Infections in pregnancy - chicken pox, parovirus B19 and Toxoplasmosis Flashcards
Chicken pox -how is it spread?
- what are the symptoms?
respiratory droplets
- fever
- malaise
- vesicular rash
the period of infectivity is when for chicken pox ?
48 h before rash develops until all lesions are crusted over
Chicken pox risk in adults is higher .. they are at risk of developing? (3)
hepatitis
pneumonitis
encephalitis
important to ask women about their chicken pox history.. what should you discuss?
warned to avoid anyone with shingles or chicken pox during pregnancy - seek medical care
there Is a small risk of congenital infection in chicken pox.. when is this ?
if maternal infection is in the first 28 weeks of pregnancy
Fetal variecella syndrome can cause what ? (4)
skin scarring
congenital eye abnormalities
hypoplasia or ipsilateral limbs
neurological abnormalties
maternal infection in the last 4 weeks of pregnancy with chicken pox may cause?
risk of infection in newborn
what should be taken to check chicken pox immunity ?
serum IgG
POSITIVE = immune
negative - offer VZ immunoglobulin as soon as possible
what do you do if a pregnant women develops chicken pox?
avoid contact with other pregnant women and new born babies until lesions are crusted over
what can be prescribed If women presents with chicken pox within 24 hours from rash starting
oral aciclovir
what can be prescribed If women presents with chicken pox after 24 hours from rash starting
nothing - advice symptomatic treatment and hygiene
severe infection of chicken pox - what do you do?
IV aciclovir
- admit to hospital
shingles/ herpes zoster is caused by the ?
reactivation of the chicken pox virus which has laid dormant in the sensory nerve root ganglion
what is parvovirus also known as (3)
slapped cheek
fifth disease
erythema infectiousum
what % of women will be immune to parvovirus b19?
50 %
how does parvovirus spread?
typical symptoms on children ? (3)
Resp droplets
-fever, rash , erythema of cheeks
is there treatment for parvovirus b19?
no - most adults are also asymptomatic
parvovirus b19 can affect immunocompromised patients - what can it cause? (2)
- haemolysis
- aplatic anaemia
parvovirus b19 infection in pregnancy can lead to what effects on the foetus (3)
anaemia
- cardiac failure
- hydros fetalis
- fetal death
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?
12-20 weeks
5 weeks
parvovirus b19 infection - what testing is done/ what is offered ?
blood samples
if positive: weekly scan to monitor for fatal complications
Toxoplasmosis is caused by?
Toxoplasma gondii
Toxoplasmosis is transferred by?
- infected cat faeces
- undercooked meat - investing parasite
Toxoplasmosis is mainly asymptomatic in adults but may cause?
mild flu like symptoms - fever, sore throat, coryza, arthralgia
Toxoplasmosis - serious complications (4)
chorioretinitis
encephalitis
myocarditis
pneumonitis
when does parasitaemia occur?
- what infection is possible
within 3 weeks of ingestion
- placental infection
Toxoplasmosis - congenital/fetal complications - give some (7)
hydrocephalus intracranial calcifications microcephaly chorioretinitis ascites hepatosplenomegaly miscarriage/ intrauterine death
infection in what trimester poses the most risk with Toxoplasmosis?
3rd
what can identify Toxoplasmosis?
PCR analysis of amniotic fluid by amniocentesis
