Infection In Pregnancy Flashcards
Rubella
14-21 incubation
Non specific flu-like illness
Macular rash covering trunk
Serological antibody testing (checked at booking, low titres->postnatal vaccination)
1st trimester infection = 80% risk to fetus
Risk of abnormalities: 50%13
Fetal complications from rubella
Sensorineural deafness Cataracts Congenital heart disease Learning difficulties Hepatosplenomegaly Jaundice Microcephaly Spontaneous miscarriage
Listeria
G+ve coccus
Soil, animal faeces, pâté, unpasteurised dairy
3-70 day incubation
Mat sx: fever, malaise, backache, abdo pain, pharyngitis, conjunctivitis
Ix: blood cultures, placental/neonatal swab
Complications: miscarriage, still birth, preterm delivery, neonatal listeriosis with 50% mortality
Parvovirus
Droplet infection
18 day incubation
Children: slapped cheek= erythema infectiosum aka 5th disease
Adults: fever, malaise, arthralgia
Fetal death in 9%, 2nd trimester = greatest risk
Fetal sequelae: non immune hydrops, myocarditis, in utero transfusion may prevent death
No long term sequelae in survivors
Varicella zoster virus - chicken pox
Airborne spread/ personal contact with vesicle fluid
3-21 day incubation period
Prodromal malaise + fever -> itchy rash maculopapules
Infectious for 48 hrs before rash appears and until vesicles crust over
~ 5 days
90% women immune
Varicella zoster in non-immune pregnant women
Test immunity
VZIG within 10 days of exposure
If rash develops: avoid other pregnant women, oral aciclovir if seen within 24 hrs of rash
Fetal risk: varicella syndrome, esp if infection
CMV
3/1000 live births
Urine, saliva, bodily fluid transmission: 3-12 wk incubation
Mat: asymptomatic infection: IgM in blood = infection, IgG = immunity
No treatment therefore no screening
10-15% foetuses affected, any gestation, 80% normal at birth 20%: hydrops, IUGR, exomphalos, microcephaly, hydrocephalus, hepatosplenomegaly , thrombocytopenia
Later: vis impairment, hearing loss, psychomotor retardation, mental handicap
