Infections in pregnancy

Question 1

Answer 1

B - from subtropical country, therefore history not reliable

Question 2

Answer 2

A - not in exposed area

Question 3

Answer 3

H - smoker, unwell. Needs assessment and oral or IV acyclovir

Question 4

Answer 4

D - can be given again after 3 weeks.
Acyclovir can also be given again from 7 days after exposure if still non-immune

Question 5

Answer 5

A - baby also immune as antibodies cross placenta in the last 3 months of a term pregnancy (passive immunity is present). This increases if baby is BF

Question 6

Answer 6

D - as baby premature, passive immunity has not yet been established. Antibodies only pass in the last 3 months of a term pregnancy, and this is boosted if baby BF

Question 7

Answer 7

F

Because baby was born within 7 days of the rash, outcomes are significantly worse and baby has a high risk of severe disease. IgM should not be awaited until VZIG is given.
- If maternal infection 1 week before or after delivery, there is a 50% chance of infection and 23% chance of clinical disease

Question 8

Answer 8

As below 20 weeks, consider acyclovir. FMU assessment should be performed at 16-20 weeks or 5 weeks after disease onset.
Maternal risks are higher in late pregnancy; fetal risks are higher in early pregnancy (but still less than 1% infection)