infection Flashcards
most common cause of early-onset severe infection in the neonatal period
Group B strep
some mother have it in bowel flora, exposed to during labour
risk factors for group B strep infections
prematurity
prolonged rupture of membranes
previous sibling GBS infection
maternal pyrexia - secondary to chorioamnionitis
group B strep prophylaxis
benzylpenicillin
- if previous GBS baby
- women with pyrexia >38 during labour
2 main causes of sepsis in pregnancy
chorioamnionitis
UTIs
chorioamnionitis
infection of chorioamniotic membranes + amniotic fluid
- usually occurs later in preg + labour
chorioamnionitis presentation
general sepsis signs - fever, tachycardia, low BP, reduced urin
- abdo pain
- uterine tenderness
- vaginal discharge
sepsis 6
3 tests
- blood lactate
- blood cultures
- Urine output
3 mx
- oxygen
- empirical broad-spectrum ABx
- IV fluids
which patients should urine culture be sent for
women >65
recurrent UTI (2 ep in 6months or 3 in 12months)
pregnant
men
visible/no-visible haematuria
management of symptomatic UTI in pregnant woman
- urine culture
- 7 days of antibiotics
1st = nitrofurantoin (avoid near term)
2nd = amoxicillin or cefalexin
can you give trimethoprim to pregnant with UTI
NO
teratogenic in the first trimester and should be avoided during pregnancy
management of asymptomatic bacteruria in pregnant women
urine culture done at 1st antenatal visit
7 days nitrofurantoin, amox, or cefalexin
test of cure culture must be done after ABx course finished
what can chickpox exposure in pregnancy lead to
fetal varicella syndrome
- skin scarring
- eye defects
- limb hypoplasia
- microcephaly
- learning difficulties
management of chickpox exposure in pregnancy (post-exposure prophylaxis)
oral aciclovir
- give at day 7 to 14 after exposure, not immediately
- maternal blood should be urgently checked for varicella antibodies
management of chicken pox in pregnancy
oral aciclovir if >=20wks + presents within 24hrs of onset of rash
(if <20wks aciclovir should be considered with caution)
