Infections in pregnancy Flashcards
How does chicken pox present?
Fever
Malaise
Itchy vesicular rash
How is chicken pox spread?
Respiratory droplets
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)
How does chicken pox affect children?
Usually harmless and self-limiting
What are the risks of contracting chicken pox as an adult?
Hepatitis
Encephalitis
Pneumonitis
Greater risk in immunocompromised
When is there a risk of congenital infection?
When a non-immune pregnant woman is exposed within the first 28 weeks of pregnancy
Does fetal varicella syndrome increase risk of miscarriage?
No
How does fetal varicella syndrome present?
Skin scarring
Congenital eye abnormalities
Hypoplasia of ipsilateral limbs
Neuro abnormalities
What is the risk of congenital infection if the mother is exposed in the last 4 weeks of pregnancy?
Significant
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
How is severe VZ infection managed in pregnant women?
IV aciclovir
Admit to hospital
What are some other names for parvovirus b19?
Slapped cheek disease
Fifth disease
Erythema infectiosum
How is parvovirus b19 spread?
Respiratory droplets
How does parvovirus b19 present in children?
Fever
Rash
Erythema of cheeks
How does parvovirus b19 present in adults?
Usually asymptomatic
Is there a vaccine available for parvovirus b19?
No
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?
No
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?
No
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
