Lecture 51 Obstetrics And Perinatal Infections Flashcards
What does allograft mean
The sharing of tissue between 2 people, usually with an immune response
How does the females body prevent immunological response to her foetus?
Placenta is the immunological barrier
How does the placenta prevent immunological response to the allograft?
Blocking of immune cells
Inhibition of T cells
Reduced expression of MHC antigens on placental cells
Why are women more at risk of disease when pregnant?
The body downregulates T cells, ↓ the ability for the body to produce an immune response
What would happen if the. Mother would have full immunological responses during pregnancy?
Graft rejection
Infections more severe in pregnancy
Malaria- infection on RBC- blood accumulates at placenta= more severe
Influenza
UTI- obstruction to normal urinary outflow
Candidiasis
Listeriosis
Varicella
What is intrauterine infection
Infection of the Baby from the mother during pregnancy
Perinatal transmission definition
Infection of the baby during the birth
What are the TORCH infections spread intrauterine mother to baby
Toxoplasma
Others, parvovirus, syphillis,
Rubella
Cytomegalovirus
Herpes simplex
Perinatal transmission diseases list
BLOOD BOURNE, COLONISE VAGINA
HIV And HBV- blood bourne
Group B streptococci
COLONISE THE VAGINA
Listeria from food sources
Chlamydia
Gonorrhoea-
Name the types of disease transmission from mother to baby
Intrauterine- cross the placenta (TORCH)
Perinatal - blood bourne/colonise the vagina
Post natal- breast milk (HTLV- human t lymphotropic virus)
Which intrauterine disease causes sensorineural deafness, diabetes mellitus later in life, and ↑ risk of cataracts, heart and brain problems in the infant?
Congenital rubella syndrome
In the infant, where is congenital rubella syndrome best tested for? And using which test?
PCR test
Virus shed in the urine and in the throat of the infant
Congenital rubella syndrome causes microcephaly, what is this?
Microcephalic is the abnormal size of the head in relation to the rest of the body
Parvovirus B19 causes macrulopapular rash on the face of children. What is another name for this?
Slapped cheek syndrome
What maternal infection causes fetal anaemia?
Parvovirus B19
Parvovirus causes fetal anaemia (pale baby), what can this lead to in the cardiovascular system
Heart failure and hydrops foetalis (swelling of the baby)
What is hydrops foetalis
Swelling of the baby
What diseases should we look for if the pregannct mother is in contact with a rash. What should we look for?
Parvovirus b19
Rubella
Look for immunity or current infection
How should we treat baby of mother with ImG of parvovirus b19?
Intrauterine blood transfusion
Cytomegalovirus is another intrauterine infection, how can this be tested in babies?
Urine positive for CMV PCR at birth
Which of the TORCH intrauterine diseases Causes herpes, (which can damage liver cells in the baby), spleen, brain and eye damage?
Cytomegalovirus
Syphillis can also be spread from mother to baby, how does this affect the liver of the newborn?
Hepatosplenomegally, jaundice and anaemia
Also affects bones brain ears and teeth
Mother to be presents with syphillis, what is the treatment to prevent congenital syphilis, or possible miscarriage?
Penicillin in the mother
Toxoplasma gondii is spread in 2 vectors, name these.
Undercooked meat and cat faeces
Risky in all 3 trimesters
Toxoplasma gondii can cause damage in the brains, livers, eyes, spleen, and cardiac systems of babies. Name a few symptoms of these problems.
Chorioretinitis
Heptosplenomegally
Rash
Cardiac pulmonary disease
Blindness
Microcephaly
Encephalitis (learning difficulties)
Jaundice
Which virus causes the woman to possibly develop maternal pneumonitis, the baby to develop limb deformities, brain and eye abnormalities?
Varicella or chickenpox
If the woman is not immune to chickenpox, what type of treatment is given?
Human antibody product
Passive immunisation
What is given to the baby if the o pregnant woman has high HBV DNA?
Hepatitis B vaccination for the baby
Possibly immunoglobulin to fight infection passively
How do we prevent spread of HIV from mother to baby?
C section, don’t do vaginal birth, perinatal disease spread
What intervention is recommended in HIV positive pregnant woman? And viral load is high (HIV retrovirus)
Give woman antiretroviral drugs
Caesarean section
NO breast feeding
How do we treat syphillis in a pregnant woman?
Penicillin treatment for. Mother and possibly baby
What is chrioamnionitis
Infection of the uterine membrane
Maternal fever, premature delivery and still birth
What infection causes infection of the uterine membranes (placenta) and is caused by hemolytic streptococci
Chorioamnionitis
What can sepsis in the newborn lead to?
Bacterial meningitis
Perinatal infection with STI can lead to what eye and lung problem?
Conjunctivitis and pneumonia
Which bacteria can lead to sepsis in a newborn
E. coli
Group B streptococcus
Listeria
Where is listeria spread? And what should pregnant women avoid
Unpasteurised milk, soft cheese, contaminated vegetables
Prepackaged sandwiches
Listeria can cause neonatal septicaemia, what can this lead to?
Neonatal meningitis
Listeria is a gram positive bacteria, what drug is recommended for the treatment of the infection?
Amoxicillin possibly gentamicin if necessary
Which disease, carried freely in the woman GI tract or vagina asymptomatically, can result in chrioamnionitis, premature labour, abortion or still birth? It can infect transplacentally
Listeria
What can Group B streptococci cause in the neonate?
Septicaemia and meningitis
Which postpartum infection in the woman can cause pelvic pain, fever, pus discharge with bad smell, and delay in uterine size reduction?
Puerperal sepsis
How to check for CMV in baby
PCR test of the urine
What test should be carried out if suspected viral infection in baby
PCR test
Urine for CMV
Blood for toxoplasma, rubella, enterovirus
