Maternal Health and Infections Flashcards
Give the definition for maternal mortality
The annual number of deaths related to or aggravated by pregnancy/childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site
What are the main causes of maternal death?
What infections are important in pregnancy and why?
All of these infections cross the placenta and affect the baby and cause similar symptoms/outcome
Can cause miscarriage, pre mature birth etc
What infections are tested for at 10 weeks of pregnancy?
How would you treat these if the result is positive?
blood test at 10 weeks to check for:
HIV- antivirals
Hepatitis B- vaccine for the baby to stop vertical transmission
Syphilis- treat w penicillin
Not Rubella- bc you cant vaccinate them- vaccine is live and may give the baby congenital rubella
Describe Rubella virus
Rubella Virus, 60nm in size, spherical, moderately infectious by droplet spread esp when rash is present
Presentation: malaise, fever, off food, raised cervical glands and a rash on the face and upper trunk, runny nose. Many cases are sub-clinical
Rubella vaccine started in 1970 which is super important
What is congenital Rubella?
explain the risk, investigations effects in newborn, treatment
Risk is highest in the first 8 weeks, less risk after 20weeks
Causes miscarriage, stillbirth, growth retardation.
Hearing loss, cataracts, heart problems, microcephally, intellectual disability hepatosplenomegally, jaundice in the foetus
Serology and PCR for investigations
Treatment= rubella vaccine BEFORE pregnancy
briefly explain the effect of covid in pregnancy
increases premature births, infant mortality and maternal mortality in mothers who didnt take the vaccine
If a woman who is pregnant develops or comes into contact with a rash with small fluid-filled blisters (vesicular rash), what needs to happen?
What is the risk of this with chickenpox?
Must conduct VZV IgM and IgG tests. These help determine if pt has recently been infected w VZV (IgM) or if she’s had a longstanding infection (IgG)
Speak to on call microbiology
May need treatment with VZV Immunoglobulin im
There is a risk of VZV spreading throughout the body (disseminated disease) in pregnant women who develop chickenpox.
Describe congenital varicella, inc its 4 clinical features
Characteristic scarring skin lesions known as cicatrix occur
Limb abnormalities
Ocular defects: chorioretinitis, cataracts
CNS abnormalities: microcephaly
What is slapped cheek disease? Give its presentation
Aka erythema infectiosum caused by human parvovirus B19, 18nm
Only replicates in rapidly dividing cells
Presentation: non-specific viral illness for 5-7 days. Once the rash appears=on the mend and not infectious.
Can cause hydrops fetalis in pregnancy
What is hydrops fetalis
Worst outcome for the baby in middle of the pregnancy
Causes profound anemia in developing baby which can lead to HF
Describe the approach to a patient in contact with or with a non-vesicular (flat, not raised) rash
For example parvovirus, measles, rubella
Prompt blood tests for IgM (recent infection) and IgG (previous infection) of the relevant virus
Liase with microbiology, also test booking bloods
For Parvovirus; regular scans, consider intrauterine blood transfusion
What is Endometritis? What 2 things do you need to do in its management
Endometritis= infection of the womb lining: fainting, smelly discharge, temperature- can lead to sepsis so must be aware! She may need antibiotics within the hour
need a history and examination to ensure it is not a bleed
need swabs and blood cultures
What is sepsis six?
1.O2 to keep sats above 95%
2.Blood cultures, FBC, U&E, LFT, coagulations, glucose,
3.Lactate measurement
4.Give IV bolus 20ml/Kg normal saline. If no response repeat unless hay pulmonary oedema
5.IV antibiotics w/in 1hr. Do not wait for investigation results.
6.Monitor; resp rate, 02 sats, BP, heart rate, temp, fluid balance, urinary output.
Describe strep pyogenes
Streptococcus pyogenes can cause:
Scarlett fever
Tonsillitis
Rheumatic fever
Erysipelas, Endocarditis
Post puerperal infection,
Gam positive in chains
Colonies cause beta-haemolysis on blood agar
draw a table detailing toxoplasmosis, listeriosis and syphilis in pregnancy
Draw a table detailing cytomegalovirus and herpes simplex
Outline the vaccine schedule for when a child is eight weeks old
All injections in thigh unless otherwise indicated
Outline the vaccine schedule for when a child is 12 weeks
All injections in thigh unless otherwise indicated
Outline the vaccine schedule for when a child is 16 weeks and 1 years old
All injections in thigh unless otherwise indicated
