Infection in pregnancy Flashcards
What is the TORCH screen?
group of blood tests to check for infections in newborn. Toxoplasmosis Rubella Cytomegalovirus HSV, HIV
In what family of viruses is cytomegalovirus?
Herpes
What can cytomegalovirus infection in pregnancy result in for newborn?
deafness, mental impairment
no prenatal treatment.
Vertical transmission of Herpes simplex is low - only happens if mum has active primary infection at vaginal delivery. But if neonate gets infected, high mortality. What is the management of primary herpes infection in preg?
acyclovir for mum.
C section within 6wks of primary inf.
acyclovir for neonate.
Which four infections in pregnancy are particularly bad news?
cytomegalovirus
toxoplasmosis
syphilis
rubella
A woman is not vaccinated against Rubella. If she gets rubella before 16wks, what would you do?
offer termination.
What can rubella infection in pregnancy result in for newborn?
deafness, mental impairment
Which protozoan infects you through cat poo and infected meat?
Toxoplasma gondii (protozoan parasite)
To diagnose whether the mum has cytomegalovirus or toxoplasmosis you test maternal IgM. How do you diagnose whether there has been VERTICAL TRANSMISISON of these infections?
amniocentesis
What is the treatment for toxoplasmosis in pregnancy?
spiromycin
If a lady has chickenpox in early pregnancy, you treat with oral acyclovir and it’s fine. If a non-vaccinated mum-to-be is exposed to chickenpox near delivery, what do you give her to prevent infection?
immunoglobulin
Which virus suppresses foetal erythropoiesis if it crosses the placenta?
B19 Parvovirus (slapped cheek)
How do you diagnose Parvovirus in the mum in pregnancy?
maternal IgM
Mum’s IgM has tested positive for Parvovirus. On ultrasound surveillance, unfortunately the infection has crossed the placenta and the baby develops hydrops. What would Doppler of middle cerebral artery show?
increased blood flow
Group B strep a.k.a.
Strep. agalactaie
What percent of pregnant woman are asymptomatic carriers of Group B strep?
25%
What is the intervention to prevent Group B strep vertical transmission and at what time do you give it?
IV penicillin
in labour
In what scenarios do you use IV penicillin in labour to prevent neonatal Group B Strep infection?
(4 RFs)
where RFs:
- PROM >18h
- preterm labour
- maternal fever
- previous GBS neonate
or acutal positive urinary culture for GBS
The risk of vertical transmission Hep B is much more likely is which antigen is positive in mum?
HBeAg
HEP B VACCINATION AT BIRTH
What measures should be taken to prevent vertical transmission of HIV through pregnancy, childbirth and breastfeeding?
HAART for mum
C section
HAART nor neonate
avoid breastfeeding
*HAART = highly active antiretroviral therapy
Group A Strep a.k.a.
strep. pyogenes
Group A strep in pregnancy can lead to puerperal sepsis with high maternal mortality. The infected foetus often dies in utero and labour ensures. What is the treatment for the mother?
high dose IV Abx , ITU
Ix: culture.
in preg group A strep causes chorioamnionitis, abdo pain, diarrhoea
What can be the complications of syphilis in pregnancy and how is it treated in mother during pregnancy?
miscarriage, stillbirth, congenital syphilis
IM Penicillin
Why should you avoid soft cheese in pregnancy?
high risk for listeria monocyotgenes –> listeriosis
bacteraemia –> potentially fatal foetal infection
