Infections in Pregnancy Flashcards
MC bacterial infection in pregnancy
UTIs
what are UTIs and bacteriuria
with preterm delivery, preeclampsia, maternal anemia, amnionitis, and low birth weight
when should preggers get screened for UTIs
at first prenatal visit
MC UTI bug
E. coli
what does asymptomatic bacteriuria have increased risk of
pyelonephritis
is cystitis multiple or single organsim
single
most significant symptoms of cystitis
dysuria
what should you NOT use for UTIs in preggers
Sulfa (Bactrim or Septra) – inhibits folate (increased NTD)
and raises bilirubin late in pregnancy (kernicterus)
Fluoroquinolones – fetal arthropathy
Tetracyclines – affect fetal bones and teeth
what do you do after treating UTIs
test for cure
what meds do you use for UTIs
nitrofurantoin
augmentin
fosfomycin
MC urinary tract complication in preggers
pyelonephritis
what is pyelo frequently associated with
septicemia
when is pyelo MC
2nd trimester
pyelo tx
ceftriaxone favored
MC cause of neonatal sepsis
GBBHS
infant mortality of GBBHS
Infant mortality – 25% preterm, 5% term
tx of GBBHS
ampicillin or penicillin or clinda for allergies
what does TORCHES stand for
Toxoplasmosis Other (Hep B, Coxsackie, VZV, West Nile, Measles, HIV, Zika) Rubella Cytomegalovirus Herpes simplex Erythema infectiosum Syphilis
what can happen with untx toxoplasmosis
sensorineural hearing loss if untreated (28%)
congenital rubella syndrome risk highest risk in wks
8-10
what is congenital rubella syndrome
cataracts, heart defects, hearing defects
how long can you shed rubella
up to 1yr in stool
do maternal antibodies protect fetus against CMV
no
prognosis of CMV to child and what is the MC sequela
Disseminated- Mortality 12% (some statistics up to 30%)
Sensorineural hearing loss is the most common sequela of congenital CMV infection.
how is HSV contracted by the baby
**through the birth canal
when do you consider HSV
any septic neonate
do you need informed consent for HSV vaginal birth
yes
how likely is a syphilis mother to have normal baby
Mother with primary/secondary syphilis UNLIKELY to have normal infants
where can the syphilis rash appear
palms and soles!
what is pseudoparalysis of parrot and what is it associted with
syphilis and pt refuses to weight bear on painful bones
what is the only drug that can be used with infected syphilis mother
PCN
is maternal herpes zoster associated with congenital varicella syndrome?
no
when is the most critical period for parvovirus to strike
13-16wks
CHORIOAMNIONITISINTRA-AMNIOTIC INFECTION SYNDROME tx
delivery! + abx (ampicllin + gentamycin)
what drugs to NOT use in pregnancy (but could be used if its the only choice and the infection is worse than using it)
Fluoroquinolones – arthropathy (animal studies)
Streptomycin-ototoxicity
Tetracyclines- Teeth staining, growth stunting
what meds do yo avoid in 1st trimester
metronidazole
what drugs do you avoid in the 3rd trimester
Sulfonamides (hyperbilirubinemia-kernicterus)
Nitrofurantoin (hemolysis in G6PD deficiency)
postpartum fever after day 1 suspect
assume to be pelvic infection until proven otherwise
what is the most important RF in endometritis
c-section
how many organsims are involved in post partum endometritis
multiple
tx for post vaginal deliver of post partum endometritis
Gentamicin & clindamycin
tx for postc-section deliver of post partum endometritis
Ampicillin/Gentamicin & clindamycin
tx for chlamydia
Azithromycin (Zithromax) 1 gm po one dose (first-line)
Probs gonnna have terrible stomach SA
MC STI
chlamydia
gonorrhea tx
Ceftriaxone (Rocephin) 250 mg IM + azithromycin 1 g po x 1 dose
