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YR5 Obstetrics and Gynaecology > Infections in Pregnancy > Flashcards

Infections in Pregnancy Flashcards

1
Q

What are the congenital TORCH infections?

A

Toxoplasma gondii
Other: Syphilis, Parvovirus B19, VZV + Listeria
Rubella
Cytomegalovirus
Herpes Simplex 2

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2
Q

Give 4 common clinical signs of TORCH infections

A

Delayed growth
Hepatosplenomegaly
Jaundice
Thrombocytopenia

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3
Q

What is Toxoplasmosis caused by? How is usually acquired? How is it transmitted to the foetus?

A

Protozoan: Toxoplasma gondii

Contact with cat faeces/ litter
Undercooked meat, esp. pork + lamb.

Transmitted via placenta. If in first 6m- congenital toxoplasmosis

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4
Q

How does Toxoplasmosis manifest in the mother?

A

Usually asymptomatic
Lymphadenopathy (rarely)

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5
Q

What is the classic triad of congenital toxoplasmosis?

A

Chorioretinitis- yellow/ white scars on fundoscopy
Hydrocephalus- macrocephaly
Intracranial calcifications- seen on CT

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6
Q

What dermatological manifestation can arise in congenital toxoplasmosis?

A

Blueberry muffin rash
(purple-blue marks)

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7
Q

What is syphilis caused by? How is it transmitted?

A

Spirochete bacterium: Treponema pallidum

Sexual contact, inc. vaginal, anal, + oral

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8
Q

What is primary syphilis characterised by?

A

chancres (painless skin ulcers)
usually on the labia, anal region or cervix.

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9
Q

When does the second stage of syphilis occur? How can this manifest?

A

2-10w post infection- disseminated in blood stream

Generalised lymphadenopathy

Maculopapular rash: start on trunk + spread to limbs, eventually to palms, soles, genitalia, + other mucous membranes.

Condyloma lata: smooth, white, painless, wart-like lesions on genitals + around anal region.

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10
Q

How does tertiary syphilis present?

A

Gummas: granulomatous lesions form
Cardiovascular damage
Neurosyphilis

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11
Q

When is syphilis most infectious to a foetus?

A

Primary + Secondary stages
Via placenta/ during childbirth

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12
Q

What does congenital syphilis often result in?

A

Hydrops fettles: abnormal accumulation of fluid in soft tissues.
Greatly increases risk for still-birth

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13
Q

What happens to babies born with congenital syphilis?

A

Develop characteristic features:
Early signs: appear within 2y of life
Late signs: after child is 2y old

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14
Q

Give 2 early signs of congenital syphilis

A

Maculopapular rash involving palms + soles
Snuffles/ increased nasal secretions (laden with treponema)

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15
Q

What are 6 late signs of congenital syphilis?

A

Frontal bossing
Saddle nose
Short maxilla
Hutchinson teeth: small, notched, + widely spaced permanent teeth.
Saber shins: bending of shinbone or tibia.
Progessive damage to vestibulocochlear nerve (CNVIII): deafness or hearing loss.

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16
Q

How is parvovirus B19 transmitted to the mother? How is it transmitted to the foetus?

A

Mother: resp secretions
Foetus: Placenta

17
Q

What are the signs and symptoms of parvovirus B19 in the mother?

A

Arthritis: small joints of hands, wrists, knees, + feet, often symmetrical
Red cell APLASIA: decreased RBC production in BM= absence of reticulocytes in BM

18
Q

What happens to a foetus if they acquire parvovirus B19?

A

Develop anemia.
Fewer RBCs to carry oxygen, so the heart will pump a larger volume of blood to give the growing fetus all the oxygen it needs.
This raises the pressure inside fetal blood vessels, + fluid may start to leak out.
Ultimately result in hydrops fetalis- great risk for spontaneous abortion or still-birth (esp. in first half of pregnancy)

19
Q

What happens to a foetus if they survive parvovirus B19 in utero?

A

No permanent defects/ malformations

20
Q

How is VZV transmitted to the mother? How is it transmitted to the foetus?

A

Mother: Resp secretions/ Contact with the oral or skin lesions
Foetus: Placenta

21
Q

How does VZV manifest in a mother?

A

Fever, headache, + overall weakness.
After 2-3 days, develop an intensely pruritic, vesicular rash, which starts on the trunk + spreads outward, eventually covering entire body.

22
Q

When is the foetus most vulnerable to VZV?

A

First + Second trimester as still undergoing major development

23
Q

How does congenital VZV manifest?

A

Underdeveloped
Low birth weight
Limb atrophy
Microcephaly
Eye defects: cataracts (opacification of the lens)
Neuro defects: cortical atrophy or brain degeneration, + intellectual disability.

24
Q

How does Listeria present in the mother?

A

Fever
Fatigue
Gastroenteritis: D+V + abdo cramps.
Amnionitis
Sepsis

25
Q

What is Listeria? How is it transmitted to the mother? How is it transmitted to the foetus?

A

Bacteria: Listeria Monocytogenes
Mother: Unpasteurized dairy products + deli meats.
Foetus: placenta

26
Q

What are the consequences of Listeria transmission to the foetus?

A

Spontaneous abortion or still-birth.
If survives to term: may develop sepsis + meningitis (fatal if untreated)

27
Q

What is Rubella? What is it caused by? How is it transmitted to mother? How is it transmitted to foetus?

A

Rubella aka. German Measles
Virus: Rubella virus
Mother: Resp secretions
Foetus: Placenta, 1st trimester-congenital rubella syndrome.

28
Q

How does rubella manifest in the mother?

A

Maculopapular rash: starts from head + neck, spreads downward
Postauricular lymphadenopathy
Polyarthritis: >,5 joints.

29
Q

What is the characteristic triad of congenital rubella syndrome?

A

Cataracts
Congenital heart defects: PDA
Deafness

30
Q

What murmur may be heard in a baby with congenital rubella syndrome?

A

Continuous rumbling murmur, AKA “machinery” murmur.

31
Q

Which congenital infections may cause a “blueberry muffin rash”?

A

Toxoplasmosis
Rubella
Cytomegalovirus

32
Q

How is cytomegalovirus transmitted to the mother? How is it transmitted to the foetus?

A

Mother: Sexual contact/ organ transplantation.
Foetus: Placenta

33
Q

How does CMV manifest in the mother?

A

Usually asymptomatic
Some develop mononucleosis-like Sx: fever, lymphadenopathy, + sore throat.

34
Q

How does congenital CMV present? (5)

A

Petechiae
Progressive + permanent deafness
Eye abnormalities: chorioretinitis
Neuro: Seizures + intellectual disability, often a/w microcephaly.
Periventricular calcifications: seen on CT

35
Q

How is HSV-2 transmitted? When is it usually transmitted to the foetus?

A

direct contact with infected areas of the skin or mucous membranes
foetus: During birth when passing through vaginal secretions

36
Q

How does HSV-2 manifest in the mother?

A

Usually asymptomatic
Can develop genital herpes: vesicular skin lesions on vaginal mucosa, mons pubis, cervix, + labia.

37
Q

How does congenital HSV-2 present?

A

Vesicular skin lesions- mainly involve scalp, eyelid margins, + oral mucosa.
Can lead to meningoencephalitis: presents with lethargy, irritability + seizures.

YR5 Obstetrics and Gynaecology (73 decks)

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