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Year 4 Obstetrics > Infections In Pregnancy > Flashcards

Infections In Pregnancy Flashcards

1
Q

Congenital rubella syndrome effects

A

Maternal infection with the rubella virus during the first 20 weeks of pregnancy

  • Congenital deafness
  • Congenital cataracts
  • Congenital heart disease (PDA and pulmonary stenosis)
  • Learning disability
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2
Q

Precautions for rubella

A

Women thinking about pregnancy should have the MMR vaccine before becoming pregnant

Cannot have live vaccine during pregnancy

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3
Q

If ensure about vaccination status

A

Tested for immunity - infection antibodies

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4
Q

MMR vaccine

A

2 doses, 3 months apart

Not giving during pregnancy

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5
Q

Consequences of chicken pox during pregnancy

A

More severe cases in the mother - varicella pneumonitis, hepatitis or encephalitis

Fetal varicella syndrome

Severe neonatal varicella infection (if infected around delivery)

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6
Q

When in doubt about chicken pox immunity status

A

IgG levels for varicella zoster

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7
Q

Pregnant ladies not immune to chicken pox

A

Varicella vaccine before or after pregnancy

IV varicella immunoglobulins during pregnancy within 10 days of exposure

Avoid people with chicken pox

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8
Q

Management of chickenpox during pregnancy

A

Oral aciclovir- if present within 24 hours and are more than 20 weeks gestation

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9
Q

Congenital varicella syndrome effects

A

The typical features include:

  • Fetal growth restriction
  • Microcephaly, hydrocephalus and learning disability
  • Scars and significant skin changes located in specific dermatomes
  • Limb hypoplasia (underdeveloped limbs)
  • Cataracts and inflammation in the eye (chorioretinitis)
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10
Q

When can a baby get congenital varicella syndrome

A

Infection occurs in the first 28 weeks of gestation

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11
Q

Causative organism of listeriosis

A

Listeria - gram-positive bacteria

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12
Q

Presentation of listeriosis in pregnant women

A

Asymptomatic
Flu like illness

Can cause pneumonia or meningioencephalitis

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13
Q

Complications of listeriosis in pregnancy

A

Miscarriage

Severe neonatal infection

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14
Q

How is listeria transmitted

A

Through unpasteurised dairy products, processed meats and contaminated foods

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15
Q

How to avoid listeriosis in pregnancy

A

Avoid high-risk foods (e.g. blue cheese) and practice good food hygiene

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16
Q

When does Congenital Cytomegalovirus occur

A

Cytomegalovirus (CMV) infection in the mother during pregnancy

17
Q

How is CMV spread

A

Via infected saliva or urine

18
Q

Features of congenital CMV

A 
Fetal growth restriction
Microcephaly
Hearing loss
Vision loss
Learning disability
Seizures
19
Q

Causative organism of congenital toxoplasmosis

A

Toxoplasmosis gondii - parasite

20
Q

Transmission of toxoplasmosis gondii

A

Via faeces from an infected cat

21
Q

Presentation of toxoplasmosis in mother

A

Usually asymptomatic

22
Q

Features of congenital toxoplasmosis

A

Triad:

  • Intracranial calcification
  • Hydrocephalus
  • Chorioretinitis (inflammation of the choroid and retina in the eye
23
Q

Complications of parvovirus during pregnancy

A

Miscarriage
Severe fetal anaemia
Hydrops fetalis (fetal heart failure)
Maternal pre-eclampsia-like syndrome

24
Q

What congenital infection causes fetal anaemia

A

Parvovirus infection of the erythroid progenitor cells in the fetal bone marrow and liver

25
Q

Maternal pre-eclampsia-like syndrome (mirror syndrome)

A

Rare complication of severe fetal heart failure (hydrops fetalis).

Triad of:

  • hydrops fetalis
  • placental oedema
  • Maternal oedema

Also features hypertension and proteinuria

26
Q

Investigations for parvovirus during pregnancy

A
  • IgM to parvovirus - acute infection within the past four weeks
  • IgG to parvovirus - long term immunity to the virus after a previous infection
  • Rubella antibodies (as a differential diagnosis)
27
Q

Treatment of parvovirus during pregnancy

A

Supportive

Referral to fetal medicine - monitor complications and malformation

28
Q

How is Zika virus spread

A

Aedes mosquito

Intercourse with an infected individual

29
Q

Where is Zika virus prevalent

A

Brazil

South America

30
Q

Congenital Zika syndrome features

A

Microcephaly

Fetal growth restriction

Other intracranial abnormalities, such as ventriculomegaly and cerebellar atrophy

31
Q

How does Zika virus present in the mother

A

Asymptomatic

Mild flu symptoms

32
Q

Investigations for maternal Zika virus

A

Zika viral PCR and antibodies

33
Q

Management of maternal Zika virus

A

Referral to fetal medicine for fetal monitoring

Year 4 Obstetrics (60 decks)

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