Maternal Infections

Question 1

how is rubella transmitted

Answer 1

direct contact / respiratory droplet exposure

Question 2

rubella classic triad of defects

Answer 2

• cataract
• cardiac abnormalities (patent ductus arteriosus)
• deafness

Question 3

what outcome is worse - rubella infection < 8-10 weeks of gestations or later

Answer 3

early is worse

Question 4

rubella - what antibodies do we test

Answer 4

IgG (past infection) and IgM (recent infection)

Question 5

what causes measles

Answer 5

paramyxovirus

Question 6

what are the spots in mouth in measles called?

Answer 6

koplik’s spots

Question 7

are measles teratogenic

Answer 7

no

Question 8

true or false, primary infection of chicken pox is rare in pregnancy

Answer 8

true

Question 9

severe chicken pox treatment

Answer 9

IV acyclovir

Question 10

what can the outcome be if chicken pox infection happens between 7-28 weeks gestation

Answer 10

fetal varicella syndrome

Question 11

what can the outcome be if chicken pox infection happens 4 weeks before delivery

Answer 11

neonatal chicken pox

Question 12

what can the outcome be if chicken pox infection happens 7 days prior to delivery

Answer 12

neonatal chicken pox with septicaemia and increased mortality

Question 13

fetal varicella syndrome features

Answer 13

skin lesions
hypoplasia of the limbs
microcephaly
growth retardation

Question 14

what is cytomegalovirus caused by

Answer 14

human herpes virus group

Question 15

is risk of congenital infection higher in primary or secondary (recurrent) CMV infection

Answer 15

primary (30-40% risk)

secondary is only 1-2% risk of congenital infection

Question 16

is risk of congenital infection higher if CMV infection was in 1st or 3rd trimester

Answer 16

higher risk in 3rd trimester

Question 17

CMV positive antibodies

Answer 17

IgG and IgM

Question 18

management if confirmed fetal infection by amniocentesis >20 weeks gestation

if severely symptomatic foetus consider option of termination of pregnancy

Answer 18

• US every 2-4 weeks
• +/- fetal brain MRI at 28-32 weeks of gestation
• +/- fetal blood sample

Question 19

CMV treatment

Answer 19

• antiviral drugs - valacyclovir
• hyper immunogloblin

Question 20

parvovirus also known as

Answer 20

slapped cheek syndrome

Question 21

parvovirus diagnostic test

Answer 21

detection of virus specific IgM

Question 22

parvovirus - if IgG + and IgM -ve what would you tell the patient

Answer 22

likely past infection so reassure

Question 23

can women get the MMR live vaccine in pregnancy

Answer 23

no
(but they usually already had the vaccine)

Question 24

can flu vaccine be given in pregnancy and breastfeeding

Answer 24

yes

Question 25

how does zika virus primary infection happen

Answer 25

mosquito bite

Question 26

does zika virus affect pregnancy

Answer 26

can cause serious birth defects

Question 27

how is herpes simplex virus transmitted

Answer 27

sexual contact

Question 28

if HSV infection in last trimester, what type of birth is recommended

Answer 28

c section

Question 29

management if HSV infection in first or second trimester

Answer 29

antivirals

Question 30

toxoplasmosis how is it transmitted

Answer 30

raw or uncooked meat / infected cat faeces

Question 31

toxoplasmosis how is it transmitted to foetus

Answer 31

trans placental

Question 32

toxoplasmosis treatment

Answer 32

medications - e.g. pyrimethamine (not in first trimester), spiramycin

Question 33

listeriosis - what is infection caused by

Answer 33

eating infected food or through contact with infected miscarried products of animals

Question 34

true or false, pregnant women are more likely than other people to get listeriosis

Answer 34

true

Question 35

listeriosis treatment

Answer 35

ampicillin + gentamicin

Question 36

prevention of listeriosis during pregnancy

Answer 36

avoid unpasteurised milk, soft cheese, refrigerated smoked seafood

Question 37

is routine screening for Group B Strep offered to all pregnant women?

Answer 37

no

Question 38

what do we do if group B strep in a swab/urine or previous baby is affected by GBS?

Answer 38

antibiotics (penicillin) offered during labour

Question 39

management for mild UTI in pregnancy

Answer 39

7 days oral antibiotics

Question 40

management for UTI in pregnancy with systemic symptoms or sepsis

Answer 40

admission for IV antibiotics possibly ultrasound to check for hydronephrosis or pyelonephritis