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Obs and Gynae > infections in pregnancy > Flashcards

infections in pregnancy Flashcards

1
Q

what causes congenital rubella syndrome and when is the highest risk?

A

Caused by maternal infection with rubella virus in first 20 weeks
-highest risk <8-10 weeks

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2
Q

what should women who are planning to get pregnant do to protect them from rubella?

A

women planning to get pregnant should receive MMR vaccine
-if in doubt can check antibody levels to test for rubella immunity

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3
Q

what should non rubella immune pregnant women do?

A

-they should NOT receive MMR during pregnancy as it is a live attenuated vaccine
-should be offered the vaccine after giving birth

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4
Q

how does congenital rubella syndrome present?

A

Triad of:
-Cataracts (congenital blindness)
-Congenital deafness
-Cardiac abnormalities (PDA + pulmonary stenosis)

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5
Q

apart from congenital rubella syndrome- what can a rubella infection cause in pregnancy?

A

-miscarriage
-still birth
-other birth defects

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6
Q

how does rubella present?

A

-Fever
-Rash that starts on face and spreads across the body
-lymphadenopathy
-polyarthritis

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7
Q

management of rubella in pregnancy?

A

Rubella specific IgG antibody can be detected after natural infection or vaccination

-Blood IgM should be done within 10 days of exposure
-If patient not immune consider TOP
-Avoid contact with other pregnant women

suspected cases should be discussed with the local health protection unit

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8
Q

what causes measles?

A

paramyxovirus

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9
Q

Symptoms of measles?

A

-fever
-white spots inside mouth (Koplik spots)
-Runny nose
-Cough
-Red eyes
-Rash

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10
Q

what can measles cause in pregnancy?

A

Non teratogenic!

Can cause very high fever though:
-IUGR
-Microcephaly
-Miscarriage
-Stillbirth and Preterm birth

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11
Q

management of measles in pregnancy?

A

supportive care

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12
Q

what causes chicken pox?

A

varicella zoster virus (VZV)

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13
Q

how is chicken pox transmitted?

A

transmission mainly via droplets

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14
Q

symptoms of chicken pox?

A

-fever
-malaise
-vesicular rash

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15
Q

are women who have previously been infected with varicella zoster virus at risk?

A

No
-previous infection of varicella zoster means they are safe

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16
Q

what should be done if women are not sure about their varicella zoster immunity?

A

Test their VZV IgG levels
-if positive they are safe

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17
Q

what should be done when a rash starts after chicken pox exposure?

A

if they present within 24 hours and are >20 weeks give oral aciclovir

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18
Q

management of exposure to chicken pox <20 weeks?

A

<20 weeks give VZIG

19
Q

when would congenital varicella syndrome occur?

A

Usually if there is a varicella zoster infection within the first 28 weeks

20
Q

Presentation of congenital varicella syndrome?

A

-fetal growth restriction
-Microcephaly, hydrocephalus and learning disability
-Scars and significants skin changes located in specific dermatomes
-Limb hypoplasia (underdeveloped limbs)
-Cataracts and inflammation in the eye (chorioretinitis)

21
Q

is listeria gram positive or gram negative?

A

gram positive

22
Q

is listeriosis more common in pregnant or non pregnant individuals?

A

much more common in pregnant individuals

23
Q

how does listeriosis present?

A

infection in the mother may be asymptomatic or cause a flu like illness

-less commonly cause pneumonia or meningoencephalitis

24
Q

how is listeria transmitted?

A

-pasteurised dairy products, processed meats and contaminated foods

e.g. pate and soft cheese

25
Q

fetal complications if mother is infected with listeriosis?

A

-Miscarriage
-Fetal death (due to spepticaemia)
-Severe neonatal infection
-Stillbirth
-Preterm labour

26
Q

treatment- listeriosis?

A

Ampicillin + gentamicin

Trimethoprim + sulfamethoxazole

27
Q

what foods should be avoided- listeriosis?

A

Unpasteurized milk, soft cheese, refrigerated smoked seafood (salmon, trout, cod)

28
Q

what causes a CMV infection?

A

-human herpes virus family group

29
Q

how is CMV infection spread?

A

usually spread via infected saliva or urine of asymptomatic children

30
Q

complications of CMV in pregnancy?

A

Miscarriage, stillbirth, IUGR, microcephaly, mental retardation

Most causes do not cause congenital CMV
-but congenital CMV is a potential complication

31
Q

presentation of congenital cytomegalovirus?

A

HEARING LOSS= BIG ONE

-Fetal growth restriction
-Microcephaly
-Hearing loss
-Vision loss
-Learning disability
-Seizures

32
Q

management of CMV infection?

A

Check IgG levels in previous seronegative mother

if positive= Valocyclovir

33
Q

what is Parvovirus also known as?

A

slapped cheek syndrome
OR
erythema infectiosum

34
Q

what causes slapped cheek syndrome AKA erythema infectiosum?

A

Parvovirus B19

35
Q

presentation of Parvovirus infection?

A

-Starts with non specific viral symptoms

usually in children

after 2-5 days:
-rash appears quite rapidly as a diffuse bright red rash on both cheeks (slapped cheek)
-Few days later a reticular mildly erythematous rash affecting the trunk and limbs appears (net like rash)

36
Q

what can being infected with parvovirus in pregnancy leads to?

A

Infections with Parvovirus B19 in pregnancy can leaf to:
-Hydops fetalis (fetal heart failure)
-Miscarriage or fetal death
-Severe fetal anaemia
-Maternal pre eclampsia like syndrome

37
Q

management if infected with Parvovirus?

A

Diagnostic test- Detection of virus with specific IgM

Avoid contact with other children and pregnant women, but only contagious 7-10 days before rash and 24 hours after

Referal to fetal medicine

38
Q

complications of mumps infection in pregnancy?

A

No ill effects on pregnancy

remember MMR is CI in pregnancy

39
Q

is influenzae virus safe during pregnancy and breast feeding?

A

yes

40
Q

how does congenital zika syndrome present?

A

-Microcephly
-Fetal growth restriction
-Caranial abnormalities (ventriculomegaly and cerebellar atrophy)

41
Q

can HIV be passed through pregnancy and what may affect this?

A

yes there is vertical transmission of 14-25%
-higher in preterm birth and prolonged rupture of membranes
-lower if viral load is undetectable

42
Q

what is offered in labour against Group B streptococcus?

A

Penicillin

43
Q

what treatment is given for chlamydia in pregnancy?

A

-erythromycin and amoxicillin

Obs and Gynae (61 decks)

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