Infections in pregnancy - hep B,C, HIV and syphills Flashcards
what infections are screened for at the booking appointment
hep b, HIV, syphillis
HIV doesn’t increase the risk of?
what does it increase risk of (4)
congenital abnormalities
- pre-eclampsia
- miscarriage
- low birth weight
- pre term delivery
what can be offered to women with HIV whilst pregnant
serial 4 weekly fetal growth scans
babies born to HIV positive women should be?
referred for HIV testing to neonatology
MDT input includes
- obs consultant team
- com midwifery team
- hiv specialist
- neonatologist
- GP
aims of combined anti-retroviral treatment include? (cART) (3)
- viral load <50 HIV rna copies = allows for vaginal delivery
- reduce risk of vertical transmission
- improve mothers health
what increases the risk of vertical transmission of hiv
breastfeeding
throughout pregnancy with HIV- women need frequent monitoring of ? (3)
LFT’S
CD4 count
HIV viral load
viral load > 400 in HIV??
PRE-LABOUR CS recommended between 38 and 39 weeks
What can also be recommended for hiv?
intrapartum anti retro viral infusions
how are many cases of hep B spread?- how else does it spread
vertical transmission
blood and bodily fluids
Acute hep B infection in pregnancy can be?
very severe
babies born to women with acute hep b infection at birth will?
contract hep b
cirrhosis
hepatocellular cancer
Women with chronic HBV with HIGH viral load should be offered?
tenofovir monotherapy in 3rd trimester to reduce risk of transmission
HEP b vaccine can be given to pregnant women safely as it is?
inactivated
- can be give to high risk IV drug uses or IVDU partner or who has HIV/HBV
what should be offered to babies whos mother has hep B
what will they get given?
hep b immunoglobulin
accelerated immunisation schedule
- initial dose of the vaccine at birth within 24hrs of delivery
tests for hep b at 1 year old will show?
less response to vaccine seen in?
where treatment wasn’t successful
- who is chronically infected
- may be lower in preterm or low weigh babies
Hep C can lead to? (RNA virus)
severe hepatitis
chronic liver disease
increased risk of liver cancer
Hep C is found in what % of pregnant women ?
1-2%
most cases of hep c are associated with
prior injecting drug use
pregnancy in women with hep c is associated with
declining liver function
when is vertical transmission higher in hep C
if the women is co infected with HIV
When should HEP C screening be offered? (4)
- history of IV drug use / current substance missuse
- hep B or HIV
- PREV OR CURRENT partner with ivdu
- deranged liver function tests
Hep C infection should not be treated in pregnancy.. why?
the drugs used are teratogenic
- you can breastfeed
What is syphilis caused by?
Treponema pallidum
-skin lesion spread during sexual contact
syphilis can be cured by?
course of antibiotics - IM penicillin
if left untreated syphilis can cause?
neurological, cardiac, skeletal and skin abnormalities
for adults and babies affected in utero
infection more than once is possible in ?
syphilis
syphilis infection is associated with an increase risk of? (5)
miscarriage stillbirth hydrops fetalis growth restriction congenital infection
syphilis can be transferred from baby to mother.. (2)
trans placentally
exposure to infected lesion at time of birth
Primary syphilis is characterised by?
- if left untreated?
painless local ulcer - chancre
- secondary syphilis - tertiary (20-40) years
congenital infection of syphilis can present in
2/3 of neonates will be?
first 2 years of life
- asymptomatic at birth
babies at risk of congenital infection must be referred to?
neonatology
congenital infection of syphilis - what is in HUTCHINSON’S TRIAD (3)
deafness
interstitial keratitis
hutchinson’s teeth , widely spaced - peg like
