infections in pregnancy Flashcards
what infections can cause miscarriage?
- chlamydiosis
2. listeria monocytogenes
what infections can affect the unborn baby?
- rubella
- chicken pox
- parvo virus
- CMV
- Zika virus
- syphilis
- toxoplasmosis
what are the symptoms of rubella?
fever, malaise, mild conjunctivitis, transitory rash
when is rubella a risk in pregnancy?
first trimester, <13 weeks can result in severe fatal damage in up to 90% of cases
what anomalies can rubella cause in pregnancy?
cataracts, deafness, cardiac anomalies, microcephaly, growth retardation, inflammatory lesions of brain, liver, lungs, bone marrow
what are symptoms of CMV?
malaise, fever, lymphadenopathy
how is CMV transmitted?
bodily fluids - saliva, urine, blood
good hand hygiene is important
when is CMV harmful to baby?
1st trimester - risk of transplacental infection 40%
what are the manifestations ofCMV infection in baby?
microcephaly, neurological abnormalities, growth restriction, mental retardation
20-30% will die
80% survivors have serious disabilities
how is rubella transmitted?
droplets
how is Parvo virus B19 spread?
droplets
why is rubella now rare in women?
immunisations from 1970 for women, then universal MMR from 1988
what does Zika virus cause in babies?
microcephaly
major abnormalities
what rash does parvo virus produce?
slapped cheeks
what does parvo virus do?
attacks red blood cells, leading to fatal anaemia
infection in 1st 20wks may result in miscarriage/ intrauterine death or hydros fetalis
what is the presentation o chicken pox?
characteristic vesicular rash, fever, malaise, 2-3 weeks incubation
what are the risk of chicken pox to mum?
pneumonia, hepatitis, encephalitis,
what are the risks of chicken pox to fetus?
anomaly if infected before 20wks
fetal varicella syndrome = scars, limb development
what are the risks of chicken pox to neonate?
varicella infection of newborn (congenital varicella) if mum has it late in pregnancy and then deliver baby. due to mum not being able to pass on IgG to baby, can give baby IgG to protect them
where can you get toxoplasmosis?
uncooked meat, contaminated fruit/veg, soil/cat faeces
give health advice
when is risk highest baby with toxoplasmosis?
early in pregnancy = severe consequences
rare
what infections are pregnancy women screened for?
syphilis
hep b
HIV
what is syphilis associated with? and how is it treated?
late miscarriage, hydros, LBW
easily treated with penicillin
what are the TORCH infections?
toxoplasmosis rubella CMV herpes \+ parvo virus
what infections can be transmitted at delivery?
blood borne viruses - hep B,C, HIV
group B strep
herpes
chlamydia
what are the risks of hep B?
90% of infected babies will get chronic infection -> 20-25% have progressive liver disease
what groups are at risk of hep B?
high prevalence areas
family member with it
IVDU or partner
tattoos/piercing
what is the highest risk of HIV transmission?
3rd trimester (delivery and breastfeeding)
what is the HIV transmission associated with?
maternal viral load
aim to get levels to undetectable, minimise contact with maternal body fluids at birth, avoid breastfeeding, give prophylactic drugs to baby
what is the leading cause of serious neonatal infection?
group B strep
what can GBS result in?
sepsis, pneumonia, meningitis
incidence not high but devastating
what babies are at risk of GBS?
PROM, premature babies, colonised mothers (give mum penicillin before delivery to reduce incidence)
why isn’t there screening for GBS?
risk of anaphylaxis to treatment
may contribute to resistance
may change faecal flora and affect immune development
what treatment is given to women with herpes in pregnancy?
acyclovir in 3rd trimester
less of a concern if had previous infections
if its new then would recommend c-section
what can chlamydia cause to neonates?
pneumonia and conjuncitivitis
what infections can affect the mother?
urine infections, mastitis, chicken pox, influenza, pyelonephritis, uterine infections (chorioamnionitis)
what is the risk of BV?
premature delivery
treatment given to women at risk with metronidazole
what is chorioamnonitis?
ascending infection from vagina
- ruptured membranes
long labour
multiple examinations
what are post natal infection?
endometritis
mastitis
wound infections - section or perineal
what are symptoms of maternal sepsis?
fever, diarrhoea, vomiting, abode pain, rash, urine symptoms, bleeding, discharge etc
need treatment as causes maternal deaths
normally caused by E.coli, Group A strep, staph a
how do you prevent infection in pregnancy?
screening (syphilis, Hep b, HIV) health advice public health measures testing contacts awareness and observations
