Microbiology 19: Viral Infections During Pregnancy Flashcards
List 6 viruses that we are worried about during pregnancy ?
Rubella CMV HIV HSV VZV
What are the 3 classical signs of congenital rubella syndrome ?
Cataracts
Congenital cardiac disease- mainly PDA
Sensorineural hearing loss
Which tests for rubella are part of the antenatal screening program ?
Rubella IgG (+ve in about 98% of women) Avidity of IgG (high avidity suggests infection was not recent) Rubella IgM (active infection)
What does avidity tell you about when the rubella infection was ?
It is a measure of how tightly bound the IgG is to the IgM.
If high avidity it means the IgG and IgM have been bound for a long time so the rubella infection is likely to have occurred over 3 months ago.
Give 3 Obstetric risk factors for congenital HSV infection ?
Prolonged rupture of membranes
Vaginal delivery
Use of foetal scalp electrodes (integrity of mucocutaneous membranes)
What are the 3 types of presentation of HSV infection ?
SEM disease (skin eyes mouth)
CNS disease +- SEM
Disseminated Infection
What is the difference between congenital varicella syndrome and varicella neonatal infection ?
Varicella neonatal infection is when the infection occurs just prior to or just after the delivery.
Whereas Congenital varicella syndrome is when the infection takes place early in pregnancy.
Give 4 character signs of measles ?
Fever
Maculopapular rash (starting behind the ears)
Conjunctivitis
Koplik spots in the mouth
A 11 year old child who had measles as a baby is now falling behind at school and shows signs of developmental delay particularly affecting her motor skills.
What is the name of this rare complication of measles infection ?
SSPE - subacute schlerosing panencephalitis
What are some of the risks of Measles infection during pregnancy ?
Foetal loss
Preterm delivery
Increased maternal morbidity
List 4 ways in which Parvovirus can present ?
Erythema infectiosum (fifth disease) (slapped cheek syndrome)
Transient aplastic crisis
Arthralgia
Hydros foetalis
What are 5 signs of Congenital Zika syndrome ?
Severe microcephaly Decreased brain tissue +seizures Retinopathy Talipes Hypertonia
Describe the SEM symptoms seen in congenital HSV infection?
- S (coalescing vesicles
- E (retinal dysplasia, chorioretinitis,)
- M (oral ulcers)
Describe the features of CNS HSV infection in the newborn ?
- Encephalitis
- Seizures
- Microcephaly
Describe the features of Disseminated HSV infection in the newborn ?
Liver- Fulminant hepatitis
Lungs- Pneumonia, haemorhagic pneumonitis
Heart- myocarditis
CNS- Meningoencephalitis
What is the characteristic result of a lumbar puncture in HSV1 infection in the newborn ?
Lymphocytic pleiocytosis
normal glucose
high protein
What is the most common non-genetic cause of sensorineural hearing loss in the newborn ?
Congenital CMV infection
Describe some of the features seen in congenital varicella syndrome ?
- Limb hypoplasia
- Scarring
- Cataracts
- Microcephaly
Up to how many weeks gestation is the foetus at significant risk of congenital varicella syndrome ?
-20 weeks
When can IVIG be given if a women gets into contact with someone who has chicken pox ?
-Within 10 days of contact
When can a women receive acyclovir if she gets a VZV rash during pregnancy ?
- Within the first 24 hours of the start of the rash
- Should not routinely be given before 20 gestation
What is the classical triad of Infective mononucleosis?
- Fever
- Pharyngitis
- Lymohadenopathy
Which organism causes infective mononucleosis ?
EBV
