infections in pregnancy Flashcards
when can congenital rubella syndrome occur
first 20wks of pregnancy
highest risk before 10wks
MMR vaccine and pregnancy
women planning to become pregnant should ensure they’ve had it
if unsure, test for rubella immunity
pregnant woman should not have MMR as it is a live virus
features of congenital rubella syndrome
congenital deafness
congenital cataracts
congenital heart disease: PDA, pulmonary stenosis
learning disability
chicken pox - in pregnant can lead to..
- severe materal illness: varicella pneumonitis, hepatitis, encephalitis
- fetal varcicella syndrome
- severe neonatal ifection
exposure to chicken pox in pregnancy
- if woman has had previous chickenpox she is sage
- if unsure of immunity, test VSV IgG - if +ive they are safe
- if not immune give IV varicella Ig as prophylaxis against developing chickenpox
chickenpox rash starts in pregnancy
oral aciclovir if present within 24hrs and are >20wks gestation
congenital varicella syndrome features
fetal growth restriction microcephaly hydrocephalus learning disability scars/skin changes in dermatomes limb hypoplasia chorioretinitis
listeriosis in pregnant
miscarriage
fetal death
severe neonatal infection
how is listeria transmitted
unpasteurised dairy foods, processed meats and contaminated foods
avoiding listeria - advice to pregnant women
avoid high risk foods e.g. blue cheese
practice good food hygeine
features of congenital CMV
fetal growth restriction microcephaly hearing loss vision loss learning disability seizures
how is toxoplasma gondii spread
contamination with feaeces from cat who is a hot
congenital toxoplasmosis
intracranial calcification
hydrocephalus
chorioretinitis
parvovirus B19 - complications in pregnancy
miscarriage or fetal death
severe fetal anaemia
hydrops fetalis
maternal PET-like syndro,e
parvovirus B19 - why fetal anaemia
parvovirus infection of erythroid progenitor cells –> faulty RBCs produced
parvovirus B19 - hydrops fetalis
anaemia leads to heart failure which is referred to as hydrops fetalis
parvovirus B19 - maternal PET-like syndrome
aka mirror syndrome
triad
- hydrops fetalis
- placental oedema
- maternal oedema
women suspected of parvovirus B19 infection need tested for
IgM to parovirus - tests for acute infection in last 4wks IgG to parvovirus - tests for long-term immunity rubella antibodies (differential)
parvovirus B19 infection in pregnancy - Mx
supportive
referred to fetal medicine
congenital Zika syndrome features
microcephaly
fetal growth restriction
intracranial abnormalities - ventriculomegaly, cerebellar atrophy
