Infections in Pregnancy

Question 1

HIV - Trimester of Risk

Answer 1

Late 3rd
Delivery
Breastfeeding

Question 2

HIV- Effects on Foetus/Infant

Answer 2

Untreated 25-30% transmission rate

Question 3

HIV - Treatment

Answer 3

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

Question 4

Rubella - Trimester of Risk

Answer 4

1st

Question 5

Rubella - Effects on Foetus/Infant

Answer 5

Sensorineural deafness
Cataracts
CHDefects
Developmental delay

Question 6

Rubella - Treatment

Answer 6

None if infected, focus on prevention

Question 7

VZV - Trimester of Risk

Answer 7

All trimesters

Highest risk of foetal varicella syndrome <20/40

Question 8

VZV - Effects on Foetus/Infant

Answer 8

FVS:
Limb hypoplasia
Skin scarring
Deafness
Developmental delay

Varicella of the newborn

Question 9

VZV - Treatment

Answer 9

VZV Immunoglobulin

Aciclovir if infection develops

Question 10

HZV - Trimester of Risk

Answer 10

Infant at risk if delivered vaginally within 6 weeks of infection

Question 11

HZV - Effects on Foetus/Infant

Answer 11

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

Question 12

HZV - Treatment

Answer 12

CS if within 6 weeks of primary infection

Aciclovir if severe

Question 13

CMV - Trimester of Risk

Answer 13

All trimesters

Question 14

CMV - Effects on Foetus/Infant

Answer 14

IUGR
Microencephaly
Intracerebral calcification
Developmental
Cataracts
Deafness

Question 15

CMV - Treatment

Answer 15

Supportive

Question 16

Toxoplasmosis - Trimester of Risk

Answer 16

1st & 2nd

Question 17

Toxoplasmosis - Effects on Foetus/Infant

Answer 17

Hydrocephaly
Chorioretinits
Intracerebral calcification

Question 18

Toxoplasmosis - Treatment

Answer 18

Spiramycin suspected

Pyrimethamine confirmed

Question 19

Listeriosis - Trimester of Risk

Answer 19

All

Question 20

Listeriosis - Effects on Foetus/Infant

Answer 20

Miscarriage
Preterm
Cerebral haem
Pneumonitis
Developmental

Question 21

Listeriosis - Treatment

Answer 21

Ampicillin or co-trimoxazole

Question 22

Parvovirus B19 - Trimester of Risk

Answer 22

All

Question 23

Parvovirus B19 - Effects on Foetus/Infant

Answer 23

Miscarriage
Haem Anaem
Non-immune foetal hydrops
IUD

Question 24

Parvovirus B19 - Treatment

Answer 24

Supportive

Question 25

Group B Strep - Trimester of Risk

Answer 25

Once membranes have ruptured

Question 26

Group B Strep - Effects on Foetus/Infant

Answer 26

Neonatal GBS disease:
Pneumonia
Sepsis
Death

Question 27

Group B Strep - Treatment

Answer 27

IV Benzylpenicillin to carriers while in labour

Question 28

Syphilis - Trimester of Risk

Answer 28

All tri

Question 29

Syphilis - Effects on Foetus/Infant

Answer 29

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

Question 30

Syphilis - Treatment

Answer 30

Penicillin, generally very effective

Question 31

Chlamydia - Trimester of Risk

Answer 31

All trimesters

Question 32

Chlamydia - Effects of Foetus/Infant

Answer 32

Preterm
Stillbirth

Neonatal chlamydia —> Pneumonia

Question 33

Chlamydia - Treatment

Answer 33

Maternal azithromycin or doxycycline, follow-up test to determine whether cured
Foetal erythromycin if mother not cured