Infections in Pregnancy Flashcards
clinical features of chickenpox
- fever
- malaise
- itchy vesicular rash
what is the period of infectivity of chickenpox?
48hrs before rash develops to once lesions have ‘crusted’ over
- usually takes 5-7 days
Fetal Varicella Syndrome occurs in 2% of cases of maternal primary chickenpox. What fetal issues can it cause?
- skin scarring
- neurological abnormalities
- congenital eye abnormalities
- hypoplasia of ipsilateral limbs
- no increased risk miscarriage
what is the next step if a pregnant woman has had significant exposure to varicella infection, but in unsure if she is immune?
- check immunity status by taking serum IgG
- if immune (IgG positive) > reassure
- if non-immune (IgG negative) > offer varicella zoster immunoglobulin ASAP
what do you do if a pregnant woman does develop chickenpox?
- inform GP
- avoid contact with potentially susceptible individuals e.g. other pregnanct women, neonates until lesions crusted over.
- Mild infection (if presents within 24hrs from onset of rash): > 20 weeks gestation offer oral aciclovir. Also consider if under 20 weeks gestation. Advise symptomatic treatment and hygiene.
- Mild infection (if presents > 24hrs from onset of rash): advise symptomatic treatment and hygiene to prevent secondary bacterial infection.
- severe infection: give IV aciclovir, admit to hospital
how does parvovirus B19 typically present?
- fever
- rash
- erythema of the cheeks
what complications in pregnancy can parvovirus B19 cause?
- fetal anaemia
- fetal cardiac failure
- hydrops fetalis
- fetal death
which is the most critical time period for exposure to parvovirus B19 during pregnancy?
12-20 weeks
- from maternal infection, it usually takes 5 weeks before their are signs of fetal infection
if a pregnant women reports possible exposure to parvovirus B19 or possible illness, what are the next steps?
- blood samples should be taken for immunoglobulin testing
- if positive > weekly scans are offered to monitor for fetal complications
toxoplasmosis clinical features
- usually asymptomatic in adults but may cause mild, flu-like symptoms e.g. fever, sore throat, coryza, arthralgia
list the serious complications of toxoplasmosis
- chorioretinitis
- encephalitis
- myocarditis
- pneumonitis
what are the possible fetal complications of toxoplasmosis?
- hydrocephalis
- intracranial calcifications
- microcephaly
- chorioretinitis
- ventriculomegaly
- IUGR
- ascites
- hepatosplenomegaly
- miscarriage and intrauterine death
maternal infection of toxoplasmosis in which trimester puts the fetus at the highest risk?
third trimester
how can fetal infection with toxoplasmosis be diagnosed?
PCR of amniotic fluid
Hiv increases the risk of what during pregnancy?
- pre-eclampsia
- miscarriage
- preterm delivery
- low birth weight