infections in pregnancy

Question 1

what causes rubella

Answer 1

togavirus

Question 2

when is rubella most dangerous in pregnancy

Answer 2

8-10 weeks

Question 3

maternal symptoms rubella

Answer 3

flu, polyarthritis, rash, fever, lymph

Question 4

congenital rubella syndrome

Answer 4

sensorineural deafness // cataracts // heart disease // growth retardation // hepatosplenomegaly // chorioretinitis

Question 5

diagnosis maternal rubella

Answer 5

IgM // (also check parvovirus)

Question 6

mx rubella

Answer 6

discuss with local health protection unit

Question 7

when can MMR vaccine be given in pregnancy

Answer 7

only in post-natal (contraindicated in pregnancy)

Question 8

risks of chicken pox to moother

Answer 8

pneumonitis

Question 9

when is Fetal varicella syndrome most common in pregnancy

Answer 9

before 20 weeks (up to 280

Question 10

symptoms Fetal varicella syndrome

Answer 10

skin scar // eye defects // limb hypoplasia // microcephaly

Question 11

management of chicken pox exposure pregnancy if <20

Answer 11

check for varicella antibody –> IV Ig ASAP (up to 10 days post exposure)

Question 12

management of chicken pox exposure pregnancy if >20

Answer 12

check for antibodies –> IV Ig or aciclovir (give 7-14 days AFTER exposure)

Question 13

mx chicken pox in pregnancy

Answer 13

refer // oral aciclovir within 24 hours of rash

Question 14

what family does CMV belong too

Answer 14

herpes

Question 15

features congenital CMV

Answer 15

deaf and blind // IUGR // microcephaly // petechial blueberry muffin skin

Question 16

when is CMV most likely to cause disability

Answer 16

2nd semester

Question 17

invx CMV

Answer 17

IgG

Question 18

mx CMV pregnancy

Answer 18

Valacyclovir or hyper immune globin

Question 19

mx cold sore pregnancy

Answer 19

1st or 2nd trimester oral aciclovir // 3rd = aciclovir and recommend C section

Question 20

mx HIV pregnancy

Answer 20

HART

Question 21

delivery HIV

Answer 21

vaginal delivery if CD4 <50 at 26 weeks

Question 22

if c section in HIV what is given before delivery

Answer 22

IV zidovudine

Question 23

mx neonate born to HIV mother

Answer 23

maternal CD4 <50 = oral zidovudine // maternal CD4 >50 = triple ART

Question 24

breastfeeding HIV

Answer 24

advice bottle feeding

Question 25

mx baby born to hep B mother

Answer 25

vaccination + hep B Ig

Question 26

breastfeeding and hep B

Answer 26

ok to breastfeed

Question 27

most common cause of early severe infection in pregnancy

Answer 27

group B strep

Question 28

RF for group B strep neonatal infection

Answer 28

premature // prolonged rupture of membranes // maternal pyexia eg chorioamnionitis

Question 29

mx for group B strep infection in mothers with previous GBS

Answer 29

intrapartum antibiotic prophylaxis OR testing in late pregnancy + abx

Question 30

who should recieve antiobiotic prophylaxis for GBS

Answer 30

previous baby with GBS, late onset disease, pyrexia during labour >38

Question 31

abx given in group B strep pregnancy

Answer 31

pen V

Question 32

what is Chorioamnionitis

Answer 32

ascending bacterial infection of amniotic fluid or placenta

Question 33

RF Chorioamnionitis

Answer 33

preterm premature rupture of membanes

Question 34

mx Chorioamnionitis

Answer 34

delivery + IV abx