Maternal Diseases And Pregnancy Flashcards
Maternal disease can be categorized into what kind of categories? 3
- Infection
- Endocrine disorders
- Hypertension
What is the function the placenta? 3
Exchange of
1. Gas
2. Nutrients
3. Waste products
Harm can be done to the fetus in what two ways?
- Directly by transmission of disease from maternal circulation to the fetal circulation
- Indirectly by the disease affecting the placenta itself
What are maternal infections? 4
- TORCH (some of the most common maternal infection)
- Viral
- Bacterial
- Parasitic infection
What happens in terms of infection early in the pregnancy? What happens during if it happens during organogenesis?
- Infections usually result in spontaneous abortions
- Occurring during organogenesis (week 6-8) results in the largest number of adverse fetal effect
What happens if there is an infection later in pregnancy?
Usually results in IUGR or stillborn
What does TORCH stand form?
Toxoplasmosis
Other trans placental infections
Rubella
Cytomegalovirus (CMV)
Herpes simplex
What are some complications of TORCH? 10
- Small head
- Cataracts
- Conjunctivitis
- Heart diseases
- Enlarged spleen
- Hepatitis and jaundice
- Pneumonia
- Small eyes
- Brain calcifications
- Skin hemorrhages
What is toxoplasmosis? Where can the mom get affected by this?
- A parasitic infection
- Can be from cat feces, undercooked or raw lamb or pork
During the 1st trimester what is the risk of toxoplasmosis transferring from a fetus?
Low, parasite is a large cell, can’t permeate through placenta
What is the risk of toxoplasmosis transferring to mom in later pregnancy?
Much higher, increased placental surface area and aging placenta makes it easier
What are some fetal features of toxoplasmosis? 7
- Ventriculomegaly
- Cerebral calcification
- Microcephalic
- Hepatosplenomegaly
- General Hydrpps
- IUGR
- Demise
For acute toxoplasmosis when will we see potential demise?
24 weeks?
What are some things we see on the ultrasound for toxoplasmosis in terms of the abdomen? 3
Larger abdomen
1. AC measures 29 weeks
2. Due to hepatosplenomegaly
3. Ascites and pleural effusions
What will the heart look like during acute toxoplasmosis?
No heart motion with colour doppler over the heart
What does the head look like during acute toxoplasmosis? 3
- Ventriculomegaly due to brain atrophy
- Head measured normal
- No brain calcinations seen (probably would have seen them in a later gestation)
What does the placenta/ Amniotic fluid look like during acute toxoplasmosis? 2
- Thick placenta
- No amniotic fluid
What can be included in the other category in terms of the TORCH? 5
- Malaria
- Syphilis
- Varicella zoster virus
- HIV
- Parvaovirus
What is malaria? How does it affect the fetus?
- Another common parasitic infection
- Placental insufficiency resulting in IUGR, low birth weight, abortion and still birth
Why does malaria affect the fetus?
The anti parasitic drug therapy manages toxoplasmosis and malaria in pregnancy but the drug may be teratogenic
How does syphilis affect early fetus?
Can lead to spontaneous abortion
How does syphilis affect the fetus later? What do we see? 5
Later infection can lead to neonatal
1. Hepatosplenomegaly
2. Hyperbilirubinemia
3. Evidence of hemolysis
4. Generalized lymphadenopathy
What is a potential consequence of syphilis?
Stillborn
What is the varicella zoster virus? When will anomalies are at the highest?
- Chicken pox
- Fetal anomalies are highest in the 1st and 2nd trimester
When does the postnatal newborn disease varicella zoster virus occur? How serious is it? What is it called when it occurs in later years of life?
- Occurs with a 3rd trimester maternal infection
- Benign to fatal
- Shingles - can occur months of ages to years after birth
What are some fetal features of varicella zosters virus? 8
- Demise
- IGUR
- MSK abnormalities
- Hydrops and polyhydraminos
- Microcephaly
- Ventriculomegaly
- Brain calcification
- Microphthalmia
When does transmission of HIV to the infant?
From mother to infant near or at delivery
Transmission of HIV to infant depends on what? 3
- Number of maternal HIV particles
- Effectiveness of the placental barrier
- Maternal/ Fetal immune response
What are some possible effects of HIV on the infant? 4
- IUGR
- Hepatomegaly
- Lymphadenopathy
- Premature delivery
What is parvovirus (fifth disease) not? 2
- Not the virus that effects pets
- Not transmitted between humans and pets
What does parvovirus look like?
Slapped cheek virus
If most moms have had the infection as a child what does this do for the fetus?
They will have antibodies
What are some sonographic features of parvovirus? 8
- Demise
- Non immune hydrops
- Fetal anemia
- Neurological anomalies
- Heart anomalies
- Hepatosplenomegaly
- Polyhydraminos
- Placental enlargement
What is rubella? When does it affect the fetus?
- German measles
- Malformation with 1st trimester exposure
With rubella the earlier exposure what happens to the fetus?
More severe defects
What is the main effects of exposures for rubella? 3
- Cataracts
- Cardiac defects
- Deafness
What are some non specific effects of rubella exposure? 6
- IUGR
- Great vessel abnormalities
- Microcephaly
- Microphthalmia
- Hepatosplenomegaly
- Osteopathy
Is cytomegalovirus common? And where is it found?
Common and found in largely populated areas
In adults cytomegalovirus presents as what? How often and who is usually affected? 2
- Mild infection
- Many women have already had the CMV infection
What is a benefit of already having CMV?
Women who already had CMV antibodies can’t contract it again during pregnancy
When is CMV dangerous to the fetus?
Danger to the fetus when a primary infection occurs during pregnancy
What are some CMV sonographic features? 7
- Hepatosplenomegaly
- Intracranial calcification
- Brain atrophy
- Non immune hydrops
- Hyperechoic bowel
- IUGR
- Polyhydraminos
How is herpes simplex virus usually acquired? How is it rarely acquired?
- Usually acquired from herpes type 2 from maternal genital herpes
- Rarely from herpes type 1
Primary infection of herpes simplex virus results in what?
More severe reactions
Secondary infection of herpes simplex virus tends to a affect the fetus how? 2
- Not to cause much of a problem
- If there is an active outbreak - c section is performed to protect fetus from infection during birth
What does primary infection during the first 1/2 of the pregnancy with Herpes virus?
Increased rate of spontaneous abortions, stillbirths and premature delivery
What are some sonographic features of herpes virus? 6
- Microcephaly
- Ventriculomegaly or even hydranecepahly
- IUGR
- Cataracts
- Microphthalmia
- Hepatosplenomegaly
What does having the zika virus increase the risk of? 2
- Miscarriage, preterm birth and stillbirth
- Serious birth defects (congenital zika syndrome)
What are some of the serious birth defects of zika virus? 5
- Microcephaly
- Brain damage
- Eye damage
- Joint problems
- Reduced body movement due to hypertonia
How does COVID affect pregnancy? 5
Increased risk of
1. Hospitalization
2. Intensive care and or ventilator
3. Death
4. Preterm birth
5. Pregnancy loss
What is Epstein- Barr virus? What does it cause? 2
- Common childhood viral infection
- Causes mononucleosis
What are some sonographic fetal features of Epstein Barr virus? 6
- Spontaneous abortion
- Stillbirth
- IUGR
- Microcephaly
- Congenital heart abnormalities
- Microphthalmia
How does gonorrhea affect pregnancy? 4
- IUGR
- Chorioamnionitis
- PROM
- Prematurity
Gonococcal infections in neonates can result in what?
Meningitis and arthritis
What is the most common complication in pregnancy? (Mother)
Urinary tract infection
When UTIs are asympotomatic it can cause what?
IUGR and premature delivery
If UTI progress to pyelonephritis, it can cause what? 5
- IUGR and premature delivery
- PROM
- Perinatal mortality
- Anemia an toxaemia
- Impaired mental and motor developed ent
How are UTIs treated?
Antibiotics
