Lecture 51 Obstetrics And Perinatal Infections

Question 1

What does allograft mean

Answer 1

The sharing of tissue between 2 people, usually with an immune response

Question 2

How does the females body prevent immunological response to her foetus?

Answer 2

Placenta is the immunological barrier

Question 3

How does the placenta prevent immunological response to the allograft?

Answer 3

Blocking of immune cells

Inhibition of T cells

Reduced expression of MHC antigens on placental cells

Question 4

Why are women more at risk of disease when pregnant?

Answer 4

The body downregulates T cells, ↓ the ability for the body to produce an immune response

Question 5

What would happen if the. Mother would have full immunological responses during pregnancy?

Answer 5

Graft rejection

Question 6

Infections more severe in pregnancy

Answer 6

Malaria- infection on RBC- blood accumulates at placenta= more severe

Influenza

UTI- obstruction to normal urinary outflow

Candidiasis

Listeriosis

Varicella

Question 7

What is intrauterine infection

Answer 7

Infection of the Baby from the mother during pregnancy

Question 8

Perinatal transmission definition

Answer 8

Infection of the baby during the birth

Question 9

What are the TORCH infections spread intrauterine mother to baby

Answer 9

Toxoplasma

Others, parvovirus, syphillis,

Rubella

Cytomegalovirus

Herpes simplex

Question 10

Perinatal transmission diseases list

BLOOD BOURNE, COLONISE VAGINA

Answer 10

HIV And HBV- blood bourne

Group B streptococci

COLONISE THE VAGINA
Listeria from food sources

Chlamydia

Gonorrhoea-

Question 11

Name the types of disease transmission from mother to baby

Answer 11

Intrauterine- cross the placenta (TORCH)

Perinatal - blood bourne/colonise the vagina

Post natal- breast milk (HTLV- human t lymphotropic virus)

Question 12

Which intrauterine disease causes sensorineural deafness, diabetes mellitus later in life, and ↑ risk of cataracts, heart and brain problems in the infant?

Answer 12

Congenital rubella syndrome

Question 13

In the infant, where is congenital rubella syndrome best tested for? And using which test?

Answer 13

PCR test

Virus shed in the urine and in the throat of the infant

Question 14

Congenital rubella syndrome causes microcephaly, what is this?

Answer 14

Microcephalic is the abnormal size of the head in relation to the rest of the body

Question 15

Parvovirus B19 causes macrulopapular rash on the face of children. What is another name for this?

Answer 15

Slapped cheek syndrome

Question 16

What maternal infection causes fetal anaemia?

Answer 16

Parvovirus B19

Question 17

Parvovirus causes fetal anaemia (pale baby), what can this lead to in the cardiovascular system

Answer 17

Heart failure and hydrops foetalis (swelling of the baby)

Question 18

What is hydrops foetalis

Answer 18

Swelling of the baby

Question 19

What diseases should we look for if the pregannct mother is in contact with a rash. What should we look for?

Answer 19

Parvovirus b19

Rubella

Look for immunity or current infection

Question 20

How should we treat baby of mother with ImG of parvovirus b19?

Answer 20

Intrauterine blood transfusion

Question 21

Cytomegalovirus is another intrauterine infection, how can this be tested in babies?

Answer 21

Urine positive for CMV PCR at birth

Question 22

Which of the TORCH intrauterine diseases Causes herpes, (which can damage liver cells in the baby), spleen, brain and eye damage?

Answer 22

Cytomegalovirus

Question 23

Syphillis can also be spread from mother to baby, how does this affect the liver of the newborn?

Answer 23

Hepatosplenomegally, jaundice and anaemia

Also affects bones brain ears and teeth

Question 24

Mother to be presents with syphillis, what is the treatment to prevent congenital syphilis, or possible miscarriage?

Answer 24

Penicillin in the mother

Question 25

Toxoplasma gondii is spread in 2 vectors, name these.

Answer 25

Undercooked meat and cat faeces Risky in all 3 trimesters

Question 26

Toxoplasma gondii can cause damage in the brains, livers, eyes, spleen, and cardiac systems of babies. Name a few symptoms of these problems.

Answer 26

Chorioretinitis Heptosplenomegally Rash Cardiac pulmonary disease Blindness Microcephaly Encephalitis (learning difficulties) Jaundice

Question 27

Which virus causes the woman to possibly develop maternal pneumonitis, the baby to develop limb deformities, brain and eye abnormalities?

Answer 27

Varicella or chickenpox

Question 28

If the woman is not immune to chickenpox, what type of treatment is given?

Answer 28

Human antibody product Passive immunisation

Question 29

What is given to the baby if the o pregnant woman has high HBV DNA?

Answer 29

Hepatitis B vaccination for the baby Possibly immunoglobulin to fight infection passively

Question 30

How do we prevent spread of HIV from mother to baby?

Answer 30

C section, don’t do vaginal birth, perinatal disease spread

Question 31

What intervention is recommended in HIV positive pregnant woman? And viral load is high (HIV retrovirus)

Answer 31

Give woman antiretroviral drugs Caesarean section NO breast feeding

Question 32

How do we treat syphillis in a pregnant woman?

Answer 32

Penicillin treatment for. Mother and possibly baby

Question 33

What is chrioamnionitis

Answer 33

Infection of the uterine membrane Maternal fever, premature delivery and still birth

Question 34

What infection causes infection of the uterine membranes (placenta) and is caused by hemolytic streptococci

Answer 34

Chorioamnionitis

Question 35

What can sepsis in the newborn lead to?

Answer 35

Bacterial meningitis

Question 36

Perinatal infection with STI can lead to what eye and lung problem?

Answer 36

Conjunctivitis and pneumonia

Question 37

Which bacteria can lead to sepsis in a newborn

Answer 37

E. coli Group B streptococcus Listeria

Question 38

Where is listeria spread? And what should pregnant women avoid

Answer 38

Unpasteurised milk, soft cheese, contaminated vegetables Prepackaged sandwiches

Question 39

Listeria can cause neonatal septicaemia, what can this lead to?

Answer 39

Neonatal meningitis

Question 40

Listeria is a gram positive bacteria, what drug is recommended for the treatment of the infection?

Answer 40

Amoxicillin possibly gentamicin if necessary

Question 41

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

Answer 41

Listeria

Question 42

What can Group B streptococci cause in the neonate?

Answer 42

Septicaemia and meningitis

Question 43

Which postpartum infection in the woman can cause pelvic pain, fever, pus discharge with bad smell, and delay in uterine size reduction?

Answer 43

Puerperal sepsis

Question 44

How to check for CMV in baby

Answer 44

PCR test of the urine

Question 45

What test should be carried out if suspected viral infection in baby

Answer 45

PCR test Urine for CMV Blood for toxoplasma, rubella, enterovirus