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Obs & Gynae > Infections in Pregnancy > Flashcards

Infections in Pregnancy Flashcards

1
Q

How can infection spread

A 
Placental 
Intrapartum - exposure to maternal blood / tissue 
Hands / respiratory tract
Instruments
Breast milk
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2
Q

If a rash presents in pregnancy what should you always investigate for

A 
Rubella and Parovirus (present similar and affect foetus) 
Measles
Strep
Meningococcus
Syphillis
EBV
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3
Q

How does HIV spread

A

Transplacental
Intrapartum
Breast milk

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4
Q

What does HIV in pregnancy result in

A

Congenital HIV

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5
Q

How do you prevent HIV being passed to baby

A 
Maternal ARVT if +ve
Minimse invasive
Intrapartum ARVT infusion
C-section
Advise breast
Neonatal ARVT for 4-6 weeks
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6
Q

How is Hep B spread

A

Transplacental
Intrapartum
SAFE to breast fee

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7
Q

What does hep B in pregnancy lead to

A

Chronic in foetus
Cirrhosis
Or carrier

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8
Q

How do you prevent Hep B

A 
Screening 
Immunisation to mother if -ve
Avoid invasive 
Ig and vaccine to newborn if mother infected
Further vaccines in future
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9
Q

How is paravirus b19 passed

A

Transplacental

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10
Q

What does it cause in foetus

A

Fetal loss due to cardiac failure / anaemia / fatal hydrops

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11
Q

What does mother present with

A

Rash
Fever
Arthropathy
Similar to Rubella so check serology

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12
Q

How do you treat parvovirus if exposed

A

Passive Ig if in contact

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13
Q

What does influenza cause in pregnancy so what do you do

A

More severe
Premature and small baby
Give inactivated vaccine

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14
Q

How is CMV spread

A

Transplacentla
Intrapartum
Breast milk

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15
Q

What are the consequences of CMV

A 
Growth retardation 
Mental retardation / LD
Microcephaly 
Sensorineural Deafness
Visual loss 
Seizures 
More motor and cognitive impairment than Rubella 
Purpuric rash - blueberry muffin 
Encephalitis
IUGR 
HSM
Anaemia
Thrombocytopenia 
Jaundice  
Cerebral palsy
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16
Q

How is HSV spread

A

Intrapartum

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17
Q

What is the risk of HSV in neonate

A

Neonatal herpes
Encephalitis
High mortality

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18
Q

How do you prevent HSV in nenate

A

Elective C section
Avoid invasive procedures
Oral acyclovir prophylaxis to mother

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19
Q

How is VZV spread

A

Transplacental

Intrapartum

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20
Q

What are the consequences of VZV

A 
Greater risk of more severe infection e.g. pneumonitis / encephalitis in mother 
Fetal varicella syndrome
- Fatal growth restriction 
-Eye defects - microphanthia / cataract 
-Skin scar
-Limb hypoplasia
-Microcephaly
- Hydrocephalus 
-LD
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21
Q

What do you do if pregnant women comes in contact with VZV

A

Establish immunity by checking if had chicken pox or AB

Passive immunisation if in contact <10 days if IgG -ve

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22
Q

What do you do if mother develops chicken pox / shingles

A

Chicken pox = acyclovir if within 24 hours of rash
Shingles = no risk
NO VACCINE in pregnancy

23
Q

How is Rubella spread

A

Transplacental

24
Q

What does congenital rubella syndrome cause

A 
Sensorineural deaf
Eye - cataract / retinopathy / microphtalmia 
Congenital heart - PA stenosis / PDA
Growth retardation
HSM
Purpuric skin
Cerebral palsy

Less motor / cognitive than CMV

25
Q

What are the symptoms of Rubella

A 
Rash
Arthropathy
Fever
Flu
Miscarriage
26
Q

What do you do if in contact with Rubella

A

Check IgM and IgG

MMR vaccine post partum if found but can’t give if pregnant as CI as live vaccine so jut avoid if not immune

27
Q

How will a mother with TB present

A

Cough
Fever
Weight loss

28
Q

What do you do if mother gets TB

A

BCG to all babies

Isoniazid until +ve Mantoux

29
Q

What does measles cause to foetus

A

IUD

Pre-term

30
Q

How does measles present in mother

A 
Rash 
Fever
Cough
Coryza
COnjunctivits 
Enephalitis 
Pneumonia
31
Q

How do you treat measles

A

Passive immunisation if exposed to prevent neonatal pan encephalitis

32
Q

How does enterovirus spread

A

Faecal-oral

Transplacental

33
Q

What does enterovirus cause

A 
Fever
Meningitis
Myocarditis
Sepsis
HFMD
34
Q

What do you do if outbreak of enterovirus

A

Resp sample / vesicle swab
Infection control
Ig to neonate exposed

35
Q

Why do you check for asymptomatic bacteria in UTI

A

Risk of IUGR and pre-term

36
Q

What are the effects of toxoplasma Gondi

A 
Congenital toxoplasmosis 
Convuslions
Calcification
Hydrocephalus
Microcephaly 
Microthelmia
Anaemia, HSM, cerebral palsy
37
Q

How is toxoplasma Gondi spread

A

Transplacental

Cats are main source

38
Q

How do you Dx and Rx toxoplasmosis Gondi

A

Serology

Steroid

39
Q

What is chlamydiosis

A

Bacterial disease caused by chlamydia psittaci
Still birth
Miscarriage
Avoid lambing / milking or live vaccine

40
Q

What can you get from soft cheese or unpatuerised milk

A

Listeria monocytogenes

41
Q

How does listeria monocytogenes present

A

Bacteraemia
Flu
Miscarriage
Fever - do culture in any pregnancy women feel >48 hours

42
Q

What does listeria cause in newborn

A 
Still born
IRDS - pneumonia
Nenatal meningitis
Convulsion
HSM
Rash
Fever
43
Q

How do you Dx

A

Culture

44
Q

How do you treat

A

Amoxicillin

Gentamicin

45
Q

What are complications of whooping cough

A 
Bronchopneumonia
Cerebral hypoxia and brain damage
Weight loss - vomit
Epistaxis
Facial oedema
Ulceration of tongue
Otitis media
46
Q

How do you prevent

A

Immunisation to pregnant women and vaccine to newborn

47
Q

What is group B strep

A

Common commensal of genital tract

48
Q

What does group B cause

A

UTI
Septic abortion
Meningitis / sepsis in newborn

49
Q

Do you screen for GBS

A

NO

May be found on swab or urine culture if clinically indicated

50
Q

When would you screen for GBS

A

If previous GBS

51
Q

Who gets prophylactic benpen in labour

A

GBS in pregnancy discovered
Previous baby with GBS
Pre-term
Any fever

52
Q

What are RF for neonatal GBS

A

Premature
PPROM
Previous sibling GBS
Maternal fever

53
Q

When would you have low threshold for Ax in neonate

A

Monitor if 1 RF above

If 2+ RF then IV Ax and full septic screen

Obs & Gynae (23 decks)

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