Infections in Pregnancy Flashcards by Adam Davie

HIV - Trimester of Risk

Late 3rd
Delivery
Breastfeeding

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HIV- Effects on Foetus/Infant

Untreated 25-30% transmission rate

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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

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Rubella - Trimester of Risk

1st

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Rubella - Effects on Foetus/Infant

Sensorineural deafness
Cataracts
CHDefects
Developmental delay

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Rubella - Treatment

None if infected, focus on prevention

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VZV - Trimester of Risk

All trimesters

Highest risk of foetal varicella syndrome <20/40

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VZV - Effects on Foetus/Infant

FVS:
Limb hypoplasia
Skin scarring
Deafness
Developmental delay

Varicella of the newborn

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VZV - Treatment

VZV Immunoglobulin

Aciclovir if infection develops

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HZV - Trimester of Risk

Infant at risk if delivered vaginally within 6 weeks of infection

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HZV - Effects on Foetus/Infant

Neonatal herpes - skin, eyes, mouth
CNS herpes - encephalitis
Disseminated infection

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HZV - Treatment

CS if within 6 weeks of primary infection

Aciclovir if severe

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CMV - Trimester of Risk

All trimesters

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CMV - Effects on Foetus/Infant

IUGR
Microencephaly
Intracerebral calcification
Developmental
Cataracts
Deafness

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CMV - Treatment

Supportive

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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