Infections in Pregnancy

Question 1

What is the period of infectivity in chicken pox?

Answer 1

48hrs before rash develops to once lesions have ‘crusted’ over (usually 5-7 days)

Question 2

Course of action if a pregnant woman has been exposed to chicken pox and is unsure if she is immune?

Answer 2

• Check immunity status by taking serum IgG
• If immune reassure
• If not immune offer VZ immunoglobulin asap

Question 3

Management if woman presents with mild infection within 24hrs onset of rash?

Answer 3

• > 20 weeks gestation offer oral aciclovir (consider if under 20weeks)
• Advise symptomatic treatment and hygiene to prevent secondary bacterial infection

Question 4

Management if woman presents with mild infection >24hrs onset of rash?

Answer 4

Advise symptomatic treatment and hygiene to prevent secondary bacterial infection

Question 5

Management if woman presents with severe infection?

Answer 5

Give IV aciclovir and admit to hospital

Question 6

Risks associated with HIV in pregnancy?

Answer 6

• Pre-eclampsia
• Miscarriage
• Preterm delivery
• Low birth weight

Question 7

Aims of anti-retroviral treatment in pregnancy?

Answer 7

1. Viral load <50 HIV RNA copies/ml (allows vaginal delivery)
2. Reduce risk of vertical transmission
3. Improve mothers health

Question 8

What are women with chronic Hep B and a high viral load offered?

Answer 8

Tenofovir monotherapy (reduce risk of transmission to baby)

Question 9

Vaccination schedule for babies with HepB positive mothers?

Answer 9

• Dose within 24hrs of birth
• 4 weeks of age
• 8 weeks of age
• 12 months of age

Question 10

What is offered to HepB negative women who are high risk?

Answer 10

Vaccine (as it is inactive)

Given to intravenous drug users and women with IVDU partners or has HepB/HIV

Question 11

Indications to offer Hepatitis C antenatal screening to pregnant women?

Answer 11

• All substance misusing pregnant women
• Previous history of IV drug use
• Current or previous partner with history of IV drug use
• HIV/HepB positive
• Deranged LFTs

Question 12

Is breastfeeding safe in HepB/C

Answer 12

Hep B = No, increases risk of transmission to baby

Hep C = Yes, no risk of transmission to baby

Question 13

Associated risks of syphillis infection in pregnancy?

Answer 13

• Miscarriage
• Stillbirth
• Hydrops fetalis
• Growth restriction
• Congenital infection

Question 14

How are pregnant women who test positive for syphilis treated?

Answer 14

IM Penicillin

Question 15

What is Hutchinson’s triad? (Signs of congenital syphillis)

Answer 15

• Deafness
• Interstitial keratitis
• Hutchinson’s teeth (widely spaced, peg like)