Infections in pregnancy

Question 1

When to screen for GBS if previous history in pregnancy

Answer 1

35-37 weeks

Question 2

When is intrapartum antibiotic prophylaxis indicated for GBS

What drug is used for IAP

Answer 2

GBS bacteruria or on high vaginal swab during pregnancy
Previous baby with GBS
Fever during labour

Benzylpenicillin

Question 3

Mode of delivery in GBS

Answer 3

Induce at term

Question 4

Neonatal care in GBS

Answer 4

Blood culture
FBC, CRP
Start antibiotics (benzylpenicillin +/- gentamicin)

Question 5

Signs to look out for in neonate in GBS

Answer 5

Abnormal behaviour
Floppy
Difficulty feeding 
Pyrexia
Rapid breathing
Skin colour change

Question 6

Organism responsible for GBS

Answer 6

Streptococcus agalactiae

Question 7

Risks of BV

Answer 7

Prematurity

Low birth weight

Question 8

Risks of trichomonas vaginitis

Answer 8

PPROM

Low birthweight

Question 9

Risks of gonorrhoea

Answer 9

Chorioamnionitis
Maternal disseminated gonococcal infection
Neonatal sepsis
Neonatal conjunctivitis

Question 10

Risks of chlamydia

Answer 10

Chorioamnionitis
Neonatal conjunctivitis
Neonatal sepsis

Question 11

Risks of rubella

Answer 11

Cataracts 
PDA
Deafness
Low IQ
Microcephaly

Question 12

Risks of CMV

Answer 12

Fetal mortality 30%

Fetal hepatosplenomegaly and deafness

Question 13

Risks of HSV

Answer 13

Fetal:
Viral sepsis
Mouth and skin ulcers
Encephalitis

Reduce risk with C/S

Question 14

Risks of hep B/C

Answer 14

Fetal chronic hepatitis

Question 15

Risks of syphilis

Answer 15

Still birth

Fetal hepatosplenomegaly and deafness

Question 16

TORCH

Answer 16

Toxoplasmosis
Other - syphilis, hep B/C
Rubella
Cytomegalovirus
Herpes simplex

Question 17

Treatment of BV in pregnancy

Answer 17

Can’t give stat dose of metronidazole

400mg BD for 5 days

Question 18

Management of HIV

Answer 18

Start mother on antiretroviral drugs
Avoid invasive procedures during pregnancy
Plan for C/S unless viral load undetectable
Start baby on ARV for 4 weeks
NO BREASTFEEDING, even in undetectable viral load

Question 19

UTI treatment in pregnancy

Answer 19

Send sample for MCS

If <32 weeks can give Nitrofurantoin 7 days but preferably not in third trimester I.e not beyond 28 weeks

If >12 weeks can give
Trimethoprim 7 days