Infections In Pregnancy Flashcards
Congenital rubella syndrome effects
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
Precautions for rubella
Women thinking about pregnancy should have the MMR vaccine before becoming pregnant
Cannot have live vaccine during pregnancy
If ensure about vaccination status
Tested for immunity - infection antibodies
MMR vaccine
2 doses, 3 months apart
Not giving during pregnancy
Consequences of chicken pox during pregnancy
More severe cases in the mother - varicella pneumonitis, hepatitis or encephalitis
Fetal varicella syndrome
Severe neonatal varicella infection (if infected around delivery)
When in doubt about chicken pox immunity status
IgG levels for varicella zoster
Pregnant ladies not immune to chicken pox
Varicella vaccine before or after pregnancy
IV varicella immunoglobulins during pregnancy within 10 days of exposure
Avoid people with chicken pox
Management of chickenpox during pregnancy
Oral aciclovir- if present within 24 hours and are more than 20 weeks gestation
Congenital varicella syndrome effects
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)
When can a baby get congenital varicella syndrome
Infection occurs in the first 28 weeks of gestation
Causative organism of listeriosis
Listeria - gram-positive bacteria
Presentation of listeriosis in pregnant women
Asymptomatic
Flu like illness
Can cause pneumonia or meningioencephalitis
Complications of listeriosis in pregnancy
Miscarriage
Severe neonatal infection
How is listeria transmitted
Through unpasteurised dairy products, processed meats and contaminated foods
How to avoid listeriosis in pregnancy
Avoid high-risk foods (e.g. blue cheese) and practice good food hygiene
When does Congenital Cytomegalovirus occur
Cytomegalovirus (CMV) infection in the mother during pregnancy
How is CMV spread
Via infected saliva or urine
Features of congenital CMV
Fetal growth restriction Microcephaly Hearing loss Vision loss Learning disability Seizures
Causative organism of congenital toxoplasmosis
Toxoplasmosis gondii - parasite
Transmission of toxoplasmosis gondii
Via faeces from an infected cat
Presentation of toxoplasmosis in mother
Usually asymptomatic
Features of congenital toxoplasmosis
Triad:
- Intracranial calcification
- Hydrocephalus
- Chorioretinitis (inflammation of the choroid and retina in the eye
Complications of parvovirus during pregnancy
Miscarriage
Severe fetal anaemia
Hydrops fetalis (fetal heart failure)
Maternal pre-eclampsia-like syndrome
What congenital infection causes fetal anaemia
Parvovirus infection of the erythroid progenitor cells in the fetal bone marrow and liver
Maternal pre-eclampsia-like syndrome (mirror syndrome)
Rare complication of severe fetal heart failure (hydrops fetalis).
Triad of:
- hydrops fetalis
- placental oedema
- Maternal oedema
Also features hypertension and proteinuria
Investigations for parvovirus during pregnancy
- 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)
Treatment of parvovirus during pregnancy
Supportive
Referral to fetal medicine - monitor complications and malformation
How is Zika virus spread
Aedes mosquito
Intercourse with an infected individual
Where is Zika virus prevalent
Brazil
South America
Congenital Zika syndrome features
Microcephaly
Fetal growth restriction
Other intracranial abnormalities, such as ventriculomegaly and cerebellar atrophy
How does Zika virus present in the mother
Asymptomatic
Mild flu symptoms
Investigations for maternal Zika virus
Zika viral PCR and antibodies
Management of maternal Zika virus
Referral to fetal medicine for fetal monitoring
