Maternal Infections in Pregnancy Flashcards
Rubella risks?
Miscarriage if contracted in 1st semester and non-immune
Teratogenic
Rubella in early gestation consider what if ptnt isn’t immune
TOP
Risk of what syndrome in rubella?
Congenital rubella syndrome
- Cataract
- Cardiac abnormalities
- Deafness
What is Rubella?
Viral infection
Transmitted by direct contact/resp droplet exposure
Presnetation of rubella?
Fever
Rash
Lymphadenopathy
Polyarthritis
-Miscarriage, still birth, birth defects
-Birth defects: cataracts, cardiac issues, deafness
Management of Rubella?
- Rubella specific IgG Antibody can be detected after natural infection or vaccination
- Blood IgM should be done within 10 days of exposure
- If patient not immune consider TOP
- Supportive treatment: rest, fluids, paracetamol, avoid contact with other pregnant woman
What causes measles?
Paramyxovirus
Highly contagious
Presnetation of measles?
Fever White spots inside mouth Runny nose Cough Red eyed and rash Non teratogenic However fever can cause IUGR, microcephaly, miscarriage, stillbirth, preterm High mortality rate if mother develops pneumonia and encephalitis
Harm caused by measles?
Not teratogenic
- Bad fever can harm baby
What is chicken pox?
VZV is dna virus of herpes family
Transmission via droplets
Presnetation of chicken pox?
Fever Malaise Vesicular rash Primary infections Severe infection: he, encephalitis, pneumonia
Management of chiken pox?
Check for VSV immunity
Offer VZIG within 10 days of exposure
Ptt should avoid contact with other pregnants
Infective until lesions crust
Acyclovir considered if 20+ weeks (800mg x5 a day for 7 days)
Infection at 7-28 weeks?
Hypoplasia of limbs Psychomotor retardation IUGR Chorioretinal scarring Cataracts Microcephaly Cutaneous scarring
Risk of chicken pox before 28 weeks?
Fetal varicella syndrome and >28 weeks of neonatal VZV
What is CMV the leading cause of?
Deafness
Foetal parovirus infection associated with?
Severe anaemia
Heart failure
Hydrops fetalis
Mumps effect on pregnancy>
None
Flu vaccine in pregnancy and breast feeidng?
Safe
Zika virus presnettaion in majority of people infected?
Asymptoomatic
However what can zika virus cause?
Severe birth defects
HIV and pregnancy?
Viral load <50 copies/ml she can be offered vaginal delivery if higher c section is protective
Breast feeding vs formula in HIV?
Formula safest but if mother on ARV and undetectable viral load then it is mothers choice
During vaginal delivery which strep is commonly found in vagina so could be transmitted?
Group B strep
If risk factors for neonatal infection are present for Group B strep?
Use of intrapartum IV penicillin can reduce risk
Women are less/more prone to UTIs i pregnancy?
More as increased progesterone causes sphincters to relax
Ig a woman has a primary HSV infection in third trimester the risk of infection to fetus is?
Much higher, these women need a c section, and possibly started on IV acyclovir, fetal monitoring and fetal antiviral agents
Congenital CMV diagnosed by?
IgG positive seronegative mother
Management of CMV?
Antiviral drugs: valacyclovir
Hyper immune globulin
WHat is parovirus AKA?
Slapped cheek syndrome
Presentation of parovirus?
Slapped cheek appearance
Aplastic anaemia, congenital HF, hydrops and foetal death
Diagnosis of parovirus?
Detection of virus specific IgM
Management of parovirus?
Avoid contact with children and pregnant woman
Serial USS
Foetal MCA doppler
How does toxoplasmosis affect babies?
Hydrocephalus Chorioretinitis Cerebral calcifications Microcephaly Mental retardation
Management of toxoplasmosis?
Spiraycin 3mg orally daily
Management of listeriosis?
Ampicillin + gentamicin
Trimethoprim and sulfamethazole
