Infections in pregnancy Flashcards
When to screen for GBS if previous history in pregnancy
35-37 weeks
When is intrapartum antibiotic prophylaxis indicated for GBS
What drug is used for IAP
GBS bacteruria or on high vaginal swab during pregnancy
Previous baby with GBS
Fever during labour
Benzylpenicillin
Mode of delivery in GBS
Induce at term
Neonatal care in GBS
Blood culture
FBC, CRP
Start antibiotics (benzylpenicillin +/- gentamicin)
Signs to look out for in neonate in GBS
Abnormal behaviour Floppy Difficulty feeding Pyrexia Rapid breathing Skin colour change
Organism responsible for GBS
Streptococcus agalactiae
Risks of BV
Prematurity
Low birth weight
Risks of trichomonas vaginitis
PPROM
Low birthweight
Risks of gonorrhoea
Chorioamnionitis
Maternal disseminated gonococcal infection
Neonatal sepsis
Neonatal conjunctivitis
Risks of chlamydia
Chorioamnionitis
Neonatal conjunctivitis
Neonatal sepsis
Risks of rubella
Cataracts PDA Deafness Low IQ Microcephaly
Risks of CMV
Fetal mortality 30%
Fetal hepatosplenomegaly and deafness
Risks of HSV
Fetal:
Viral sepsis
Mouth and skin ulcers
Encephalitis
Reduce risk with C/S
Risks of hep B/C
Fetal chronic hepatitis
Risks of syphilis
Still birth
Fetal hepatosplenomegaly and deafness
TORCH
Toxoplasmosis Other - syphilis, hep B/C Rubella Cytomegalovirus Herpes simplex
Treatment of BV in pregnancy
Can’t give stat dose of metronidazole
400mg BD for 5 days
Management of HIV
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
UTI treatment in pregnancy
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
