Infections in pregnancy - chicken pox, parovirus B19 and Toxoplasmosis

Question 1

Chicken pox -how is it spread?

• what are the symptoms?

Answer 1

respiratory droplets

• fever
• malaise
• vesicular rash

Question 2

the period of infectivity is when for chicken pox ?

Answer 2

48 h before rash develops until all lesions are crusted over

Question 3

Chicken pox risk in adults is higher .. they are at risk of developing? (3)

Answer 3

hepatitis
pneumonitis
encephalitis

Question 4

important to ask women about their chicken pox history.. what should you discuss?

Answer 4

warned to avoid anyone with shingles or chicken pox during pregnancy - seek medical care

Question 5

there Is a small risk of congenital infection in chicken pox.. when is this ?

Answer 5

if maternal infection is in the first 28 weeks of pregnancy

Question 6

Fetal variecella syndrome can cause what ? (4)

Answer 6

skin scarring
congenital eye abnormalities
hypoplasia or ipsilateral limbs
neurological abnormalties

Question 7

maternal infection in the last 4 weeks of pregnancy with chicken pox may cause?

Answer 7

risk of infection in newborn

Question 8

what should be taken to check chicken pox immunity ?

Answer 8

serum IgG

POSITIVE = immune
negative - offer VZ immunoglobulin as soon as possible

Question 9

what do you do if a pregnant women develops chicken pox?

Answer 9

avoid contact with other pregnant women and new born babies until lesions are crusted over

Question 10

what can be prescribed If women presents with chicken pox within 24 hours from rash starting

Answer 10

oral aciclovir

Question 11

what can be prescribed If women presents with chicken pox after 24 hours from rash starting

Answer 11

nothing - advice symptomatic treatment and hygiene

Question 12

severe infection of chicken pox - what do you do?

Answer 12

IV aciclovir

- admit to hospital

Question 13

shingles/ herpes zoster is caused by the ?

Answer 13

reactivation of the chicken pox virus which has laid dormant in the sensory nerve root ganglion

Question 14

what is parvovirus also known as (3)

Answer 14

slapped cheek
fifth disease
erythema infectiousum

Question 15

what % of women will be immune to parvovirus b19?

Answer 15

50 %

Question 16

how does parvovirus spread?

typical symptoms on children ? (3)

Answer 16

Resp droplets

-fever, rash , erythema of cheeks

Question 17

is there treatment for parvovirus b19?

Answer 17

no - most adults are also asymptomatic

Question 18

parvovirus b19 can affect immunocompromised patients - what can it cause? (2)

Answer 18

• haemolysis

- aplatic anaemia

Question 19

parvovirus b19 infection in pregnancy can lead to what effects on the foetus (3)

Answer 19

anaemia

• cardiac failure
• hydros fetalis
• fetal death

Question 20

critical time period for exposure in pregnancy of parvovirus b19 infection?

• after maternal infection, how long will it take until there are signs of fatal infection?

Answer 20

12-20 weeks

5 weeks

Question 21

parvovirus b19 infection - what testing is done/ what is offered ?

Answer 21

blood samples

if positive: weekly scan to monitor for fatal complications

Question 22

Toxoplasmosis is caused by?

Answer 22

Toxoplasma gondii

Question 23

Toxoplasmosis is transferred by?

Answer 23

• infected cat faeces

- undercooked meat - investing parasite

Question 24

Toxoplasmosis is mainly asymptomatic in adults but may cause?

Answer 24

mild flu like symptoms - fever, sore throat, coryza, arthralgia

Question 25

Toxoplasmosis - serious complications (4)

Answer 25

chorioretinitis
encephalitis
myocarditis
pneumonitis

Question 26

when does parasitaemia occur?

- what infection is possible

Answer 26

within 3 weeks of ingestion

• placental infection

Question 27

Toxoplasmosis - congenital/fetal complications - give some (7)

Answer 27

hydrocephalus
intracranial calcifications
microcephaly
chorioretinitis 
ascites
hepatosplenomegaly 
miscarriage/ intrauterine death

Question 28

infection in what trimester poses the most risk with Toxoplasmosis?

Answer 28

3rd

Question 29

what can identify Toxoplasmosis?

Answer 29

PCR analysis of amniotic fluid by amniocentesis