Maternal Infections Flashcards
how is rubella transmitted
direct contact / respiratory droplet exposure
rubella classic triad of defects
- cataract
- cardiac abnormalities (patent ductus arteriosus)
- deafness
what outcome is worse - rubella infection < 8-10 weeks of gestations or later
early is worse
rubella - what antibodies do we test
IgG (past infection) and IgM (recent infection)
what causes measles
paramyxovirus
what are the spots in mouth in measles called?
koplik’s spots
are measles teratogenic
no
true or false, primary infection of chicken pox is rare in pregnancy
true
severe chicken pox treatment
IV acyclovir
what can the outcome be if chicken pox infection happens between 7-28 weeks gestation
fetal varicella syndrome
what can the outcome be if chicken pox infection happens 4 weeks before delivery
neonatal chicken pox
what can the outcome be if chicken pox infection happens 7 days prior to delivery
neonatal chicken pox with septicaemia and increased mortality
fetal varicella syndrome features
skin lesions
hypoplasia of the limbs
microcephaly
growth retardation
what is cytomegalovirus caused by
human herpes virus group
is risk of congenital infection higher in primary or secondary (recurrent) CMV infection
primary (30-40% risk)
secondary is only 1-2% risk of congenital infection
is risk of congenital infection higher if CMV infection was in 1st or 3rd trimester
higher risk in 3rd trimester
CMV positive antibodies
IgG and IgM
management if confirmed fetal infection by amniocentesis >20 weeks gestation
if severely symptomatic foetus consider option of termination of pregnancy
- US every 2-4 weeks
- +/- fetal brain MRI at 28-32 weeks of gestation
- +/- fetal blood sample
CMV treatment
- antiviral drugs - valacyclovir
- hyper immunogloblin
parvovirus also known as
slapped cheek syndrome
parvovirus diagnostic test
detection of virus specific IgM
parvovirus - if IgG + and IgM -ve what would you tell the patient
likely past infection so reassure
can women get the MMR live vaccine in pregnancy
no
(but they usually already had the vaccine)
can flu vaccine be given in pregnancy and breastfeeding
yes
how does zika virus primary infection happen
mosquito bite
does zika virus affect pregnancy
can cause serious birth defects
how is herpes simplex virus transmitted
sexual contact
if HSV infection in last trimester, what type of birth is recommended
c section
management if HSV infection in first or second trimester
antivirals
toxoplasmosis how is it transmitted
raw or uncooked meat / infected cat faeces
toxoplasmosis how is it transmitted to foetus
trans placental
toxoplasmosis treatment
medications - e.g. pyrimethamine (not in first trimester), spiramycin
listeriosis - what is infection caused by
eating infected food or through contact with infected miscarried products of animals
true or false, pregnant women are more likely than other people to get listeriosis
true
listeriosis treatment
ampicillin + gentamicin
prevention of listeriosis during pregnancy
avoid unpasteurised milk, soft cheese, refrigerated smoked seafood
is routine screening for Group B Strep offered to all pregnant women?
no
what do we do if group B strep in a swab/urine or previous baby is affected by GBS?
antibiotics (penicillin) offered during labour
management for mild UTI in pregnancy
7 days oral antibiotics
management for UTI in pregnancy with systemic symptoms or sepsis
admission for IV antibiotics
possibly ultrasound to check for hydronephrosis or pyelonephritis
