Infections During Pregnancy Flashcards
Torch infection
Toxoplasmosis Other Rubella Cmv HSV
Chicken pox varicella zoster virus Transmission Greatest risk of transmission Effect of fetus Diagnosis Management
1) to mom: resp droplet, to fetus: transplacental
2) 13-30 week and 5 days pre-2 days post-delivery
3) congenital varicella syndrome, preterm delivery
4) clinical, vesicle culture , serology
5) VZIG for mother if exposed. NO vaccine –> live attenuated virus
Congenital varicella syndrome
Limb aplasia Chorioretinitis Cataracts Cutaneous scars Cortical atrophy IUGR Hydrops
CMV
1) to mom: sexual contact, blood transfusion, to fetus: transplacental, during delivery, breast milk
2) primary infection of mother, same in all trimesters
3) mental retardation, cerebral calcification, hydrocephalus, microcephaly, DEAFNESS ( most common cause of congenital deafness) chorioretinitis
4) serology
5) no treatment
Erythema infectiosum/parvovirus/5th disease
To baby: transplacental
2) 10-20 weeks
3) stillbirth, spontaneous abortion, hydrous in utero
4) serology, viral PCR, maternal AFP
5) transfusion if hydrops is present
Rubella
1) To baby: transplacental
2) 1st trimester
3) cataracts, deafness, congenital heart disease
4) serological testing: infection if Ig M is present or > 4x increase in Ig G
5) no treatment. Do not give vaccine during pregnancy
Toxoplasmosis
1) To mom: goat cheese, cat feces, raw meat, to baby: transplacental
2) 3rd trimester
3) congenital toxoplasmosis: chorioretinitis, hydro or microcephaly, intracranial calcification
4) serology: IG M og IG G, + avidity test. high = chronic, low= acute
5) spiramycin
Congenital rubella syndrome
Hearing loss Cataract CV lesions IUGR hepatitis Cns defects Oaseous changes
Syphilis
1) To baby: transplacental
2) 1-3 trimester, most common after 16-18 weeks,
3) risk of PTL, misscarriage, hydrops, stillbirth or neonatal death. Congenital infection: HSM, desqumative skin rash, jaundice, pseudo paralysis, Amelia, thrombocytopenia
4) VDRL
5) Iv penicillin G
HSV Transmission: Greatest transmission risk: Effect on fetus: Diagnosis Treatment
1) transplacental, during delivery/ mucocutaneous contact (NB CI for vaginal delivery)
2) delivery (if genital lesions are present)
3) disseminated herpes (20%) cns sequela 35 %
4) clinical
5) acyclovir for symptomatic women
Group B strep
When to screen?
35-37 w
Treatment of GBS
Iv penicillin G
Clinical findings in fetus with GBS infection
Pneumonia
Sepsis
Hypotension
Meningitis
Hours within birth
When to give AB prophykaxis in GBS
Positive urine GBS culture or previous baby with neonatal sepsis
Positive third tri vaginal culture
Preterm
ROM > 18 h, intrapartum fever
