Infections in Pregnancy

Question 1

Complications of bacerial vaginosis in pregnancy

Answer 1

PROM, preterm labour and birth, intrauterine and wound infections, post partum endometritis

Question 2

Treatment of BV in pregnancy

Answer 2

Clindamycin cream

Question 3

Complications of TV in pregnancy

Answer 3

Low birth weight, PROM, preterm birth, post partum sepsis

Question 4

Treatment of TV in pregnancy

Answer 4

2g metronidazole

Question 5

What does treatment not acheive in TV in pregnancy

Answer 5

Damage is done early on to the membrane and treatment does not reverse this damage.

Question 6

Rate of verticle transmission in TV

Answer 6

5%, and even lower when treated

Question 7

Risk of genital warts to neonate in pregnancy

Answer 7

Warts on vocal cords of neonates, neonatal infection and obstruction, but complications are uncommon

Question 8

Treatment of genital warts in pregnancy

Answer 8

Physical treatment using cryotherapy

Question 9

What happens to genital warts during pregnancy and after

Answer 9

During pregnancy they can get bigger and more widespread when the mothers immune system is weakened, and after delivery they often resolve

Question 10

Complications of chlamydia in pregnancy

Answer 10

Decreased birth weight, prem delivery, PROM, chorioamnionitis, post partum sepsis, can cause cervicitis and discharge

Question 11

Rate of verticle transmission in chlamydia

Answer 11

Up to 50%

Question 12

Neonatal complications of chlamydia

Answer 12

Conjunctivitis 30-50%, nasopharyngitis, otitis media, pneumonitis 10-20% presenting 4-12 months later

Question 13

Treatment of chlamydia in pregnancy

Answer 13

Azithromycin even though cure rate is only 85%

Question 14

Complications of gonorrhoea in pregnancy

Answer 14

Decreased birth weight, premature delivery, PROM, post partum sepsis, secondary infertility, causes cervicitis and discharge in mother

Question 15

Rate of vertical transmission in gonorrhoea

Answer 15

30-50%

Question 16

Neonatal complications of gonorrhoea

Answer 16

Opthalmia neonatorum and very rarely disseminated infection

Question 17

Treatment of chlamydia in pregnancy

Answer 17

Cefriaxone

Question 18

Two neonatal presentations of HSV

Answer 18

Localised to skin/eyes/mouth in 30%
Local CNS or disseminated CNS in 70%

Question 19

Which trimester is it worst to acquire herpes in

Answer 19

3rd trimester

Question 20

Treatment of HSV in 1st and 2nd trimester

Answer 20

Vaginal delivery if no labour in next 6 weeks. Aciclovir 400mg TDS from 36/40 until delivery to reduce risk of asymptomatic shedding and risk of lesions

Question 21

Treatment of HSV in 3rd trimester

Answer 21

C section delivery even if there are no visible lesions

Question 22

Rate of vertical transmission of herpes in 3rd trimester

Answer 22

41%

Question 23

Why is there almost no risk of infection in neonates if mother is infected in 1st or 2nd trimester

Answer 23

Mother has time to build up antibodies as IgM can not cross placental barrier but IgG can

Question 24

Complications of syphilis in pregnancy

Answer 24

Stillbirth, premature delivery, congenital abnormality, active disease at delivery

Question 25

When does syphilis transfer in pregnancy

Answer 25

Transplacentally from 16 weeks or at delivery

Question 26

Risk of syphilis transfer to neonate if left untreated in pregnancy

Answer 26

PRimary or secondary infection in 100%
Early latent in 40%
Late latent 5%

Question 27

Early presentation of neonates <2 years

Answer 27

2/3 asymptomatic at birth but symptoms can occur over 5 weeks including rash, lymphadenopathy, hepatosplenomegaly, skeletal abnormality, condyloma lata, pseudoparalysis, neuroocular probs ect

Question 28

Late presentation of neonates >2 years with syphilis

Answer 28

Keratitis, short maxilla, frontal bossing, deafness, learning disability, cranial nerve palsies

Question 29

Treatment of syphilis in pregnancy

Answer 29

Penicillin