Infections in Pregnancy

Question 1

If a pregnant woman is exposed to chicken pox, what should be done?

Answer 1

Blood test to check VZV IgG to confirm immunity
If not immune:
- VZ Ig as post-exposure prophylaxis

Question 2

What should be done if a pregnant woman presents with chickenpox?

Answer 2

Oral aciclovir within 24 hours of rash developing, if over 20 weeks gestation

Assessed by foetal medicine specialist 5 weeks after infection

Question 3

What is the effect of CMV in pregnancy?

Answer 3

If mother has never had it:
- hearing loss
- visual impairment
- mild to severe learning difficulties
- epilepsy 
(in foetus)

Question 4

What is the effect of parvovirus B19 (slapped cheek) in pregnancy?

Answer 4

Can cause severe foetal morbidity + mortality:

• severe anaemia
• heart failure
• hydrops fetalis
• death

Question 5

What are the risks of rubella infection during pregnancy?

Answer 5

Miscarriage or stillbirth
Congenital rubella syndrome of the newborn:
- sensorineural hearing loss
- congenital heart disease (most commonly PDA)
- congenital glaucoma + cataracts

Question 6

Which mode of delivery is advised for women with HIV?

Answer 6

Viral load of < 50 - offer vaginal delivery

Otherwise C-section

Question 7

What are the recommendations for feeding a baby if the mother has HIV?

Answer 7

Formula milk is recommended

Breast feeding is possible if there is an undetectable viral load and the mother is taking her ART