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Obs & Gynae > Infections in Pregnancy > Flashcards

Infections in Pregnancy Flashcards

1
Q

What is cytomegalovirus?

A

Herpes virus

Transmitted by personal contact

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2
Q

What effect does cytomegalovirus have on the fetus?

A 
Vertical transmission occurs in 40%
10% of affected infants are symptomatic at birth
IUGR
Pneumonia
Thrombocytopenia
Deafness
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3
Q

How is cytomegalovirus diagnosed?

A

Most only diangosed when CMV is specifically requested

If maternal infection is confirmed, amniocentesis 6 weeks after will confirm transmission

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4
Q

How is CMV managed?

A

Close surveillance for USS abnormalities

Fetal blood sample at 32 weeks for platelet levels

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5
Q

What effect does herpes simplex have on the fetus?

A

Neonate infection rare but high mortality
Vertical transmission occurs at vaginal delivery if vesicles are present from recent infection (no maternal antibodies for herpes)

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6
Q

How is herpes simplex managed?

A

Refer to GUM clinic
C-section if delivering within 6 weeks of primary attack or with active lesions

Exposed infants given acyclovir

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7
Q

What effect does rubella have on the fetus?

A 
Maternal infection in early pregnancy results in worse defects
Deafness
Cardiac disease
Eye problems
Mental retardation
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8
Q

What is the management of rubella?

A

If mother develops rubella before 16 weeks, termination is offered

Offer vaccination after pregnancy

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9
Q

How does one become infected with toxoplasmosis?

A

Contact with cat faeces or soil

Eating infected meat

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10
Q

What effect does toxoplasmosis have on the fetus?

A 
Early infection causes:
Mental retardation
Convulsions
Spasticities
Visual impairment
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11
Q

How is toxoplasmosis diagnosed?

A

USS - hydrocephalus

Maternal testing because of exposure then amniocentesis

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12
Q

How is toxoplasmosis managed?

A

Spiramycin as soon as mother is diagnosed

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13
Q

What effects does herpes zoster have on the fetus?

A

Early pregnancy infection -> teratogenicity

If mother is infected in 4 weeks before delivery -> severe infection

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14
Q

How is herpes zoster managed?

A

Immunoglobulin used for prevention

Aciclovir treats infection

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15
Q

What infections are teratogenic?

A 
CMV
Rubella
Toxoplasmosis
Syphilis
Herpes zoster
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16
Q

What is parvovirus?

A

Slapped cheek appearance with arthralgia

Infection from children

17
Q

What effect does parvovirus have on the fetus?

A

Suppresses fetal erythropoiesis -> anaemia
Thrombocytopenia

Fetal death in 10% esp if before 20 weeks gestation

18
Q

How is parvovirus diagnosed?

A

Post maternal exposure or symptoms, fetal surveillance

USS - anaemia (increased blood flow in middle cerebral artery), oedema from cardiac failure

19
Q

How is parvovirus managed?

A

Scanned regularly for anaemia and blood transfusion offered if severe

20
Q

What effects does group B strep have on the fetus?

A

Usually infected during delivery after membranes have ruptured
Pre term labour
Prolonged labour
Maternal fever

Early onset neonatal group B strep sepsis

21
Q

How is group B strep managed?

A

Treatment for:

  • previous affected neonate
  • positive urinary culture
  • > 18hr rupture of membranes
22
Q

What is the effect of hep B on neonates?

A

Vertical transmission at delivery

- 90% of infected neonates become chronic carriers

23
Q

How is hep B managed?

A

Neonatal immunisation

Maternal screening

24
Q

What effect does HIV have on the mother?

A

Increased risk of pre-eclampsia

Gestational diabetes

25
Q

What effect does HIV have on the fetus?

A

Stillbirth
Pre-eclampsia
IUGR
Prematurity

Vertical transmission mostly after 36 weeks, intrapartum or during breastfeeding

26
Q

How is HIV managed?

A

Maternal antiretrovirals
Elective C-section
Avoidance of breastfeeding
Neonatal antiretroviral therapy

27
Q

How does group A strep (streptococcus pyogenes) present in the population?

A

Sore throat

Usually passed on form children

28
Q

What effect does group A strep have on pregnancy?

A

Choriomanionitis with abdo pain, diarrhoea and severe sepsis

Infected fetus dies in utero and labour ensues

29
Q

What effect does syphilis have on pregnancy?

A

Active disease in pregnancy -> miscarriage, severe congenital disease or stillbirth

Benzylpenicillin will prevent but not reverse fetal damage

30
Q

What effect does TB have on pregnancy?

A

Prematurity
IUGR
Maternal mortality

Can’t do BCG in pregnancy

31
Q

What effect does hep C have on pregnancy?

A

Vertical transmission -> chronic hepatitis

32
Q

What effect does listeria have on pregnancy?

A

Infection following consumption of pate, soft cheese, prepacked meals and causes febrile illness

Bacteraemia may cause fatal infection of fetus

33
Q

What effect does chlamydia and gonorrhoea have on the fetus?

A

Preterm labour and neonatal conjunctivitis

Chlamydia Tx: azithromycin, erythromycin
Gonorrhoea Tx: cephalosporins

34
Q

What effect does BV have on pregnancy?

A

Preterm labour
Late miscarraige

Tx: clindamycin

Obs & Gynae (20 decks)

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