Infections in Pregnancy Flashcards
What is the commonest cause of neonatal sepsis?
Group B streptoccocus
What is the management for definite or suspected Group B strep in a mother?
Intrapartum IV benzypenicillin
What are some of the consequences of CMV infection during pregnancy on the foetus?
HEaring loss Visual impairment / blindness learning difficulties Epilepsy Congenital infection complications
What are the outcomes seen in a congenital CMV infection in the pregnancy?
IUGR Pin-point petechial "blueberry muffin appearance" on skin Jaundice Microcephaly Sensorineural hearing loss Encephalitis Hepatosplenomegaly Cataracts Developmental delay
What is the management of mothers with CMV?
Supportive management
At what trimester is HIV the highest risk?
Third trimester (plus delivery and breastfeeding)
What is the rate of transmission between HIV mothers and baby when there is no anti-retroviral therapy?
25-30%
What is the rate of HIV transmission from mother to foetus if mother is on HAART?
<2%
Can HIV positive women delivery vaginally and breastfeed?
They can deliver vaginally if undetectable viral load
Breastfeeding is still not recommended
What % of women infected with rubella will show symptoms?
Roughly on 30-50% of women show symptoms
What trimester is most dangerous for a pregnant women to have rubella?
1st trimester
very low risk in 2nd and 3rd
What are some of the consequences for the foetus if a mother becomes infected with rubella?
Congenital Rubella Syndrome: Sensorineural deafness Cataracts Congenital heart defects Developmental delay
What are some clinical signs and symptoms of a rubella infection?
Maculopapular rash
Lymphadenopathy
Arthritis
What is foetal varicella syndrome?
Limb hypoplasia
Skin scarring
Deafness
Developmental delay
How is varicella zoster managed in pregnancy?
VZV immunoglobulin to prevent infection if they’ve been potentially exposed and have never been infected.
If a mother develops a varicella infection what can be given?
Aciclovir
(and immunoglobulins if needed) + supportive management
What are some of the symptoms of a varicella infection in a pregnant mother?
Fever
Lethargy
Pruritic rash with characteristic vesicles
Increased morbidity and mortality due to increased risk of encephalitis, pneumonia and hepatitis
At what stage in the pregnancy is there the highest risk of foetal varicella syndrome ?
<20/40 weeks
What symptoms might a pregnant woman present with in herpes zoster?
Genital vesicles
Pain
Dysuria
Why should a foetus be delivered by c-section if its within six weeks of initial/primary exposure to herpes zoster?
After 6 weeks the mother will have developed maternal antibodies and they can cross the placenta so the foetus will be protected if delivered vaginally.
However if it’s before 6 weeks then those antibodies will not have come into effect yet and a vaginal delivery would be risky for the foetus.
Can you treat a pregnant woman with aciclovir if they have an ongoing herpes zoster infection?
Yes but try to only do so if severe.
What infection during pregnancy can lead to the foetus developing hydrocephalus, chorioretinitis and intracerebral calcification?
Toxoplasmosis
What medications can be used to treat a toxoplasmosis infection in prenancy?
Spiramycin
If severe or foetal infection possible, give pyrimethamine
A mother presents with a flu like illness with fever back ache and myalgia. The only thing she can think of that might have caused it was the meal she had at the restaurant a few days ago. What is the probably infective organsim?
Listeria
patient is presenting with signs and symptoms of listeriosis
How is listeriosis managed?
Ampicillin or co trimoxazole
What are some of the risks to the foetus in a listeriosis infection?
Miscarriage / preterm labour Meconium stained liquor Cerebral haemorrhage Pneumonitis Developmental delay
A pregnant woman was infected with chicken pox. At what stage post infection is the optimum point to check for any foetal abnormalities?
5 weeks post infection
What common infection is associated with risk of foetal haemolytic anaemia, hydrops fetalis, IUD and miscarriage?
Parvovirus B19
How is parvovirus managed in pregnancy?
Supportive management
If foetus severely affected preterm delivery of an intrauterine transfusion may be required
What % of women tend to be carriers of Group B strep?
25%
At what point in the pregnancy is the foetus most at risk from Group B strep?
Once membranes have ruptured
Prolonged ROM has an even higher risk
In a pregnancy affected by a rubella infection, a reassuring foetal scan rules out the concerns for congenital rubella syndrome. True or false?
False
Aspects of congenital rubella syndrome may not be apparent on a foetal scan
