ID: Prenatal transmission Disorders Flashcards
TORCH infection
infection in developing fetus or newborn that can occur in
- utero
- during delivery
- after birth
caused by any of the infectious agents: TORCH
T= toxoplasma gondii O= Other agents: syphilis, varicella zoster virus, parovirus B19, HIV R=rubella C= Cytomegalovirus H= Herpes simplex virus
Congenital Varicella Syndrome
- occurs when
- dev of what can be affected if infection occurs at 12th week, 16-20 weeks, third tri
- CM
- prevention
Occurs if mom develops Varicella (chickenpoxs) b/w 8 and 20 weeks gestation
- *can affect limb development–12 weeks
- *can affect eye and brain dev–16-20 weeks
- *less severe dz–third tri
CM:
- scarring skin lesions, abnormalities of limbs (hypoplasia of bone and muscl)
- ocular abnormalities (cataracts, chorioretinitis)
- CNS abnormalities (seizures, cognitive deficits)
Prevention:
- Varicella Immune Globulin (VZIG) reduces severity of infection after exposure to VV in patients at high risk–which are:
- Pregnnt women who lack evidence of immunity to VZV
- newborns of mothers with varicella 5 days before to 2 days after delivery
- premature infants at or greater than 28 weeks who are exposed and whose moms has no evidence of immunity
should pregnant women get the varicella vaccine?
no
its a live vaccine
if a pregnant women is not immune during pregnancy— it is recc that she get the vaccine immediately after delivery with the second dose given 6 weeks PP
congenital syphilis
-when during pregnancy can it transfer to fetus
-how can mom prevent fetal damage
-how to treat infected fetus–when do tx
CM
MC during third month of pregnancy
prevent fetal damage
*tx before 16th week of pregnancy
treat infected fetus: treatment before third trimester
CM: 60% are asympto at birth
- stillbirth
- Early <2YO: mucocutaneous (syphilitic rhinitis, rash), hematologic abnormalities, CNS and pulmonary complications
- Late >2 YO:
* facial abnormalities (saddle nose deformity, Hutchinson teeth)
* saber shins: anterior bowing of tibia
* Chorioretinitis
* sensorineural hearing loss
* developmental delays
TX:
*IV PCN G X 10 days
Congenital herpes aka neonatal HSV
-etiology
infection transmissed thru birth canal
**HSV-2 MCC
CM
- localized to the skin, mouth and eyes
- CNS: seizures, tremors, lethargy, poor feeding, encephalitis
- Disseminated: temperature instability which can lead to respiratory distress, DIC (disseminated intravascular coagulation) and septic shock
TX:
*infected moms: given meds prior to birth and during birth
OR infant is delivered c-section
- IV acyclovir x14 days followed by PO suppressive Acyclovir x6 MO
- Topical ophthalmic solution added if needed
HPV and pregnancy
-tranmissino rate to baby?
very low transmission rate
*no linnk b/w HPV and miscarriage, premmie delivery, or other pregnancy issues
Congenital Rubella
- can lead to?
- wht time is the highest risk of infecting fetus
- CM
it is TERATOGENIC— esp in first trimester
- fetal death in utero
- premature delivery
- congential defects
highest risk of transmission is at 10 weeks of gestation
CM -deafness** -cataracts ** -cardiac dz ** PDA MC OTHER: -blueberry muffin lesions--- petechia and purpura -hemolytic anemia -bone lesions -lymphadenopathy
TX: supportive
Zika Virus
- name of microbe
- transmitted?
- CM
- tx–more so preventative measures
- Arthropod vector–>Flavivirus transmitted by Aedes mosquito
- transmitted via sex or mother-fetus
CM: 5 main features
- Severe microcephaly
- decreased brain tissue
- eye damage (macular and retinal changes)
- congenital contractures (clubfoot)
- Hypertonia restricting body movement
TX
- men with exposure should wait at least 3 MO to have unprotected sex
- women should wait at least 8 weeks after symptom onset or last possible exposure b4 unprotected sex
- pregnant women should avoid or consider postponing travel to areas below 6500 ft where mosquito transmission is ongoing
Congenital CMV
-CM
10% will have symps–
- hepatosplegomegaly
- petechiae, purpura, jaundice
- microencephaly
- small size for gestational age
- chorioretinitis
- hearing loss that is progresive
