Infections in pregnancy

Question 1

How is chicken pox treated in pregnant women?

Answer 1

If mild infection presenting within 24hrs of rash onset and >20 weeks gestation, give Oral aciclovir (if mild but presenting after 24hrs since onset of rash, give symptomatic treatment)

If severe admit to hopsital and give IV aciclovir.

Question 2

What are the postential risks/complications of chicken pox infection in pregnancy?

Answer 2

Risk of morbidity
Risk of fetal varicella syndrome

No increased risk of miscarriage

Question 3

What is fetal varicella syndrome?

Answer 3

Skin scarring
Neurological abnormalities
Congenital eye abnormalities
Hypoplasia of ipsilateral limbs.

Question 4

What is parvovirus B19? How does it present in pregnancy and what are the potential complications?

Answer 4

Most adults are asymptomatic and it is usually harmless to them. Can present with fever, rash, erythema of cheek.

Can cause:
fetal anemia potentially leading to cardiac faliure
hydrops fetalis- build up of fluid in fetal tissues
fetal death

Fetal infection will occur abour 5 weeks after maternal infection.
If mother infected scan to check for fetal complications.

Question 5

What is toxoplamosis?

Answer 5

Caused by Toxoplasma gondi

Mostly asymptomatic but can have mild flu like symptoms

Can spread from under cooked meat and infected cat feces so women advised to avoid this.

Question 6

Toxoplamsosis complications in mother?

Answer 6

Myocarditis
Pneumonitis
Encephalitis

Question 7

Toxoplamsosis complications in mother?

Answer 7

Myocarditis
Pneumonitis
Encephalitis

Question 8

Toxoplamosis complications in fetus?

Answer 8

Hydrocephalus
Neurological issues
Cardiac issues
Eye problems
Increased risk miscarriage
Increased risk intrauterine death.

Question 9

What needs to be checked for in HIV positive women?

Answer 9

Pre-eclapmsia
Miscarriage
Pre-term delivery
Low birth weight

Question 10

What HIV viral load must a pregnant women be below for a vaginal delivery to be an option?

Answer 10

<50 HIV RNA copies/ml

Question 11

What are babies who get a hep B infection from vertical transmission at risk of?

Answer 11

Cirrhosis

Hepatocellular cancer

Question 12

What is given to prevent infection of mother with Hep B?

Answer 12

Hep B vaccine is given to mothers who are at high risk, e.g. is or has partner who is IVDU or has partner who has HIV or HBV

Question 13

Expectant mothers with high Hep B viral loads are given?

Answer 13

Tenofovir monotherapy

Question 14

What are babies born to Hep B postive mothers given?

Answer 14

Hep B immunoglobulin and accelerated immunisation schedule. Give 1st vaccine does with 24hrs of delivery.

Question 15

Causative organism of syphilis

Answer 15

treponema pallidum spirochete

Question 16

How does syphilis present and how is it treated?

Answer 16

Painless local ulcer

Intramuscular penincilin injection

Question 17

What are the complications of chronic syphilis?

Answer 17

Cardiac, neurological, skeletal and skin problems.

Increased miscarriage risk
Increased risk of stillbirth
Hydrops fetalis
Growth restriction

Question 18

How can babies infected with syphilis present?

Answer 18

Most asymptomatic at birth:

Most present within 5 weeks.
Can present with Hutchinson’s triad:
Deafness
Interstital keratitis (blood vessels grow into cornea)
Hutchinson’s teeth- widely spread and peg-like