Infections In Pregnancy

Question 1

What are the complications of infections

Answer 1

→ spontaneous abortions
→ perinatal death
→ abnormal growth
→ fatal anomalies : choriorenitis, hydrocephalus and microcephalic , cerebral calcification

Question 2

Modes of transmission

Answer 2

• Transplacental • latrogenic • Ascending

* perinatal • breast milk • nosocomial

Question 3

Describe trans placental infection

Answer 3

Spread haematogencusly via placenta
Follows primary or re-activated infection
Can be blood borne, virus_bacteria or parasite
Asymptomatic or vague
Fetal however- preterm labour, growth restriction and developmental delays

Question 4

Intra-amniotic infection

Answer 4

Dx: fever uterine tenderness,leucocytosis
Histologically → chonoamnionitis more common
Due to ascending infection - polymicrobial or blood born-CMV, rubella, HIV
Affect baby with: increased (preterm delivery) PTD, palsy, endometrisis
Rx: a/b and delivery

Question 5

What is ascending infection

Answer 5

Vaginal flora - low pathogenicity- polymicrobial
E.g enterococci, staphylococci and streptococci, coliforms
Ureaplasmos and mycoplasma

Question 6

Perinatal infection

Answer 6

• Infection acquired around time of delivery→ fetus had contact with lesions or blood
• colonisation and infection group B strephemolytaic strep, e-coli, HIV, HSV, gennococal and chlamydia conjunctivitis

Question 7

Risk factors for neonatal infections

Answer 7

• Prolonged rapture of membranes
• Prematurity
• traumatic birth - difficult pregnancy
• indwelling devices
• broad spectrum a/b

Question 8

Group B streptococci labs and treatment

Answer 8

What specimens → urine, CSF, Blood
Gram stain results→ gram positive cocci in chains
Latex agglutination → group B bett hemolytic

Treatment → penicillin /ampicilin + amnogycoside for 21 days

Question 9

Prevention GBS

Answer 9

Give penicillin to women with risk factors:

• previous delivery GBS
• GBS during pregnancy
• deliver befor 37 weeks
• rupture of membranes of more than 18 hours
• Intra party temp of more than 38c

Question 10

How is lm transmitted

Answer 10

Contaminated food → cheese, milk and raw vegetables and meat

Question 11

What are the clinical signs in mother and baby of LM

Answer 11

Mother → bacteraemia, CNS infection
Baby → early → granalomatosis infantsepticum
Late → bacterial meningitis

Question 12

What is treatment of LM

Answer 12

Ampicillin and amino-glycoside

Question 13

How to prevent LM

Answer 13

It immune compromised avoid soft cheeses, left over foods should be thorouly warmed, wash raw vegetables look veggies and meat properly

Question 14

Gonorrhoea _ what is aetology

Answer 14

N. Gonorrhoea

Question 15

What is the effect of gonorrhea

Answer 15

• PROM
• preterm labour
• Chorioamnionitis
• endometritis

Question 16

How does gonorrhoed affect neonates

Answer 16

40% have gonococcal ophthalmia neonatorum

80%. Asymptomatic

Question 17

How do you treat mother to prevent (gono) neonatal infection

Answer 17

Give cefflasone

Rx: ceffriaxone 25-50mg iv 1 dose

Question 18

What prophylaxis do you give baby to prevent (Gono)

Answer 18

Erythromycin or chloramphenicol

Question 19

What are complications of Gono

Answer 19

Corneal ulcers → blindness

Question 20

How to diagnose (gono)

Answer 20

→ eye swab
→ gram neg cocci on microscopy
→ culture en selective media
Alternatively PCR

Question 21

How does chlamydia affect pregnant

Answer 21

PROM
Preterm labour
Chorioamnionitis
Endometritis
Conjunctivitis
Pneumonia
Most Asymptomatic

Question 22

How to treat clam

Answer 22

Azithromycin

Question 23

What causes syphilis

Answer 23

T palladium

Question 24

Mode of transmission for syph

Answer 24

Transplacental from 15 weeks

Question 25

What to test for in syphyls

Answer 25

RPR, VDRL

Question 26

What diagnostic tests

Answer 26

TPI, fta-abs

Question 27

How to treat Syphs

Answer 27

Penicillin IV 10-21 days (suspected cases)

Benzathine penicillin IM once a week for 3 weeks = infected mothers

Question 28

Name early signs of syphs

Answer 28

→ snuffles
→ rash
→ jaundice
→anaemia
→ osteochondritis
→ neurological signs, mucous patches

Question 29

What are the late signs of congenital Syphs

Answer 29

→ frontal bossing
→ 8th nerve deafness
→ saddle nose
→ short maxilla and protruding mandible.
→ flaring scapula

Question 30

Toxoplasmosis aetiology

Answer 30

Toxoplasma gondii

Question 31

In what does Toxo shed

Answer 31

Cat faces, raw undercooked meats

Question 32

Affects of Toxo

Answer 32

Chorioretinitis, encephalitis, neonatal jaundice, hydrocephalus, hepato and splenomegaly

Question 33

How to prevent Toxo

Answer 33

Avoid cat feces

Wash hands after out door activity, wash cooking utensils well