Infectious disease in Pregnancy Flashcards
What antenatal inectious disease screening tests should be routinely conducted?
- HBV / HCV
- HIV
- Rubella (Abs)
- Syphilis (TPHA / TPPT)
- Chlamydia (urine PCR / swab)
- GBS
- Asymptomatic bacteriuria
- VZV (Abs)
What are the routes of transmission?
- Transplacental
- Intrapartum
- Postpartum
Intervention if maternal HBsAg +ve?
Administer HepB immune globulin (HBIG) and vaccine to infant at birth (prevents carriage in 95%)
Syphilis maternal +ve intervention?
Treat with penicillin and consult with STI specialist
HIV maternal +ve intervention?
- Antiretroviral therapy for mother and infant
- greatly reduces vertical transmission
- consult HIV specialist
Chlamydia +ve intervention?
-Treat woman and sexual partners to prevent intrapartum transmission
HCV maternal +ve, child intervention?
Follow up infant for infection at 12 months; treat mother
Intervention if mother GBS +ve?
Intrapartum chemoprophylaxis to prevent neonatal GBS infection
Rubella virus family?
Togavirus
Rubella virus genus?
Rubivirus
Rubella virus structure?
ssRNA, enveloped
What is the reservoir for the rubella virus?
Humans only reservoir
When does rubella peak?
Winter - spring
How is rubella transmitted?
Droplet and direct contact
Rubella incubation period?
14 - 23 days
When is virus present in relation to rash?
7d before to 14d after
Clinical features of rubella?
- Mild or asymptomatic
- Generalised maculopapular rash
- Generalised lymphadenopathy
- Low grade fever
- Polyarthralgia
What are the features of congenital rubella syndrome?
Neurobiological fx: -meningoencephalitis -behavioural -mental retardation -deafness Other fx: -blueberry muffin rash -thrombocytopenia -radiolucent bone disease -congenital heart disease (i.e. PDA) -cataracts
When is risk of damage by rubella virus greatest?
Rubella prevention?
-Screen antepartum
-Vaccinate if -ve (or post partum if pregnant)
No Rx for pregnant woman infected with rubella.