Infections in Pregnancy

Question 1

Which babies are most at risk of infection by Strep B?

Answer 1

Preterm babies, fetus in the uterus after membrane is ruptured for >18 hours.

Question 2

What is done to treat or prevent Strep B infection?

Answer 2

IV penicillin is given to mum at risk

Question 3

What conditions or circumstances will increase the risk of vertical transfer of strep B infection and therefore warrant the administration of IV antibiotics?

Answer 3

Previous history of strep B infection, intrapartum fever >38 degree celsius, current preterm labour, and rupture of membranes >18 hours

Question 4

What does TORCHS stand for?

Answer 4

TO - Toxoplasmosis
R - Rubella
C - Cytomegalovirus CMV
H - Herpes Simplex virus
S - Syphilis

Question 5

What causes Toxoplasmosis and how is Toxoplasmosis spread?

Answer 5

Toxoplasmosis is caused by Toxoplasma gondii parasite.

It is found in meat, infected cats’ faeces, and soil or unwashed vegetables contaminated with infected cats’ faeces.

Question 6

The risk of vertical transmission of Toxoplasmosis increase/decrease as pregnancy progresses?

Answer 6

Increase.

Risk of vertical transmission increases as pregnancy progresses

Question 7

What is the effect Toxoplasma gondii has on the neonate?

Answer 7

Risk of miscarriage if contracted in the first trimester or before conception.
Developmental issues such as hydrocephalus, retinochoroiditis (inflammation of retina) and brain damage.

Question 8

What medication is given if toxoplasmosis is detected in pregnant women? How does this medication help?

Answer 8

Antibiotic Spiramycin is given once maternal infection is diagnosed.
Spiramycin can only help reduce risk of vertical transmission, and is not active against parasite.

Question 9

When will it be most dangerous to the unborn foetus if infected with Rubella?

Answer 9

Rubella infection in the first 20 weeks of gestation is most dangerous to the foetus

Question 10

How can Rubella infection affect pregnancy?

Answer 10

Cause miscarriage, stillbirth and birth defects such as hearing loss, brain damage, heart defects or cataracts.

Question 11

Can MMR vaccination be given during pregnancy?

Answer 11

No, as it is a live vaccine. Avoid becoming pregnant for 1 month after vaccination

Question 12

What sign or symptom is indicative of infection with Rubella?

Answer 12

Rash

Question 13

What is offered if a non-immune woman develops Rubella before 16 weeks of gestation?

Answer 13

Termination of pregnancy is offered if non-immune woman is infected with Rubella before 16 weeks of gestation.

Question 14

Will severity of birth defects and malformation by Rubella infection increase/decrease with advancing gestation?

Answer 14

Severity of malformation decreases with advancing gestation

Question 15

Is CMV dangerous to the foetus if she was once infected with CMV in the past and is now infected during pregnancy?

Answer 15

No, as there is a smaller risk of transmission to the baby

Question 16

In what scenario is Herpes Simplex infection most likely to infect babies?

Answer 16

Herpes Simplex virus is most likely to affect neonates during vaginal delivery, especially if it follows a recent primary maternal infection.

Question 17

What is the management of pregnant mothers delivering within 6 weeks of primary infection with Herpes Simplex virus?

Answer 17

Caeserean section

Question 18

Is C-section recommended for those with recurrent Herpes Simplex infection?

Answer 18

No, as the foetus will have passive immunity from maternal antibodies.

Question 19

What medication is given for those with syphilis? How will this medication help?

Answer 19

Prompt treatment with benzylpenicillin. This will help prevent, but not reverse fetal damage.

Question 20

Which test is done for Syphilis?

Answer 20

VDRL test

Venereal Disease Research Laboratory test