Infections in Pregnancy Flashcards
HIV - Trimester of Risk
Late 3rd
Delivery
Breastfeeding
HIV- Effects on Foetus/Infant
Untreated 25-30% transmission rate
HIV - Treatment
HAART to all women
No breastfeeding if high viral load
IV Zidovudine prior to delivery and given to infant
CS
Vaginal delivery may be possible if viral load low
Rubella - Trimester of Risk
1st
Rubella - Effects on Foetus/Infant
Sensorineural deafness
Cataracts
CHDefects
Developmental delay
Rubella - Treatment
None if infected, focus on prevention
VZV - Trimester of Risk
All trimesters
Highest risk of foetal varicella syndrome <20/40
VZV - Effects on Foetus/Infant
FVS: Limb hypoplasia Skin scarring Deafness Developmental delay
Varicella of the newborn
VZV - Treatment
VZV Immunoglobulin
Aciclovir if infection develops
HZV - Trimester of Risk
Infant at risk if delivered vaginally within 6 weeks of infection
HZV - Effects on Foetus/Infant
Neonatal herpes - skin, eyes, mouth
CNS herpes - encephalitis
Disseminated infection
HZV - Treatment
CS if within 6 weeks of primary infection
Aciclovir if severe
CMV - Trimester of Risk
All trimesters
CMV - Effects on Foetus/Infant
IUGR Microencephaly Intracerebral calcification Developmental Cataracts Deafness
CMV - Treatment
Supportive
Toxoplasmosis - Trimester of Risk
1st & 2nd
Toxoplasmosis - Effects on Foetus/Infant
Hydrocephaly
Chorioretinits
Intracerebral calcification
Toxoplasmosis - Treatment
Spiramycin suspected
Pyrimethamine confirmed
Listeriosis - Trimester of Risk
All
Listeriosis - Effects on Foetus/Infant
Miscarriage Preterm Cerebral haem Pneumonitis Developmental
Listeriosis - Treatment
Ampicillin or co-trimoxazole
Parvovirus B19 - Trimester of Risk
All
Parvovirus B19 - Effects on Foetus/Infant
Miscarriage
Haem Anaem
Non-immune foetal hydrops
IUD
Parvovirus B19 - Treatment
Supportive
Group B Strep - Trimester of Risk
Once membranes have ruptured
Group B Strep - Effects on Foetus/Infant
Neonatal GBS disease:
Pneumonia
Sepsis
Death
Group B Strep - Treatment
IV Benzylpenicillin to carriers while in labour
Syphilis - Trimester of Risk
All tri
Syphilis - Effects on Foetus/Infant
Preterm delivery
Stillbirth
Congenital syphilis features: - may not be present at birth Hutchinson's teeth, Interstitial keratitis, Deafness = HUTCHINSON'S TRIAD Saddle nose Sabre shins Frontal bossing Enlarged liver Enlarged spleen Du Bois sign
Syphilis - Treatment
Penicillin, generally very effective
Chlamydia - Trimester of Risk
All trimesters
Chlamydia - Effects of Foetus/Infant
Preterm
Stillbirth
Neonatal chlamydia —> Pneumonia
Chlamydia - Treatment
Maternal azithromycin or doxycycline, follow-up test to determine whether cured
Foetal erythromycin if mother not cured
