Infections in Pregnancy Flashcards

1
Q

clinical features of chickenpox

A
  • fever
  • malaise
  • itchy vesicular rash
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2
Q

what is the period of infectivity of chickenpox?

A

48hrs before rash develops to once lesions have ‘crusted’ over
- usually takes 5-7 days

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3
Q

Fetal Varicella Syndrome occurs in 2% of cases of maternal primary chickenpox. What fetal issues can it cause?

A
  • skin scarring
  • neurological abnormalities
  • congenital eye abnormalities
  • hypoplasia of ipsilateral limbs
  • no increased risk miscarriage
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4
Q

what is the next step if a pregnant woman has had significant exposure to varicella infection, but in unsure if she is immune?

A
  • check immunity status by taking serum IgG
  • if immune (IgG positive) > reassure
  • if non-immune (IgG negative) > offer varicella zoster immunoglobulin ASAP
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5
Q

what do you do if a pregnant woman does develop chickenpox?

A
  • 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
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6
Q

how does parvovirus B19 typically present?

A
  • fever
  • rash
  • erythema of the cheeks
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7
Q

what complications in pregnancy can parvovirus B19 cause?

A
  • fetal anaemia
  • fetal cardiac failure
  • hydrops fetalis
  • fetal death
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8
Q

which is the most critical time period for exposure to parvovirus B19 during pregnancy?

A

12-20 weeks
- from maternal infection, it usually takes 5 weeks before their are signs of fetal infection

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9
Q

if a pregnant women reports possible exposure to parvovirus B19 or possible illness, what are the next steps?

A
  • blood samples should be taken for immunoglobulin testing
  • if positive > weekly scans are offered to monitor for fetal complications
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10
Q

toxoplasmosis clinical features

A
  • usually asymptomatic in adults but may cause mild, flu-like symptoms e.g. fever, sore throat, coryza, arthralgia
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11
Q

list the serious complications of toxoplasmosis

A
  • chorioretinitis
  • encephalitis
  • myocarditis
  • pneumonitis
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12
Q

what are the possible fetal complications of toxoplasmosis?

A
  • hydrocephalis
  • intracranial calcifications
  • microcephaly
  • chorioretinitis
  • ventriculomegaly
  • IUGR
  • ascites
  • hepatosplenomegaly
  • miscarriage and intrauterine death
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13
Q

maternal infection of toxoplasmosis in which trimester puts the fetus at the highest risk?

A

third trimester

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14
Q

how can fetal infection with toxoplasmosis be diagnosed?

A

PCR of amniotic fluid

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15
Q

Hiv increases the risk of what during pregnancy?

A
  • pre-eclampsia
  • miscarriage
  • preterm delivery
  • low birth weight
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16
Q

list the aims of combined anti-retroviral treatment (cART) in a pregnant woman

A
  1. viral load < 50 HIV RNA copies/ml (allows vaginal delivery)
  2. reduce risk of vertical transmission (avoid breastfeeding)
  3. improve mothers health
17
Q

pregant women with chronic hepatitis b virus with a high viral load should be offered which treatment?

A
  • tenofovir monotherapy in the 3rd trimester to reduce the risk of transmission of hepatitis B to the baby
18
Q

what is the management of a baby who has been born to a mother with hepatitis B infection?

A
  • hepatitis b immunoglobulin
  • accelerated immunisation schedule
  • initial dose of vaccine at birth, within 24hrs of delivery, with further doses at 4 weeks and 8 weeks and a fourth dose at 12 months of age
  • test for hepatitis at 1 year of age
19
Q

if a pregnant woman if infected with syphilis there is an increased risk of…

A
  • miscarriage
  • stillbirth
  • hydrops fetalis
  • growth restriction
  • congenital infection
20
Q

if a pregnant woman is positive for syphilis infection, what is the treatment?

A
  • intramuscular penicillin
21
Q

what is Hutchinson’s triad?

A

A triad of symptoms frequently found in children with syphilis contracted transplacentally:
- deafness
- interstitial keratitis
- Hutchinson’s teeth: widely spaced, peg-like