Infections Flashcards
When across pregnancy is there a risk to fetus of foetal varicalla syndrome
If exposure prior to 20 weeks then 1%
Very small risk if after 20 weeks
How does foetal varicella syndrome present
Skin scarring
Micropthalmia
Limb hypoplasia
Microcephaly
Learning disabilities
What is management of exposure to chickenpox in pregnancy
If any doubt has been exposed measure antibodies
- under 20weeks if not immune give VZIG ASAP
- over 20 weeks if not immune give VZIG or aciclovir/valaciclovir 7-14 days AFTER exposure
How long after exposure pre 20 weeks is VZIG effective
10 days
What is risk of varicella in pregnancy to mother
Greater pneumonia risk
What is risk for severe neonatal varicella
Mother develops rash from 2 days antenatally to 5 post
Management of chickenpox if pregnant
Avoid contact with pregnant women until crusted over
Aciclovir if over 20 weeks and within 24 hours, if not consider
Good hygiene to prevent secondary bacterial infection
When can aciclovir be used to treat varicella in pregnancy
If after 20 weeks and within 24 hours
Consider if before 20 weeks
Can fetal varicella syndrome be diagnosed prenatally
If have had varicella then should be referred to fetal medicine either at 16-20 weeks or 5 weeks post infection
Do USS
Can also do amniocentesis to find varciella DNA however amniocentesis risks should be weighed up
What do if history of GBS in a previous pregnancy
Offer either intrapartum benzylpenicillin or testing at either 35-37 weeks or 3-5 weeks prior to expected delivery
What do if history of neonatal GBS in prior pregnancy but are negative
Still offer IAP
What do if GBS bacteriuria
If BGS bacteriuria identified at any point in pregnancy with colonisation over 10^5 cfu then treat infection and offer IAP
If reach 37 weeks and is rupture of membranes with known GBS colony what do
Offer IAP with immediate induction of labour
Antibiotic choice if allergic to penicillin in GBS IAP
If non-severe allergy use a cephalosporin
If severe use vancomycin
What do if preterm prelabour rupture of membranes and BGS status is positive
Before 34 weeks expectant management
After 34 weeks can expedite delivery
Management of rubella in pregnancy
Notify health protection unit
Keep away from other pregnant women
What investigations are done for suspected rubella infection
Rubella IgM
Parvovirus B19 IgM as can be difficult to distinguish clinically
What is done if baby born to mother with chronic or acute Hep B in pregnancy
Complete vaccination schedule and hep B immunoglobulin
What is chorioamnionitis
Infection of the amniotic fluid, membranes and placenta
What is exact name of a GBS
Streptococcus agalactiae
Management of pregnant woman with HIV
Should be taking ART
Delivery
- if viral load less than 50 can have vaginal delivery
- if higher must do C-section
Management of neonate born to HIV positive woman
If viral load less than 50 in mother
- oral zidovudine
If viral load over 50
- triple ART for 4-6 weeks
Do not breast feed
How does Hep B vaccination schedule work if
One within 12 hours of birth
One at 1-2 months
One at 6 months
What is done post-natally for all children born to HIV mothers
Blood tests
- within 2 days
- discharge
- 6 weeks
- 12 weeks
- 18 months
