infections in pregnancy Flashcards
chicken pox symptoms
fever
malaise
vesicular rash
chicken pox period of infectivity
48hrs before onset rash until lesions have crusted over
usually 5-7days
chicken pox and pregnancy risks
pregnant women at risk of more severe disease (immunocompromised)
small risk congenital infection in first 28wks
if infected last 4wks pregnancy risk infection in newborn
advise avoid exposure and seek medical advice if do
chicken pox: pregnant woman exposed
check immune status - serum IgG
if immune reassure
if no immunity give varicella zoster Ig ASAP
pregnant women gets chicken pox: what to do if mild infection and <24hrs since rash onset
oral aciclovir
if >20wks
consider if <20wks
pregnant women gets chicken pox: what to do if mild infection and >24hrs since rash onset
aciclovir has no role
symptomatic Rx
hygeine to avoid 2ry bacterial infection
pregnant women gets chicken pox: what to do if severe infection
IV aciclovir
hospital admission
parovirus B19
spread by resp secretions
fever, rash, erythema of cheeks
what can parovirus B19 infection in pregnancy cause
fetal anaemia: cardiac failure, hydrops fetalis, death
maternal eclampsia w significant oedema
if pregnant woman exposed to parovirus B19
check immunity - serum Ig
weekly scans to monitor for complications
parovirus B19 critical exposure period in pregnancy
12-20wks
fetal infection 5wks after maternal infection
toxoplasmosis
protozoa organism toxoplasma gondii
mild-flu like illness: sore throat, arthralgia, coryza, fever
toxoplasmosis severe complications
chorioretinitis
encephalitis
myocarditis
pneumonitis
toxoplasmosis when is placental infection possible
parasitaemia 3wks after ingestion
placental infection possible during pregnancy and immediately prior to pregnancy
pregnant women told to avoid cat litter trays and undercooked meat
toxoplasmosis congenital infection
infection 3rd trimester highest risk
PCR of amniotic fluid can identify toxoplasmosis and confirm congenital infection
toxoplasmosis congenital infection complications
hydrocephalus intracranial calcifications microcephaly IUGR ventriculomegaly hepatosplenomegaly inc risk misscarriage and IUD
HIV increases risk of
PET
misscarriage
pre-term delivery
low birth weight
HIV: fetal monitoring
serial 4wkly fetal growth scans
HIV: aims anteretrovirla treatment
viral load <50 for vaginal birth
reduce risk vertical transmission
improve mums health
HIV: viral load <50
vaginal birth
HIV: viral load 50-399
consider pre-labour CS 38-90wks
HIV: viral load 400+
prelabour CS 38-39wks recommended
babies born to mum w acute hepB infection
high risk contracting HBV at birth and risk live chirrhosis and hepatocellular cancer
women with chronic HBV infection with high viral load
tenovivir monotherapy 1st trimester
babies born to HBV +ive mum
hepB Ig
accelerated immunisation schedule (at birth, 4wks, 8wks, 12mo)
hep C virus
RNA virus
can lead to hepatitis, chronic liver disease, inc risk liver Ca
indications to offer HCV antenatal screening
- mum IVDU
- mum past Hx IVDU
- mum current/prev IVDU partner
- hepatitis screen due to derranged LFTs
- mum HIV+ or HBV+
HCV Rx in pregnancy
none
drugs teratogenic
syphilis Rx pregnant woman
prompt IM penicillin
syphilis increases risk of
misscarriage hydrops fetalis still birth growth restriction congenital infection
syphilis congenital infection
most develop Sx 5wks after birth
hutchinosn’s triad: deaf, interstitial keratitis, hutchinson’s teeth
penicillin
how is syphilis spread to baby
trans-placentally
lesion exposure at birth
