Exam 4 - Perinatal Infections of the Newborn

Question 1

How and where is chlamydia transmitted to the neonate during the delivery process?

Answer 1

Acquisition thought to occur around the time of delivery via inoculation of the infant’s eye or respiratory tract with infected maternal secretions

Question 2

What can chlamydia infections cause in the neonate (like what conditions)?

Answer 2

PNA or conjunctivitis (often with delayed onset)

Question 3

How would a neonate with chlamydial conjunctivitis present? What would the differentials be?

Answer 3

Swollen eyes, significant amount of eye discharge

Differentials: blocked tear duct

Question 4

What findings on examination would cause the provider to suspect chlamydial PNA in the newborn?

Answer 4

PNA heard in right lobe

Question 5

When are high risk pregnant women versus all women be screened for chlamydia?

Answer 5

High risk - early in pregnancy

All women - third trimester

Question 6

Should asymptomatic babies who were born to mothers with chlamydia infection be treated?

Answer 6

Not recommended - there is a risk for pyloric stenosis when treating babies with oral erythromycin

Question 7

True/false - coinfection of gonorrhea with chlamydia is common

Answer 7

True - when a pregnant women is positive for gonorrhea, have to consider her having chlamydia

Question 8

Complications associated with gonorrheal infection for the mom (and her pregnancy)

Answer 8

• Spontaneous abortion
• PROM
• Premature delivery
• Chorioamnionitis

Question 9

Risks of gonorrheal infection on the newborn

Answer 9

• Perinatal distress
• Neonatal sepsis
• Arthritis
• Meningitis
• Scalp abscess
• Opthalmia

Question 10

When should the provider culture for gonorrhea during pregnancy?

Answer 10

Should occur at the first prenatal visit

Question 11

When is repeat testing warranted in the pregnant mom for gonorrhea?

Answer 11

Repeat testing during the third trimester for those at high risk for repeat infection

Question 12

What treatments are given to newborns to prevent gonorrheal infection of the eye?

Answer 12

Gonorrheal infection can lead to blindness

Given eye prophylaxis at birth with 1% tetracycline opthalmic ointment or erythromycin 0.5% opthalmic ointment

Question 13

What treatment is given to infants born to mothers with active gonorrhea?

Answer 13

Ceftriaxone 125 mg IV/IM x one dose