Infections In Pregnancy

Question 1

What is the treatment for community acquired pneumonia in pregnancy?

Answer 1

1st Line: Macrolide OR beta-OA tam

Question 2

What are the effects of tetracyclines (including doxycycline) on the fetus in pregnancy?

Answer 2

Fetal Teeth Staining

Bone Growth Suppression

Question 3

What is the risk of sulfonamides in pregnancy?

Answer 3

Kernicterus

Question 4

What peripartum recommendations would you suggest in a pregnant women with active genital HSV lesions?

Answer 4

C-section to reduce neonatal exposure.

Consider acyclovir starting at 36 + weeks to suppress an outbreak.

Question 5

When would you treat HBV during pregnancy and what treatment regimen would you recommend?

Answer 5

(1) Start antiviral therapy between 28-32 weeks if HBV DNA > 200 000
(2) Tenofovir is the preferred treatment
(3) Breast Feeding OK
(4) Infant will need hep b vaccine and IVIG (consult paediatrics)

Question 6

What is the recommended management of hepatitis C in pregnancy?

Answer 6

(1) Treat postpartum if identified during pregnancy.

(2) Do not breast feed during antiviral therapy.

Question 7

Which vaccines SHOULD NOT be given during pregnancy?

Answer 7

Live Attenuated Vaccines:

• Varicella
• MMR
• Rabies
• Yellow Fever
• Nasal Influenza

Question 8

Which vaccines are OK to give during pregnancy, as indicated?

Answer 8

Inactivated Influenza
Tdap - to be given in every pregnancy between 21-32 weeks GA
Pneumococcal in Asthma
Hepatitis A or B for travel or household exposures.
Meningococcal