Infections in Pregnancy Flashcards
How can infection spread
Placental Intrapartum - exposure to maternal blood / tissue Hands / respiratory tract Instruments Breast milk
If a rash presents in pregnancy what should you always investigate for
Rubella and Parovirus (present similar and affect foetus) Measles Strep Meningococcus Syphillis EBV
How does HIV spread
Transplacental
Intrapartum
Breast milk
What does HIV in pregnancy result in
Congenital HIV
How do you prevent HIV being passed to baby
Maternal ARVT if +ve Minimse invasive Intrapartum ARVT infusion C-section Advise breast Neonatal ARVT for 4-6 weeks
How is Hep B spread
Transplacental
Intrapartum
SAFE to breast fee
What does hep B in pregnancy lead to
Chronic in foetus
Cirrhosis
Or carrier
How do you prevent Hep B
Screening Immunisation to mother if -ve Avoid invasive Ig and vaccine to newborn if mother infected Further vaccines in future
How is paravirus b19 passed
Transplacental
What does it cause in foetus
Fetal loss due to cardiac failure / anaemia / fatal hydrops
What does mother present with
Rash
Fever
Arthropathy
Similar to Rubella so check serology
How do you treat parvovirus if exposed
Passive Ig if in contact
What does influenza cause in pregnancy so what do you do
More severe
Premature and small baby
Give inactivated vaccine
How is CMV spread
Transplacentla
Intrapartum
Breast milk
What are the consequences of CMV
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
How is HSV spread
Intrapartum
What is the risk of HSV in neonate
Neonatal herpes
Encephalitis
High mortality
How do you prevent HSV in nenate
Elective C section
Avoid invasive procedures
Oral acyclovir prophylaxis to mother
How is VZV spread
Transplacental
Intrapartum
What are the consequences of VZV
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
What do you do if pregnant women comes in contact with VZV
Establish immunity by checking if had chicken pox or AB
Passive immunisation if in contact <10 days if IgG -ve
What do you do if mother develops chicken pox / shingles
Chicken pox = acyclovir if within 24 hours of rash
Shingles = no risk
NO VACCINE in pregnancy
How is Rubella spread
Transplacental
What does congenital rubella syndrome cause
Sensorineural deaf Eye - cataract / retinopathy / microphtalmia Congenital heart - PA stenosis / PDA Growth retardation HSM Purpuric skin Cerebral palsy
Less motor / cognitive than CMV
What are the symptoms of Rubella
Rash Arthropathy Fever Flu Miscarriage
What do you do if in contact with Rubella
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
How will a mother with TB present
Cough
Fever
Weight loss
What do you do if mother gets TB
BCG to all babies
Isoniazid until +ve Mantoux
What does measles cause to foetus
IUD
Pre-term
How does measles present in mother
Rash Fever Cough Coryza COnjunctivits Enephalitis Pneumonia
How do you treat measles
Passive immunisation if exposed to prevent neonatal pan encephalitis
How does enterovirus spread
Faecal-oral
Transplacental
What does enterovirus cause
Fever Meningitis Myocarditis Sepsis HFMD
What do you do if outbreak of enterovirus
Resp sample / vesicle swab
Infection control
Ig to neonate exposed
Why do you check for asymptomatic bacteria in UTI
Risk of IUGR and pre-term
What are the effects of toxoplasma Gondi
Congenital toxoplasmosis Convuslions Calcification Hydrocephalus Microcephaly Microthelmia Anaemia, HSM, cerebral palsy
How is toxoplasma Gondi spread
Transplacental
Cats are main source
How do you Dx and Rx toxoplasmosis Gondi
Serology
Steroid
What is chlamydiosis
Bacterial disease caused by chlamydia psittaci
Still birth
Miscarriage
Avoid lambing / milking or live vaccine
What can you get from soft cheese or unpatuerised milk
Listeria monocytogenes
How does listeria monocytogenes present
Bacteraemia
Flu
Miscarriage
Fever - do culture in any pregnancy women feel >48 hours
What does listeria cause in newborn
Still born IRDS - pneumonia Nenatal meningitis Convulsion HSM Rash Fever
How do you Dx
Culture
How do you treat
Amoxicillin
Gentamicin
What are complications of whooping cough
Bronchopneumonia Cerebral hypoxia and brain damage Weight loss - vomit Epistaxis Facial oedema Ulceration of tongue Otitis media
How do you prevent
Immunisation to pregnant women and vaccine to newborn
What is group B strep
Common commensal of genital tract
What does group B cause
UTI
Septic abortion
Meningitis / sepsis in newborn
Do you screen for GBS
NO
May be found on swab or urine culture if clinically indicated
When would you screen for GBS
If previous GBS
Who gets prophylactic benpen in labour
GBS in pregnancy discovered
Previous baby with GBS
Pre-term
Any fever
What are RF for neonatal GBS
Premature
PPROM
Previous sibling GBS
Maternal fever
When would you have low threshold for Ax in neonate
Monitor if 1 RF above
If 2+ RF then IV Ax and full septic screen
