Infections in pregnancy Flashcards by Michael Gray

How does chicken pox present?

Fever
Malaise
Itchy vesicular rash

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How is chicken pox spread?

Respiratory droplets

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What is the period of infectivity for chicken pox?

48h before the rash develops until all the lesions have crusted over (5-7 days after rash starts usually)

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How does chicken pox affect children?

Usually harmless and self-limiting

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What are the risks of contracting chicken pox as an adult?

Hepatitis
Encephalitis
Pneumonitis
Greater risk in immunocompromised

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When is there a risk of congenital infection?

When a non-immune pregnant woman is exposed within the first 28 weeks of pregnancy

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Does fetal varicella syndrome increase risk of miscarriage?

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How does fetal varicella syndrome present?

Skin scarring
Congenital eye abnormalities
Hypoplasia of ipsilateral limbs
Neuro abnormalities

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What is the risk of congenital infection if the mother is exposed in the last 4 weeks of pregnancy?

Significant

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What test is taken if a woman who is unsure if she is immune has been exposed to chicken pox?

Serum IgG to check her immunity status
If IgG positive, we just need to reassure
If IgG negative then VZ immunoglobulin should be offered asap

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How is severe VZ infection managed in pregnant women?

IV aciclovir

Admit to hospital

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What are some other names for parvovirus b19?

Slapped cheek disease
Fifth disease
Erythema infectiosum

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How is parvovirus b19 spread?

Respiratory droplets

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How does parvovirus b19 present in children?

Fever
Rash
Erythema of cheeks

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How does parvovirus b19 present in adults?

Usually asymptomatic

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Is there a vaccine available for parvovirus b19?

How can parvovirus b19 infection affect pregnancy?

Fetal anaemia
Cardiac failure
Fetal death
Hydrops fetalis

What is hydrops fetalis?

A condition in the fetus characterised by an accumulation of fluid, or oedema, in at least two fetal compartments

What is the critical period for infection of parvovirus b19 during pregnancy?

12-20 weeks

How is parvovirus b19 infection in pregnancy managed?

Serum IgG taken

If positive weekly scans are offered to monitor fetal abnormalities

What causes toxoplasmosis?

Toxoplasmogondii

How is toxoplasmosis usually contracted?

Infected cat faeces

Undercooked meats

How does toxoplasmosis present in adults?

Usually asymptomatic

May cause flu like symptoms (Sore throat, coryza, arthralgia)

Can toxoplasmosis increase risk of miscarriage or intrauterine death?

Yes

Does HIV increase risk of congenital abnormalities?

What are some risks associated with HIV in pregnancy?

Pre-eclampsia Preterm delivery Low birth weight

What are the aims of combined ant-retroviral treatment (cART)?

Reduce viral load Reduce risk of vertical treatment Improve mother's health

Does breastfeeding increase or decrease the chance of vertical transmission of HIV?

Increase

What are some measurements taken to check up on HIV risk throughout pregnancy?

CD4 count LFTs whilst on cART HIV viral load

What does low viral load indicate?

Vaginal birth supported

How is Hep B usually spread?

Vertical transmission | Blood and other body fluids

What are some conditions which Hep B contraction at birth could from mother could predispose you to?

Liver cirrhosis | Hepatocellular cancer

How are mothers with chronic HBV and high viral load managed?

Tenofivir monotherapy in 3rd trimester to reduce risk of transmission

How are babies managed when mother has Hep B?

Hep B immunoglobulins at birth | Accelerated immunisation schedule

Does breastfeeding increase Hep C transmission?

Which pathogen causes syphilis?

Treponema pallidum

Can syphilis be cured?

Yes | IM penicillin course

How may syphilis be transmitted from mother to child?

Trans-placental | Exposure to lesion at birth

When can congenital syphilis present?

Usually first 2 years of life | Most develop symptoms within 5 weeks