Neonatology - Conditions in Pregnancy Flashcards
When are the greatest effects of alcohol in pregnancy?
Mothers should not drink at all
First trimester, due to neural tube development needing B vitamins
What can alcohol in early pregnancy lead to?
Miscarriage
Small for dates
Preterm delivery
What are the effects and characteristics in foetal alcohol syndrome?
Microcephaly
Thin upper lip
Smooft flat philtrum
Short palpebral fissure
Learning disability
Behavioural difficulties
Hearing and vision problems
Cerebral palsy
What causes congenital rubella syndrome?
Maternal infection during pregnancy
Highest risk during first 3 months
Women planning to get pregnant should have MMR, can be checked for immunity, can be vaccinated with 2 doses 3 months apart
Why should pregnant women not get the MMR vaccine?
Live vaccine
Non-immune women should get it after giving birth
What are the features of congenital rubella syndrome?
- Congenital cataracts
- Congenital heart disease (PDA and PS)
- Learning disability
- Hearing loss
What causes congenital varicella syndrome?
Varicella zoster virus
What can varicella zoster lead to in pregnancy?
- Varicella pneumonitis, hepatitis or encephalitis
- Foetal varicella syndrome
- Severe neonatal varicella infection (if infected around delivery)
If there is doubt about chickenpox immunity in the mother what should be done?
Check IgG levels for VZV
Women that are not immune can be offered varicella vaccine before or after pregnancy
If a mother is exposed during pregnancy to chickenpox what should be done?
If previously had chickenpox, they are safe
- Test VZV IgG levels, positive = safe
- Not immune, give IV varicella immunoglobulins as prophylaxis
- Oral acyclovir if they present within 24 hours and more than 20 weeks gestation
What are the typical features of congenital varicella syndrome?
Occurs when there is infection in the first 28 weeks of gestation
- Foetal growth restriction
- Microcephaly, hydrocephalus and learning disability
- Scars and significant skin changes in dermatomes
- Limb hypoplasia
- Cataracts and inflammation in the eye (chorioretinitis)
When does congenital CMV occur?
Maternal CMV infection during pregnancy
How is CMV spread?
Infected saliva or urine in asymptomatic children
Most cases do not cause congenital CMV
What are the features of congenital CMV?
Foetal growth restriction
Microcephaly
Hearing loss
Vision loss
Seizures
Learning disability
What causes congenital toxoplasmosis?
Infection with Toxoplasma gondii parasite usually asymptomatic
Risk is higher later in pregnancy
How is Toxoplasma gondii parasite spread?
Contamination with faeces from a cat with the parasite
What is the classic triad in congenital toxoplasmosis?
Intracranial calcification
Hydrocephalus
Chorioretinitis
What causes congenital zika syndrome?
Zika virus spread by Aedes mosquitos
How is zika virus spread?
Aedes mosquitos
Sex with infected person
What are the features of congenital zika syndrome?
Microcephaly
Foetal growth restriction
Other intracranial abnormalities e.g. ventriculomegaly and cerebellar atrophy
If a pregnant woman may have contracted Zika virus what should be done?
Test with viral PCR
Test antibodies to Zika virus
Positive result should be referred to foetal medicine
No treatment for the virus
