infections in pregnancy Flashcards
what causes rubella
togavirus
when is rubella most dangerous in pregnancy
8-10 weeks
maternal symptoms rubella
flu, polyarthritis, rash, fever, lymph
congenital rubella syndrome
sensorineural deafness // cataracts // heart disease // growth retardation // hepatosplenomegaly // chorioretinitis
diagnosis maternal rubella
IgM // (also check parvovirus)
mx rubella
discuss with local health protection unit
when can MMR vaccine be given in pregnancy
only in post-natal (contraindicated in pregnancy)
risks of chicken pox to moother
pneumonitis
when is Fetal varicella syndrome most common in pregnancy
before 20 weeks (up to 280
symptoms Fetal varicella syndrome
skin scar // eye defects // limb hypoplasia // microcephaly
management of chicken pox exposure pregnancy if <20
check for varicella antibody –> IV Ig ASAP (up to 10 days post exposure)
management of chicken pox exposure pregnancy if >20
check for antibodies –> IV Ig or aciclovir (give 7-14 days AFTER exposure)
mx chicken pox in pregnancy
refer // oral aciclovir within 24 hours of rash
what family does CMV belong too
herpes
features congenital CMV
deaf and blind // IUGR // microcephaly // petechial blueberry muffin skin
when is CMV most likely to cause disability
2nd semester
invx CMV
IgG
mx CMV pregnancy
Valacyclovir or hyper immune globin
mx cold sore pregnancy
1st or 2nd trimester oral aciclovir // 3rd = aciclovir and recommend C section
mx HIV pregnancy
HART
delivery HIV
vaginal delivery if CD4 <50 at 26 weeks
if c section in HIV what is given before delivery
IV zidovudine
mx neonate born to HIV mother
maternal CD4 <50 = oral zidovudine // maternal CD4 >50 = triple ART
breastfeeding HIV
advice bottle feeding
mx baby born to hep B mother
vaccination + hep B Ig
breastfeeding and hep B
ok to breastfeed
most common cause of early severe infection in pregnancy
group B strep
RF for group B strep neonatal infection
premature // prolonged rupture of membranes // maternal pyexia eg chorioamnionitis
mx for group B strep infection in mothers with previous GBS
intrapartum antibiotic prophylaxis OR testing in late pregnancy + abx
who should recieve antiobiotic prophylaxis for GBS
previous baby with GBS, late onset disease, pyrexia during labour >38
abx given in group B strep pregnancy
pen V
what is Chorioamnionitis
ascending bacterial infection of amniotic fluid or placenta
RF Chorioamnionitis
preterm premature rupture of membanes
mx Chorioamnionitis
delivery + IV abx
