Module 4 : Maternal Diseases Flashcards
what is the function of the placenta
- exchange gas, nutrients and waste products between the mother and fetus
is the placenta a barrier
- yes but not always
in what two ways can harm be done to the fetus
- directly or indirectly
how is harm directly done to the fetus
- by transmission of the disease to the fetus
how is harm indirectly done to the fetus
- by diseases affecting placenta
- causing decreased placental flow which will compromise fetal growth or IUGR
how does timing of infection affect the severity of the infection
- earlier \+ result in spontaneous abortion \+ during organogenesis results in large number of adverse fetal effects - later \+ result in IUGR or still birth
what are the three different types of infections
- viral
- bacterial
- parasitic
what does TORCH stand for in torch infections
T = toxoplasmosis
O = other Transplacental infections
\+ syphillis, chlamydia, varicella-zoste, HIV, measles, parvo virus
R = rubella
C = cytomegalovirus
H = herpes simplexwhat are sonographic signs of TORCH infections
- small head
- cataracts
- conjunctivitis
- heart disease
- enlarged spleen
- hepatitis and jaundice
- pneumonia
- small eyes
- brain calcifications
- skin hemorrhages
what are the the 7 viral infections that can affect the fetus
- cytomegalovirus CNV
- herpes simplex virus type II
- varicella zoster virus chicken pox
- Epstein Barr virus MONO
- parvovirus
- rubella
- zika
is cytomegalovirus common or uncommon
- very common
where is cytomegalovirus commonly found
- largely populated areas
how do patients typically present with cytomegalovirus
- mild infection
do women who have had CMV typically contract it again or no
- they will not contract it again because they have the antibodies against it
when is a CMV infection most dangerous to the fetus
- when a primary infection occurs in pregnancy
what are the sonographic features of CMV in the fetus
- hydrops
- brain atrophy = ventriculomegaly, microcephaly
- intracranial calcification
- hyperechoic bowel/calcifications
- IUGR
- polyhydramnnious
how is fetal herpes virus type II acquired
- acquired from herpes type II (maternal genital herpes)
when is the greatest risk of transmission of maternal genital herpes to the fetus
- occurs in initial maternal infection contracted in the second half of pregnancy
what decreases risk of transmission with fetal herpes virus
- decreases with antiviral drugs or C section
what is the method of transmission of herpes type 1 to the fetus and is it common or rare
- oral
- rare
what is the sonographic characteristics of of a fetus infected with a primary maternal infection of herpes
- increased rate of spontaneous abortions
- increased rate of still birth
what are the sonographic appearance of herpes in the fetus
- microcephaly
- ventriculomegaly or hyradnechephaly
- IUGR
- cataracts
- micropthalmia
- hepatosplenomegaly
- premature delivery
what is varicella Zoster virus
- chicken pox
+ 1st and 2nd trimester maternal infection
+ congenital abnormalities
what is the affect of chicken pox as a postnatal newborn disease and when does it infect the fetus
- occurs with 3rd trimester maternal infection
- benign to fatal
when can shingles occur
- can occur months to years after birth
what are the fetal features of chicken pox
- demise
- IUGR
- MSK abnormalities (club feet, limb aplasia)
- hydrops and polyhydramnios
- microcephaly
- ventriculomegaly
- brain calcs
- microphthalmia
what is Epstein-barr virus
- common childhood viral infection but not commonly associated with pregnancy
what does Epstein Barr virus cause
- mononucleosis
what are the fetal sonographic features of Epstein Barr virus
- spontaneous abortion
- still births
- IUGR
- microcephaly
- congenital heart abnormalities
- microphthalmia
what two things is parvovirus not
- not the virus that effects pets
- not transmitted between humans and pets
what is parvovirus also referred to as
- slapped cheek virus
- children present with red cheeks
is parvovirus common or uncommon
- common among children
what are the features of parvovirus in the fetus
- non immune hydrops fetalis anemia
- heptosplenomegaly
- poly hydro
- placental enlargement
- heart failure
- MCA doppler performed
what velocity is measure of the MCA to diagnose fetal anemia
- peak velocity
how are children infected with HIV
- result from transmission from mother to infant which occurs near or at delivery
what does transmission of HIV depend on
- number of maternal HIV particles
- effectiveness of the placental barrier
- maternal/fetal immune response
what 4 things does HIV cause in the fetus
- IUGR
- hepatomegaly
- lymphadenopathy
- premature delivery
what does rubella/German measles causes for the fetus
- malformations in the first trimester
what affects the severity of rubella on the fetus
- the earlier the infection is transmitted
what are the congenital defects that occur due to rubella
- cataracts
- cardiac defects
- deafness
what are 4 other nonspecific abnormalities that occur form rubella infection
- IUGR
- cardiac and great vessel abnormalities
- microcephaly
- microphthalmas
what is the associated risk to the fetus with mother diagnosed with zika virus
- microcephaly
what can syphilis lead to early on
- early infection can lead to spontaneous abortion
what can syphilis lead to later on in pregnancy
- hepatomegaly
- hyperbilirubinemia
- evidence of hemolysis (hydrops)
- generalized lymphadenopathy
- still born
what 4 things can gonorrhoea cause in the fetus
- IUGR
- chorioamnionitis
- PROM
- prematurity
what can gonococcal infections cause in neonates
- meningitis
- and arthritis
can gonorrhoea and syphillis be treated
- yes with penicillin or other antibiotics
what is the most common complication in pregnancy
- urinary tract
what can result in the fetus from urinary tract complications
- IUGR
- perinatal mortality
- PROM
- premature delivery
what are the two parasitic infections
- toxoplasmosis
- malaria
where does toxoplasmosis usually originate from
- cat feces
- undercooked or raw meat
when is there risk of transferring toxoplasmosis to the fetus the lowest and highest
- 1st trimester low
- later in pregnancy much higher
what are the fetal features of toxoplasmosis
- ventriculomegaly
- cerebral calcifications
- microcephaly
- hepatosplenomegaly
- general hydrops
- IUGR
- demise
what does malaria due to the fetus and how does it occur
- placental insufficiency resulting in IUGR
- low birth rate
- abortion
- still birth
