Immune System Flashcards
Why does the immune system change
Paternal antigens are expressed on fetal cells from as early as as the 8-cell stage which risks the foetus being rejected as a foreign body
Maternal mound system must adapt to avoid rejecting the foetus
What are the local changes in the decidua
Hig levels of progesterone, corticosteroids and/or HCG may act locally on the uterus to change the immune response to stop fetal rejection.
During pregnancy, thedecidua contains a high number of immune cells such as macrophage, natural killer cells and regulatory T cells.
Absence of these immune cell lead to termination of the pregnancy
What do macrophages do
Remodel tissue and clear debris
Hat do oregulatory T cells do
Acts as brakes they limit the response of other T cells hence they rotect the foetus from the immune response
What do natural killer cells do
Recognise and destroy invading trophoblastic cells
what do rising level of progesterone do
Cause a natural suppression in immunity
However pregnancy does not necessarily make the women moe susceptible to infectious disease - the immune system reponds differently to different micro organisms
What does the white blood cell count do
Increasing oestrogen levels abuse the white cell count mainly neutrophils to rise. This eats around 30/40 then plateaus until labour when it rises slightly.
The proportion of of t helper cells declines to suppress the immune response reduce capacity for making antibodies.
Listeriosis
Pregnant women may avoid mould-ripened soft cheeses, unpasteurised milk products and dncooked smoked fish. There is a small chance of listeriosis leaving to miscarriage or stillbirth
Toxoplasmosis
Infection from toxoplasma Gondi parasite usually from raw uncooked meat or handing cat faeces. Can result in miscarriage, stillbirth and damage to fetal brain, eyes and organs.
Salmonella
From eating raw or partially cooked unvaccinated hens egg. Risk of food poising
Commmon antenatal infections
Thrush
Group b strep
Parvovirus
Rubella
Hep B
HIV
Covid
Intrapartum infections
Group b strep
Chlorioamnionitis
Postnata infection
Strep a sore throat
Strep B
Thrush
Infections in neonat
Group B strep
Latrogenic lesions - cuts from forceps ventouse or c section
Viral infections
Thrush in mouth
Eye infection - chlamydia or gonorrhoea
Cord infection
What is the midwife role
Health promotion - dietary and lifestyle factors
Screening test - blood takin
Identification of unwell mother or baby - awareness of signs of infection
