infections in pregnancy

Question 1

what are features of congenital rubella syndrome?

Answer 1

Congenital deafness
Congenital cataracts
Congenital heart disease (PDA and pulmonary stenosis)
Learning disability

Question 2

up until which week of gestation is the foetus most at risk of congenital rubella syndrome?

Answer 2

week 20

the highest risk is before 10 weeks of gestation

Question 3

how quickly should IV varicella immunoglobulin be given to mothers who are exposed to chicken pox?

Answer 3

within 10 days of exposure

Question 4

how is chicken pox rash treated in pregnant women

Answer 4

oral acyclovir if they present within 24 hours and are >20 weeks

Question 5

how does congenital varicella syndrome present?

Answer 5

occurs in <1 percent of babies who’s mothers had chickenpox, features include:

Fetal growth restriction
Microcephaly, hydrocephalus and learning disability
Scars and significant skin changes located in specific dermatomes
Limb hypoplasia (underdeveloped limbs)
Cataracts and inflammation in the eye (chorioretinitis)

Question 6

what can listeriosis cause?

Answer 6

• causes flu-like symptoms in mother and can cause pneumonia
• women have a high rate of miscarriage and fetal death
• it id typically transmitted in unpasteurised dairy products and processed meats

Question 7

what are features of congenital CMV?

Answer 7

Fetal growth restriction
Microcephaly
Hearing loss
Vision loss
Learning disability
Seizures

Question 8

what is the classic triad of congenital toxoplasmosis?

Answer 8

Intracranial calcification
Hydrocephalus
Chorioretinitis (inflammation of the choroid and retina in the eye)

Question 9

when in gestation is the risk of congenital toxoplasmosis highest?

Answer 9

later in pregnancy

Question 10

what are complications of parvovirus B29 infection in pregnancy?

Answer 10

Miscarriage or fetal death
Severe fetal anaemia
Hydrops fetalis (fetal heart failure)
Maternal pre-eclampsia-like syndrome

Question 11

how is Zika virus spread?

Answer 11

aedes mosquitos- test with viral PCR swab

Question 12

what are features of congenital zika syndrome?

Answer 12

Microcephaly
Fetal growth restriction
Other intracranial abnormalities, such as ventriculomegaly and cerebellar atrophy

Question 13

what are common organisms that cause UTI?

Answer 13

• E.coli
• Klebsiella

both gram negative anaerobic rods

Question 14

what are abx options for UTI in pregnancy?

Answer 14

Nitrofurantoin (avoid in the third trimester)–> can cause neonatal haemolysis

Amoxicillin (only after sensitivities are known)

Cefalexin

Question 15

why is trimethoprim avoided in the first trimester?

Answer 15

to be avoided in the first trimester as it is works as a folate antagonist. Folate is important in early pregnancy for the normal development of the fetus. Trimethoprim in early pregnancy can cause congenital malformations, particularly neural tube defects (i.e. spina bifida). It is not known to be harmful later in pregnancy, but is generally avoided unless necessary.