Infections in pregnancy - hep B,C, HIV and syphills Flashcards

1
Q

what infections are screened for at the booking appointment

A

hep b, HIV, syphillis

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2
Q

HIV doesn’t increase the risk of?

what does it increase risk of (4)

A

congenital abnormalities

  • pre-eclampsia
  • miscarriage
  • low birth weight
  • pre term delivery
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3
Q

what can be offered to women with HIV whilst pregnant

A

serial 4 weekly fetal growth scans

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4
Q

babies born to HIV positive women should be?

A

referred for HIV testing to neonatology

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5
Q

MDT input includes

A
  • obs consultant team
  • com midwifery team
  • hiv specialist
  • neonatologist
  • GP
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6
Q

aims of combined anti-retroviral treatment include? (cART) (3)

A
  • viral load <50 HIV rna copies = allows for vaginal delivery
  • reduce risk of vertical transmission
  • improve mothers health
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7
Q

what increases the risk of vertical transmission of hiv

A

breastfeeding

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8
Q

throughout pregnancy with HIV- women need frequent monitoring of ? (3)

A

LFT’S
CD4 count
HIV viral load

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9
Q

viral load > 400 in HIV??

A

PRE-LABOUR CS recommended between 38 and 39 weeks

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10
Q

What can also be recommended for hiv?

A

intrapartum anti retro viral infusions

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11
Q

how are many cases of hep B spread?- how else does it spread

A

vertical transmission

blood and bodily fluids

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12
Q

Acute hep B infection in pregnancy can be?

A

very severe

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13
Q

babies born to women with acute hep b infection at birth will?

A

contract hep b
cirrhosis
hepatocellular cancer

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14
Q

Women with chronic HBV with HIGH viral load should be offered?

A

tenofovir monotherapy in 3rd trimester to reduce risk of transmission

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15
Q

HEP b vaccine can be given to pregnant women safely as it is?

A

inactivated

- can be give to high risk IV drug uses or IVDU partner or who has HIV/HBV

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16
Q

what should be offered to babies whos mother has hep B

what will they get given?

A

hep b immunoglobulin
accelerated immunisation schedule

  • initial dose of the vaccine at birth within 24hrs of delivery
17
Q

tests for hep b at 1 year old will show?

less response to vaccine seen in?

A

where treatment wasn’t successful

  • who is chronically infected
  • may be lower in preterm or low weigh babies
18
Q

Hep C can lead to? (RNA virus)

A

severe hepatitis
chronic liver disease
increased risk of liver cancer

19
Q

Hep C is found in what % of pregnant women ?

A

1-2%

20
Q

most cases of hep c are associated with

A

prior injecting drug use

21
Q

pregnancy in women with hep c is associated with

A

declining liver function

22
Q

when is vertical transmission higher in hep C

A

if the women is co infected with HIV

23
Q

When should HEP C screening be offered? (4)

A
  • history of IV drug use / current substance missuse
  • hep B or HIV
  • PREV OR CURRENT partner with ivdu
  • deranged liver function tests
24
Q

Hep C infection should not be treated in pregnancy.. why?

A

the drugs used are teratogenic

  • you can breastfeed
25
Q

What is syphilis caused by?

A

Treponema pallidum

-skin lesion spread during sexual contact

26
Q

syphilis can be cured by?

A

course of antibiotics - IM penicillin

27
Q

if left untreated syphilis can cause?

A

neurological, cardiac, skeletal and skin abnormalities

for adults and babies affected in utero

28
Q

infection more than once is possible in ?

A

syphilis

29
Q

syphilis infection is associated with an increase risk of? (5)

A
miscarriage
stillbirth 
hydrops fetalis 
growth restriction 
congenital infection
30
Q

syphilis can be transferred from baby to mother.. (2)

A

trans placentally

exposure to infected lesion at time of birth

31
Q

Primary syphilis is characterised by?

- if left untreated?

A

painless local ulcer - chancre

- secondary syphilis - tertiary (20-40) years

32
Q

congenital infection of syphilis can present in

2/3 of neonates will be?

A

first 2 years of life

- asymptomatic at birth

33
Q

babies at risk of congenital infection must be referred to?

A

neonatology

34
Q

congenital infection of syphilis - what is in HUTCHINSON’S TRIAD (3)

A

deafness
interstitial keratitis
hutchinson’s teeth , widely spaced - peg like