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CP > Infections of pregnancy, puerperium and neonate > Flashcards

Infections of pregnancy, puerperium and neonate Flashcards

1
Q

What is the definition of puerperium?

A

the period the few weeks following delivery during which the mothers tissue returns to their non pregnant state (usually 6-8 weeks post partum)

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2
Q

What is the medical definition of a neonate?

A

an infant less that 4 weeks old

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3
Q

How are infections transmitted from the baby to the mother?

A

Haematogenous - via placenta

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4
Q

What two infections can be transmitted from the mother to the baby during delivery from the birth canal that are screened for and given prophylaxis in the UK?

A

HIV

Hep B

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5
Q

What 6 factors need to be taken into consideration when prescribing antimicrobials to a pregnant lady?

A

Immunological changes - can make infections worse/present no symptoms at all
Increased glomerular filtration rate = faster excretion of drugs and higher doses needed
Serum levels of antimicrobials generally lower during pregnancy
Can cause harm to the baby
All antimicrobials cross the placenta to an extent
Virtually all antimicrobials appear in breast milk

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6
Q

What two classes of antimicrobials are safe to use in pregnancy?

A

penicillins

cephalosporins

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7
Q

What 4 classes of antimicrobials are considered unsafe to use in pregnancy?

A

chloramphenicol
tetracycline
fluoroquinolones (e.g. ciprofloxacin)
trimethoprim-sulphamethoxazole

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8
Q

Which viruses are teratogenic?

A

rubella

zika

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9
Q

What should be screened for in a pregnant woman to check they do not have a UTI and why?

A

bacteruria - can lead to symptomatic UTI

associated with premature delivery/perinatal mortality

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10
Q

What is the treatment for a UIT during pregnancy?

A

amoxicillin/cefalexin
7 days
trimethoprim can be given if with folate - avoid in first trimester

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11
Q

What is chorioamnionitis?

A

Intra-amniotic infection

inflammation of the umbilical cord, amniotic membranes and placenta

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12
Q

What are the symptoms of intra-amniotic infections?

A 
maternal fever - >38 degrees
uterine tenderness
malodorous (unpleasantly smelling) amniotic fluid
maternal/foetal tachycardia
raised white cell count
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13
Q

What are the risk factors of intra-amniotic infections?

A 
prolonged rupture of membrane
amniocentesis
cordocentesis
cervical cerclage - stitching up of the cervix to avoid miscarriage
multiple vaginal examinations
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14
Q

What is the main organism that causes intra-amniotic infections, neonatal sepsis/meningitis?

A

group B streptococcus

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15
Q

What is puerperal endometritis?

A

infection of post pregnancy endometritis

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16
Q

What are the risk factors for puerperal endometritis?

A

caesarean section
prolonged labour
prolonged rupture of membranes
multiple vaginal examinations

17
Q

What are the symptoms of puerperal endometritis?

A

fever
uterine tenderness - normal but should get better in time
smelly lochia (vaginal discharge after pregnancy)
increases white cells
malaise
abdominal pain

18
Q

What organisms causes puerperal endometritis?

A

E.coli
Beta-haemolytic streptococci
Anaerobes

19
Q

What is the treatment for puerperal endometritis?

A

broad spectrum IV antimicrobials
combination therapy
co-amoxiclav can be an oral option

20
Q

What is puerperal mastitis?

A

infection of the breast
gains access via cracked/fissured nipples
common in breastfeeding woman but not exclussive

21
Q

What are the symptoms of puerperal mastitis?

A 
onset post delivary
fever
chills
breast sourness - could be blocked duct if systemic symptoms not present
redness
warmth
tenderness
22
Q

What organism causes puerperal mastitis?

A

staphylococcus aureus

23
Q

What is the treatment for puerperal mastitis?

A

flucloxacillin
optimise nursing techniques/breast care
incision/drainage is abscess

24
Q

What are the symptoms of neonatal sepsis/meningitis?

A 
May be subtle/atypical
Temperature
Dyspnoea (SOB), apnoeas (stops breathing), cyanosis
Tachycardia, bradycardia, hypotension
Hepatomegaly, jaundice
Anorexia, vomiting, abdominal distension, diarrhoea
Bleeding disorders
Lethargy, irritability, seizures
25
Q

What is the treatment for neonatal sepsis?

A

broad spectrum antimicrobial e.g. amoxicillin + gentamicin

26
Q

What investigations are used to diagnose neonatal sepsis/meningitis?

A

blood
urine
CSF

CP (50 decks)

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