infections in pregnancy

Question 1

when can congenital rubella syndrome occur

Answer 1

first 20wks of pregnancy

highest risk before 10wks

Question 2

MMR vaccine and pregnancy

Answer 2

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

Question 3

features of congenital rubella syndrome

Answer 3

congenital deafness
congenital cataracts
congenital heart disease: PDA, pulmonary stenosis
learning disability

Question 4

chicken pox - in pregnant can lead to..

Answer 4

• severe materal illness: varicella pneumonitis, hepatitis, encephalitis
• fetal varcicella syndrome
• severe neonatal ifection

Question 5

exposure to chicken pox in pregnancy

Answer 5

• 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

Question 6

chickenpox rash starts in pregnancy

Answer 6

oral aciclovir if present within 24hrs and are >20wks gestation

Question 7

congenital varicella syndrome features

Answer 7

fetal growth restriction 
microcephaly 
hydrocephalus 
learning disability 
scars/skin changes in dermatomes
limb hypoplasia 
chorioretinitis

Question 8

listeriosis in pregnant

Answer 8

miscarriage
fetal death
severe neonatal infection

Question 9

how is listeria transmitted

Answer 9

unpasteurised dairy foods, processed meats and contaminated foods

Question 10

avoiding listeria - advice to pregnant women

Answer 10

avoid high risk foods e.g. blue cheese

practice good food hygeine

Question 11

features of congenital CMV

Answer 11

fetal growth restriction
microcephaly 
hearing loss
vision loss
learning disability 
seizures

Question 12

how is toxoplasma gondii spread

Answer 12

contamination with feaeces from cat who is a hot

Question 13

congenital toxoplasmosis

Answer 13

intracranial calcification
hydrocephalus
chorioretinitis

Question 14

parvovirus B19 - complications in pregnancy

Answer 14

miscarriage or fetal death
severe fetal anaemia
hydrops fetalis
maternal PET-like syndro,e

Question 15

parvovirus B19 - why fetal anaemia

Answer 15

parvovirus infection of erythroid progenitor cells –> faulty RBCs produced

Question 16

parvovirus B19 - hydrops fetalis

Answer 16

anaemia leads to heart failure which is referred to as hydrops fetalis

Question 17

parvovirus B19 - maternal PET-like syndrome

Answer 17

aka mirror syndrome

triad

• hydrops fetalis
• placental oedema
• maternal oedema

Question 18

women suspected of parvovirus B19 infection need tested for

Answer 18

IgM to parovirus - tests for acute infection in last 4wks
IgG to parvovirus - tests for long-term immunity 
rubella antibodies (differential)

Question 19

parvovirus B19 infection in pregnancy - Mx

Answer 19

supportive

referred to fetal medicine

Question 20

congenital Zika syndrome features

Answer 20

microcephaly
fetal growth restriction
intracranial abnormalities - ventriculomegaly, cerebellar atrophy