Infcetions in Pregnancy Flashcards
How is chicken pox spread?
Respiratory droplets
What are the symptoms of chicken pox?
Fever
Malaise
Itchy vesicular rash
When is chicken pox infective?
48hrs before rash develops to once the chicken pox lesions have crusted over (usually 5-7 days after the rash starts)
In children, what is the treatment for chickenpox?
Nothing as usually harmless and self-limiting
In adults, chickenpox is associated with a greater morbidity and can increase risks of the development of what?
Hepatitis
Pneumonitis
Encephalitis
->risk especially pronounced in immunocompromised and in pregnancy so important to ask women about chicken pox history in their appointment
If a women is pregnant and has no history of chickenpox, what advice should be given?
Avoid exposure to anyone with chickenpox or shingles during pregnancy and seek urgent medical help if they do
What syndrome may occur in the foetus if there was maternal primary chickenpox?
Foetal varicella syndrome
What can foetal varicella syndrome cause to happen?
Skin scarring
Congenital eye abnormalities
Hypoplasia of ipsilateral limbs
Neurological abnormalities
What happens if chickenpox infection occurs in the last four weeks of pregnancy?
Risk of infection in the newborn
If a pregnant women has had significant exposure to chickenpox but is unsure if she is immune, what can be done?
Take serum IgG:
If immune (IgG positive), reassure
If non-immune (IgG negative) , offer Varicella Zoster immunoglobulin asap
What shoulder be done if a pregnant person develops mild chickenpox infection and presents within 24hrs of onset of rash?
Advise to avoid other potentially susceptible individuals e.g. other pregnant people or neonates
Oral aciclovir
Advise regarding symptomatic treatment and hygiene to prevent secondary bacterial infection
What shoulder be done if a pregnant person develops mild chickenpox infection and presents after 24hrs of onset of rash?
Advise regarding symptomatic treatment and hygiene to prevent secondary bacterial infection
What shoulder be done if a pregnant person develops severe chickenpox infection?
IV aciclovir
Admit to hospital
What causes shingles?
Reactivation of the chickenpox virus which has remained dormant in the sensory nerve root ganglion
Can you catch chickenpox from someone with shingles?
Yes, but it’s rare
What is parvovirus B19?
Common and mild febrile illness, commonly seen in childhood.
50% approx of women will be immune
How is parvovirus B19 spread?
Respiratory secretions
How does parvovirus B19 present?
Fever
Erythema of cheeks
Rash
->can be known as slapped cheek disease
Most adults are completely asymptomatic
What is the treatment for parvovirus B19?
No treatment or vaccine available as usually harmless
What can parvovirus B19 cause in immunocompromised patients?
Aplastic anaemia
Haemolysis
What can parvovirus B19 infection in pregnancy lead to?
Foetal anaemia leading to cardiac failure, hydrops fatalis and foetal death
->rare but can cause preeclamptic condition in mother with significant oedema
What is the most critical exposure period of parvovirus B19 in pregnant people?
12-20wks
Foetal infection occurs 5wks after maternal infection
What should be done if a pregnant person reports exposure to parvovirus B19?
Blood samples for immunoglobulin testing
What happens if immunoglobulin testing for parvovirus B19 comes back positive?
Weekly scans are offered to monitor foetal complications