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Year 3- Reproduction > Infcetions in Pregnancy > Flashcards

Infcetions in Pregnancy Flashcards

1
Q

How is chicken pox spread?

A

Respiratory droplets

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2
Q

What are the symptoms of chicken pox?

A

Fever
Malaise
Itchy vesicular rash

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3
Q

When is chicken pox infective?

A

48hrs before rash develops to once the chicken pox lesions have crusted over (usually 5-7 days after the rash starts)

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4
Q

In children, what is the treatment for chickenpox?

A

Nothing as usually harmless and self-limiting

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5
Q

In adults, chickenpox is associated with a greater morbidity and can increase risks of the development of what?

A

Hepatitis
Pneumonitis
Encephalitis

->risk especially pronounced in immunocompromised and in pregnancy so important to ask women about chicken pox history in their appointment

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6
Q

If a women is pregnant and has no history of chickenpox, what advice should be given?

A

Avoid exposure to anyone with chickenpox or shingles during pregnancy and seek urgent medical help if they do

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7
Q

What syndrome may occur in the foetus if there was maternal primary chickenpox?

A

Foetal varicella syndrome

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8
Q

What can foetal varicella syndrome cause to happen?

A

Skin scarring
Congenital eye abnormalities
Hypoplasia of ipsilateral limbs
Neurological abnormalities

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9
Q

What happens if chickenpox infection occurs in the last four weeks of pregnancy?

A

Risk of infection in the newborn

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10
Q

If a pregnant women has had significant exposure to chickenpox but is unsure if she is immune, what can be done?

A

Take serum IgG:

If immune (IgG positive), reassure
If non-immune (IgG negative) , offer Varicella Zoster immunoglobulin asap

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11
Q

What shoulder be done if a pregnant person develops mild chickenpox infection and presents within 24hrs of onset of rash?

A

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

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12
Q

What shoulder be done if a pregnant person develops mild chickenpox infection and presents after 24hrs of onset of rash?

A

Advise regarding symptomatic treatment and hygiene to prevent secondary bacterial infection

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13
Q

What shoulder be done if a pregnant person develops severe chickenpox infection?

A

IV aciclovir
Admit to hospital

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14
Q

What causes shingles?

A

Reactivation of the chickenpox virus which has remained dormant in the sensory nerve root ganglion

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15
Q

Can you catch chickenpox from someone with shingles?

A

Yes, but it’s rare

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16
Q

What is parvovirus B19?

A

Common and mild febrile illness, commonly seen in childhood.

50% approx of women will be immune

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17
Q

How is parvovirus B19 spread?

A

Respiratory secretions

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18
Q

How does parvovirus B19 present?

A

Fever
Erythema of cheeks
Rash

->can be known as slapped cheek disease
Most adults are completely asymptomatic

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19
Q

What is the treatment for parvovirus B19?

A

No treatment or vaccine available as usually harmless

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20
Q

What can parvovirus B19 cause in immunocompromised patients?

A

Aplastic anaemia
Haemolysis

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21
Q

What can parvovirus B19 infection in pregnancy lead to?

A

Foetal anaemia leading to cardiac failure, hydrops fatalis and foetal death

->rare but can cause preeclamptic condition in mother with significant oedema

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22
Q

What is the most critical exposure period of parvovirus B19 in pregnant people?

A

12-20wks
Foetal infection occurs 5wks after maternal infection

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23
Q

What should be done if a pregnant person reports exposure to parvovirus B19?

A

Blood samples for immunoglobulin testing

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24
Q

What happens if immunoglobulin testing for parvovirus B19 comes back positive?

A

Weekly scans are offered to monitor foetal complications

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25
Q

Which microorganism causes toxoplasmosis?

A

Toxoplasma Gondi

26
Q

How is toxoplasmosis infection usually transmitted?

A

Usually from infected cat faeces or consumption of undercooked meats

27
Q

Symptoms of toxoplasmosis?

A

Usually asymptomatic in adults
Mild, flu-like symptoms e.g. fever, sore throat, arthralgia

28
Q

What are some of the potential serious complications which can occur as a result of toxoplasmosis?

A

Chorioretinitis
Encephalitis
Myocarditis
Pneumonitis

29
Q

How long after ingestion of the parasite does parasitaemia of toxoplasmosis occur?

A

Within 3wks of ingestion

30
Q

What measures should pregnant people take to reduce risks of toxoplasmosis?

A

Avoid cleaning cat litter trays
Avoid consumption of undercooked meats

31
Q

Congenital infection of toxoplasmosis is rare but can have serious foetal complications if it does occur. What are some of these?

A

Hydrocephalus
Intracranial calcifications
Microcephaly
Chorioretinitis
Ascites
Hepatosplenomegaly

Can cause miscarriage and intrauterine death

32
Q

How can toxoplasmosis of the foetus be diagnosed?

A

PCR of amniotic fluid

33
Q

A 24wk pregnant woman phones you, her GP, as she has just found out her nephew has chicken pox. She had had significant contact with him on Saturday and the rash appeared on Sunday evening. She is unsure is she has been previously infected. What is the most appropriate action?

A. Give Varicella Zoster immunoglobulin
B. Give IV aciclovir
C. Give oral aciclovir
D. Take serum IgG to check her immunity status
E. No action, as you are not infectious before developing the rash.

A

D- take serum IgG to check her immunity status

->if found to have no immunity, give Varicella Zoster immunoglobulin

34
Q

Does HIV increase risks of congenital abnormalities?

A

No

35
Q

What can HIV increase risks of in pregnancy?

A

Pre-eclampsia
Miscarriage
Preterm delivery
Low birth weight

36
Q

What can be offered to pregnant people with HIV?

A

Serial four weekly foetal growth scans

37
Q

What should all babies born to HIV positive mothers be referred to?

A

Neonatology for HIV testing

38
Q

How does breastfeeding increases risks of HIV in the foetus?

A

Can increase risks of vertical transmission

39
Q

Which type of meds are pregnant people with HIV put on?

A

Anti-retrovirals

40
Q

Throughout pregnancy, what do people on anti-retrovirals be monitored for?

A

LFTs
CD4 count
HIV viral load

->if HIV viral load is low, vaginal birth is supported, otherwise C-section is advised

41
Q

How can hepB be transmitted?

A

Many cases spread by vertical transmission
Bloods or other bodily fluids

42
Q

What can happen to babies born to mothers with acute HepB infection?

A

Majority will contract HepB
Increased risks of cirrhosis and hepatocellular cancer

43
Q

What should women with chronic hepatitis B with a high viral load be offered in their third trimester?

A

Tenofovir monotherapy to reduce risks of HepB transmission to baby

44
Q

What can be given to pregnant women who are at high risks of HepB?

A

HepB vaccine as it is inactivated so safe in pregnancy

->just so you know, risks of HepB include IVDU, partner with HIV or HepB

45
Q

Is vaginal birth safe if the mother has HepB?

A

Yes

46
Q

What should be offered to babies who’s mother has HepB?

A

Hepatitis B immunoglobulin

47
Q

What can HepC lead to?

A

Severe hepatitis
Chronic liver disease
Increased risk of liver cancer

48
Q

What are most cases of HepC associated with?

A

Prior injecting drug usage

49
Q

What can decline in pregnancy in those with HeoC?

A

Liver function

50
Q

How common is vertical transmission in pregnant people with HIV and their child?

A

Common, 1 in 20, higher in coinfected with HIV

51
Q

How is HepC treated in pregnancy?

A

Should not be treated as the drugs are teratogenic and are contraindicated

52
Q

Can vaginal birth occur if mother has HepC?

A

Yes

53
Q

Which microorganism causes syphilis?

A

Treponema palladium

54
Q

How is syphilis transmitted?

A

Direct contact with skin lesion

55
Q

How can syphilis be treated?

A

With a course of antibiotics

56
Q

If untreated, what can chronic syphilis cause?

A

Neurological, cardiac, skeletal and skin abnormalities for adults and babies affected in utero

57
Q

What does syphilis in pregnancy increase risks of?

A

Miscarriage
Stillbirth
Hydrops fetalis
Growth restriction
Congenital infection

58
Q

How can syphilis be transmitted to babies?

A

Via placenta of infected mother
Exposure to infected lesion at time of birth

59
Q

What is primary syphilis characterized by?

A

Painless local ulcer known as a canker

60
Q

What treatment is given if a pregnant person is found to have syphilis infection?

A

Prompt treatment of intramuscular penicillin

61
Q

Rarely seen in the UK, late congenital syphilis is a subset of congenital syphilis.

It presents with Hutchinson’s triad. What makes up this?

A

Deafness
Interstitial keratitis
Hutchinson’s teeth- widely spaced, peg like

62
Q
A

Year 3- Reproduction (23 decks)

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