Infection in pregnancy Flashcards
What causes chicken pox?
The varicella zoster virus
What can occur in mothers with chicken pox?
Varicella Pneumonitis (viral pneumonia)
Hepatitis
Encephalitis
What are the symptoms of chicken pox?
Fever
Malaise
vesicular rash
What can occur in children who’s mothers had chicken pox?
Foetal varicella syndrome
Severe neonatal varicella syndrome
What are the signs and symptoms of foetal varicella syndrome?
skin scarring
eye abnormalities
hyperplasia of limbs
neurological abnormalities
How do you know if a mother is immune to chicken pox?
previous chicken pox = immune.
Can test - IgG levels for VZV (positive = immune)
What can be done for mothers who aren’t immune to chicken pox?
They can be given the vaccine before or after pregnancy.
What should be done to women who have been exposed to chicken pox within pregnancy?
Previous infection - safe.
Positive IgG for VZV - safe.
Not sure - give IV varicella immunoglobulins (within 10 days of exposure).
What is the treatment for a women who develops a rash (infection) during pregnancy?
Within 24hrs and 20wks - oral acyclovir.
Severe - IV acyclovir and hospital admission
After 24hrs - just hygiene.
When does chicken pox infectivity begin and end?
48hrs before the rash presents - until 5-7 days after the rash starts (when they crust over)
When does chicken pox infectivity begin and end?
48hrs before the rash presents - until 5-7 days after the rash starts (when they crust over)
What is shingles?
Reactivation of chicken pox virus which has remained dormant in the sensory nerve root ganglion since primary infection.
What is ‘slapped cheek’ caused by?
The Parovirus B19 virus.
What are the signs and symptoms of parvovirus B19?
Non - specific viral symptoms
Fever
2-5 days after - erythematous of cheeks, few days later - rash on trunk
Most adults are asymptomatic
When is parvovirus B19 infectious and when does it end?
Begins 7-10 days before the rash appears. Once the rash appears, it’s not infectious.
What are the outcomes of getting parvovirus B19 during pregnancy?
Miscarriage or foetal death
severe foetal anaemia
hydros foetalis
Maternal-pre-eclampsia like syndrome.
What are the outcomes of getting parvovirus B19 during pregnancy?
Miscarriage or foetal death
severe foetal anaemia
hydros foetalis
Maternal-pre-eclampsia like syndrome.
Which tests should be done for pregnant women with suspected parvovirus B19?
IgM to parvovirus (acute infection)
IgG to parvovirus (previous exposure)
Rubella antibodies (as alternative)
What is the treatment for parvovirus B19 infection?
Treatment is conservative.
If pregnant - referral to foetal medicine.
What causes congenital toxoplasmosis?
The toxoplasma Gondii parasite.
How is toxoplasmosis spread?
By contamination of faeces from a cat who is the host
When is the highest risk of congenital toxoplasmosis?
The risk increases the further on in pregnancy the infection is acquired
(Highest risk = 3rd trimester)
What are the outcomes of developing toxoplasmosis infection when pregnant?
Increased risk of:
Miscarriage
Intrauterine death
What is the triad of symptoms that come with congenital toxoplasmosis?
Intracranial calcification
Hydrocephalus
Chorioretinitis
Which infections are screened for during a pregnancy booking appointment?
Hepatitis B
Syphilis
HIV
What are the risks associated with HIV during pregnancy?
NO increased risk of congenital abnormalities.
Pre-eclampsia
Misscarriage
Preterm delivery
Low birth weight
What are the viral load levels for vaginal birth and C section for HIV?
<50 - vaginal birth should be supported
50-399 - pre labour CS should be considered between 38 and 29 weeks
>400 - pre labour CS is recommended between 38 and 39 weeks.
Can you breast feed if you have HIV?
It gives an increased risk of transmission.
How is hepatitis B spread?
Through blood and bodily fluids
Vertical transmission
What is the risk of infection to babies who have mothers with acute Hep B infection?
9 in 10 babies will develop the infection.
What is the risk of infection to babies who’s mothers have chronic hepatitis B infection?
1/2 in 10.
What can Hepatitis B contracted at birth cause?
Hepatocellular cancer and serosis
How is chronic hepatitis B treated during pregnancy?
Tenofovir mono therapy in the 3rd trimester.
What can be given to babies of infected Hepatitis B mothers?
Hepatitis B immunoglobulin
Can Hepatitis C be treated in pregnancy?
NO - the medications are teratogenic.
They can be used during breast feeding.
What are the complications of syphilis?
Misscarriage
Still birth
Hydrops Fetalis
Growth restriction
What is congenital syphilis?
Hutchinson’s triad:
Teeth
keratitis
deafness
Treated with penicillin.
