for dx in preg:
- serology
- avidity test
- look in amniotic fluid
screening for babies post partum who are normal at birth include 4 biggies:
auditory Ax
visual Ax
psychomotor
pneumonitis
treatment for babies with cytomegalovirus at birth?
ganciclovir
Rubella clinical presentation: 4
- Fever - low-grade
- lymphadenopathy - occipital, postauricular/cervical
- exanthem
- polyarthralgia
highest risk of damage to fetus with Rubella at which age?
> 4/40 weeks (85% risk of damage)
if fetus gets rubella >12/40, what defects only possible?
retinopathy
deafness
classic triad for congenital rubella syndrome?
- opthalmological: cataracts, glaucoma, retinopathy
- cardiac
- Auditory: deafness
2 ways to Dx fetal Rubella?
serology
amniotic fluid
Rubella prevention?
Vaccine pre
vaccine post
Rubella vaccine during preg? why?
NOPE. because live attenuated
Parvo Virus pathogenesis?
shortens RBC progenitors lifespans
Parvo Virus presentation?
fever, rash (‘slapped cheek’), maculopapular rash
congenital Parvo Virus? causes?
hydrops foetalis (anaemia)
How to treat hydrops foetalis (anaemia)?
intrauterine transfusions
Herpes Simplex Virus during preg?
abortion, preterm labour, IUGR
Herpes Simplex Virus perinatal?
skin-eye-mouth
encephalitis
disseminated
Herpes Simplex Virus management during preg?
Acyclovir for suppression
Syphilis fetal prevention
antenatal screening
Toxoplasma gondii from? 2 big sources
cats and cat litter
raw meat
how many women are chronic carriers?
0.2%
Hep B management infant?
vaccination
Hep B immunoglobulin post-partum
Hep C usually co-infected with?
HIV
Hep C intervention?
None
HIV transmission %?
0-30% depending on viral load and membrane rupture
Group B Strep acquisition how usually?
ascending
colonised at delivery
1% invasive out of 40-70% colonised babies
Group B Strep symptoms?
penumonia
septicaemia
Group B Strep treatment?
penicillin
gentamicin
