Infections in Pregnancy Flashcards
Mother - Slapped check, reticular rash or “mirror syndrome” preeclampsia w anemia and swelling
Parvovirus
How does parvovirus present in the fetus?
Most lethal - stillbirth, hydrops, abortion
What is the treatment for parvovirus?
None
What are the labs for parvovirus?
IgG, IgM, and PCR
ONLY complete absence of all 3 will endorse non-exposure
% of fetuses severely infected with parvovirus if exposed at 1-12 weeks
20% of fetuses are severely infected
% of fetuses severely infected with parvovirus if exposed after 20 weeks
6% of fetuses are severely infected
How does CMV present in the mother?
Mononucleosis sx
How does CMV present in the fetus?
Congenital hearing loss (from maternal reactivation)
Blueberry muffin baby
Treatment for CMV
None
Labs for CMV
Avidity = 0.6 or higher
Acute Infection with IgM Ab in the absence of IgG (positive for up to 9 months, hence avidity)
What is associated with the worst presentation of CMV?
If contracted in the first trimester
Ultrasound findings of CMV
Microcephaly Ventriculomegaly Intracerebral calcification Ascites Hydrops Echogenic bowel IUGR Oligohydramnios
How does varicella present in the mother?
It is highly contagious with a 30% mortality rate if co-existing w PNA
How does varicella present in the fetus?
Limb hypoplasia Neonatal death Chorioretinitis Cataracts Cutaneous scarring
What is the tx for varicella?
Immune globulin
Acyclovir, Valcyclovir
Labs for varicella
If no hx/unsure of prior infection or immunization –> draw IgG serology
If negative then administer immune globulin
Results of varicella if exposure occurs <20 weeks gestation
Abortion
Fetal varicella syndrome (2%)
Results of varicella if exposure near term
Congenital disseminated varicella
5 days before delivery - varicella PNA
2 days after delivery - can be FATAL
Possible results of varicella exposure regardless of timing
Fetal death
Herpes zoster 1st year of life
Ultrasound findings of varicella
Growth restriction
Limb hypoplasia
Microcephaly
How does toxoplasmosis present in the mother?
Fever
Malaise
Night sweats
How does toxoplasmosis present in the fetus?
Hearing and vision deficits
Tx of toxoplasmosis
Spiramycin
Labs of toxoplasmosis
IgG stays positive a long time after exposure
If IgM positive and IgG negative; a reference lab should be completed
If IgM and IgG positive; an infection should be assumed
Collect second sample two weeks prior to 1st to confirm possible false positive IgM
What is the most common source of toxoplasmosis?
Undercooked meats that were infected
Cat litter is more rare
