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OB/GYN - CSE > Infectious Diseases in Pregnancy > Flashcards

Infectious Diseases in Pregnancy Flashcards

1
Q

Common sequela of maternal-fetal infections

A
  • Premature Delivery
  • CNS abnormalities
  • Anemia
  • Jaundice
  • Hepatosplenomegaly
  • Growth restriction
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2
Q

Congenital toxoplasmosis syndrome

A
  • Triad: Hydrocephalus, Intracranial calcifications, Chorioretinitis
  • Ring-enhancing lesions on MRI
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3
Q

Toxoplasmosis diagnosis

A

Not routine; Serologic testing

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4
Q

Toxoplasmosis treatment

A

Pyrimethamine + sulfadiazine

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5
Q

Toxoplasmosis prevention

A

Avoid exposure to cat feces or uncooked meat during pregnancy; spiramycin prophylaxis for the third trimester

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6
Q

Congenital rubella syndrome

A
  • Purpuric “blueberry muffin” rash
  • Cataracts, congenital glaucoma
  • Mental retardation, microcephaly
  • Hearing loss (most common single defect)
  • PDA
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7
Q

Rubella diagnosis

A

Serologic testing

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8
Q

Rubella prevention

A

Immunize before pregnancy; vaccinate the mother after delivery if serologic titers remain ⊝

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9
Q

Congenital CMV syndrome

A
  • Chorioretinitis
  • Periventricular calcifications
  • Microcephaly; Mental and motor retardation
  • Hemolytic anemia
  • Sensorineural deficits (e.g. hearing loss)
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10
Q

CMV diagnosis

A

Not routine: Urine culture, PCR of amniotic fluid

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11
Q

CMV treatment

A

Postpartum gangciclovir

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12
Q

HSV newborn symptoms

A

Skin, eye, and mouth infections
Life-threatening CNS/systemic
infection

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13
Q

HSV diagnosis

A

Not routine; Serologic testing

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14
Q

HSV treatment

A

Acyclovir

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15
Q

HSV prevention

A

Perform a C-section if lesions are present at delivery

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16
Q

HIV diagnosis

A

ELISA, Western blot

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17
Q

HIV treatment

A

HAART

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18
Q

HIV prevention

A

AZT or nevirapine in pregnant women with HIV; perform elective C-section if viral load is > 1000
Treat infants with prophylactic AZT; avoid breastfeeding

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19
Q

Syphilis fetal symptoms

A
  • Maculopapular skin rash
  • Lymphadenopathy
  • Hepatomegaly
  • “Snuffles”: mucopurulent rhinitis
  • Osteitis
  • Late congenital syphilis:
    • Saber shins
    • Saddle nose, frontal bossing, short maxilla, high palatal arch
    • CNS involvement
    • Hutchinson triad: peg-shaped central incisors, deafness, interstitial keratitis
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20
Q

Syphilis diagnosis

A

Dark-field microscopy, VDRL/RPR, FTA-ABS/MHA-TP

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21
Q

Syphilis treatment

A

Penicillin (if allergic, should desensitize and give penicillin)

22
Q

Syphilis prevention

A

Penicillin in pregnant women who test ⊕

23
Q

Infections more common in pregnancy and puerperium

A

Pyelonephritis, endomyometritis, mastitis, toxic shock syndrome

24
Q

Infections whose complications increase during pregnancy

A

UTIs, bacterial vaginosis, surgical wounds

25
Q

ABS/UTI complications in pregnancy

A

Preterm birth, low-birth-weight infants; bacteremia, sepsis, adult ARDS for mother

26
Q

Weeks of gestation in which routine urine culture is used to screen ASB

A

12-16 weeks (1st trimester)

27
Q

Acute cystitis syndrome

A

Urgency, frequency, dysuria and suprapubic discomfort

28
Q

First line antibiotics in ASB/UTIs in pregnancy

A

Penicillins or cephalosporins

29
Q

Treatment when patient has dysuria or bladder pain

A

Phenazopyridine

30
Q

BV complications in pregnancy

A

Preterm premature rupture of membranes (PPROM), preterm delivery, puerperal infections (chorioamnionitis and endometritis)

31
Q

Amsel criteria (3 out of 4)

A

1) vaginal discharge
2) whiff test (10% KOH) positive
3) ph > 4.5
4) clue cells > 20%

32
Q

BV treatment in pregnancy

A

Oral metronidazole (or clindamycin) for 1 wk

33
Q

Weeks of gestation in which routine vagina/rectal swab culture is performed to screen for GBS

A

35-37 weeks

34
Q

GBS prophylaxis in pregnancy

A

IV penicillin G (or ampicillin) at time of labor or ROM

35
Q

GBS complications in pregnancy

A

Neonatal sepsis; UTIs, PROM, chorioamnionitis and endomyometritis

36
Q

Chorioamnionitis complications in pregnancy on neonate

A

Neonatal respiratory distress, pneumonia, meningitis, periventricular leukomalacia, cerebral palsy

37
Q

Chorioamnionitis complications in pregnancy on mother

A

Uterine atony, postpartum hemorrhage, need for cesarean, endomyometritis, septic shock

38
Q

Diagnosis of Triple I

A

High index of suspicion, fever >39°C or 102.2°F (oral temp) + another sign (↑ WBC [>15k/mL], purulent fluid, fetal tachycardia [>160 bpm]) or ⊕ amniocentesis culture

39
Q

Treatment of chorioamnionitis

A

IV antibiotics (2/3rd gen cephalosporins or amp/genta) and delivery of fetus

40
Q

Varicella syndrome (transplacental in first trimester)

A
  • Skin scarring and limb hypoplasia
  • Chorioretinitis
  • Microcephaly (cerebral cortical atrophy)
  • Hydronephrosis
41
Q

Neonatal varicella infection (acquired during labor) treatment

A

VZIG for passive immunity

42
Q

Influenza vaccine

A

Given at any gestational age

43
Q

Parvovirus B19 complications in fetus

A

Nonimmune hydrops (due to aplastic anemia), fetal death (abortion)

44
Q

Parvovirus B19 infection in newborn

A

Erythema infectiosum or fifth disease

45
Q

Most common cause of perinatal infection

A

CMV

46
Q

Most common cause of congenital hearing loss

A

CMV

47
Q

Most common cause of chorioamnionitis

A

GBS

48
Q

GBS prophylaxis in pregnancy does not prevent

A

Late-onset (1wk - 3m) disease, usually meningitis

49
Q

Most common cause of ophthalmia neonatorum

A

Chlamydia trachomatis

50
Q

Hepatitis B prevention

A

Vaccine to mother during pregnancy; HBIG and vaccine to infant upon delivery

51
Q

Neonatal HPV infection

A

Juvenile-onset respiratory laryngeal papillomatosis (due to HPV-6 and 11)

52
Q

Infections associated with preterm delivery

A

Gonorrhea, Trichomoniasis, BV

OB/GYN - CSE (3 decks)

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