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Obstetrics > Infections In Pregnancy > Flashcards

Infections In Pregnancy Flashcards

1
Q

Risk of vertical transmission of CMV in pregnancy?

A

40% in 1st and 2nd trimester
65% in 3rd trimester
(Thulsi 80% in third trimester)
Recurrent infection -1-2%

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2
Q

Ultrasound picture of fetal CMV?

A

Bilateral periventricular calcification

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3
Q

Neurodevelopmental damage in CMV?

A

10-15% (majority initially asymptomatic)

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4
Q

Treatment of falciparum anaemia?

A

Admit, oral quinine 600mg 8hourly and oral clindamycin 450mg 8hourly for 7 days

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5
Q

Treatment of vivax malaria?

A

Admit, give oral chloroquine 600mg, followed by 300mg 68 hours later, 300mg on day 2 and 3

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6
Q

Treatment of severe malaria?

A

Admit to ITU, give IV 2.4mg/kg at 0, 12, 24 hours and daily thereafter

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7
Q

What is the most likely infectious cause of symmetrical fgr?

A

CMV

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8
Q

IOL at 35/40 for fgr with reduced EDF, what is the baby most at risk of out of: aki, hepatsplenomegaly, meconium ileus, pneumonia, polycythaemia?

A

Polycythaemia (because try to increase rbc to improve oxygen delivery, therefore also at risk of hyperbilirubinaemia)

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9
Q

Mortality of severe sepsis with organ dysfunction?

A

20-40%

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10
Q

Mortality of sepsis with septic shock?

A

60% (persistent hypoperfusion despite adequate ivi)

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11
Q

Centor criteria?

A

For sore throat, need abx if >3/4 of fever, tonsillar exudate, tender LN and no cough

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12
Q

Malaria - incidence of different types?

A

80% falciparum, 13% vivax, 5.5% ovale, 2% malaria (vivax especially from Asia)

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13
Q

Mortality of severe malaria?

A

50%, vs 15-20% nonpregnant, 2-10x increase. (Malaria twice as likely generally in pregnant vs nonpregnant)

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14
Q

Malaria chemoprophylaxis?

A

Mefloquine 1st line unless epilepsy or psych hx, then give malarone = atovaquone proguanil. Doxy (teeth, cataracts, bone growth) and primaquine (haemolysis) CI. Continue mefloquine 1/12 after.

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15
Q

Side effect of quinine?

A

Hypoglycaemia

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16
Q

Ix for neonate after malaria in pregnancy?

A

Blood film at birth and weekly for 28/7 (if peripartum do placental histology)

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17
Q

Prevalence of congenital malaria?

A

8-33%

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18
Q

Treatment for listeria?

A

Amoxicillin (resistant to cephalosporins)

19
Q

Incidence of CMV?

A

0.5-2% (but most common antenatal infection, ? Accounts for >70% of infections)

20
Q

Incidence of parvovirus?

A

1.1% per year

21
Q

Transmission rates of parvovirus?

A

15%<15/40
25% 15-20/40
70% towards term

22
Q

Risks of parvovirus?

A

Miscarriage, IUD (<10%), hydrous (3%, 50% mortality)

23
Q

Rx once parvovirus dx?

A

Serial USS 4/52 after illness, then every 1-2/52 for up to 12/52

24
Q

Incidence of toxo?

A

0.2% (can get lymphadenopathy)

25
Q

Rates of transmission of toxo?

A

<1% before 4/40
4-15% at 13/40
>60% at 36/40
Highest risk of transmission if 1st trimester

26
Q

Rx of toxo?

A

Spiramycin for suspected infection - reduces risk by 60-70%

Pyrimethamine/sulfadiazine and Folinic acid 50mg weekly for confirmed feral infection (on amnio)

27
Q

Rubella incubation period?

A

14-21 days

28
Q

Proportion of women rubella non-immune?

A

1-2%

29
Q

Rubella vertical transmission?

A

90%<12/40
55% 12-16/40
45% >16/40

30
Q

Proportion of women with chlamydia who develop puerperal infection?

A

34%

31
Q

Neonates with ophthalmia neonatorum in untx chlamydia?

A

50%

32
Q

Neonates who get chlamydia pneumonitis?

A

15%

33
Q

Follow up of chlamydia?

A

Test of cure swan 5-6/52 later and repeat screening in third trimester

34
Q

Proportion of co-infection with chlamydia if gonorrhoea?

A

40%

35
Q

Ophthalmia neonatorum in gonorrhoea?

A

50%

36
Q

Proportion of women seropositive for hsv 1 and 2 at start of pregnancy?

A

50% and 25%

37
Q

Incidence of neonatal hsv?

A

1/60000

38
Q

Jarisch-herxheimer reaction in syphilis?

A

45% (resembles sepsis, from rapid release of toxins from micro organisms after abx treatment)

39
Q

Transmission of syphilis?

A

Up to 100% in early pregnancy, and 50% PTB or SB. If late infection 10%

40
Q

Most common cause of vaginal discharge?

A

Bac vag

41
Q

Amstel criteria?

A 
3/4 of:
Thing grey white discharge
Clue cells 
pH >4.5
Fishy odour on adding 10% potassium hydroxide
42
Q

Transmission of CMV?

A

40% in 1st and 2nd trimesters, 80% in 3rd

43
Q

Feral mortality with non-immune hydrops?

A

80%

Obstetrics (13 decks)

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