Obstetrics and Parenatal Infections Flashcards
Name 3 risk factors modifying infective risk in pregnancy for the mother
Increased susceptibility, May alter clinical presentation, Many drugs contraindicated in pregs
Name 3 risk factors modifying infective risk in pregnancy for the baby
infection can severely affect fetal development, immune system not fully mature, congental infections - long term consequences
UTIs in pregnancy usually express which symptoms? they can lead to?
asymptomatic + pyelonephritis
What is varicella pneumonia?
chicken pox in adults! much more dangerous if pregnant
Dangers of a rash in pregnancy?
Could be rubella (small risk in UK) or parvovirus b19
Danger of CMV in pregnancy ?
severe -bilat deafness 10%. minor 5% unilat deafness. 85% not affected
Why is CMV so common?
mother asymptomatic (unless recurrent)
Describe how the timing of a pregnant womans rubella infection can affect the baby
1st trimester - many defects e.g. CNS / heart and eye - CRS (congenital rubella syndrome)
12-18 weeks - deafness most common
after 18 weeks - no risk
How is rubella prevented?
MMR vaccination at a young age. antenatal screening, post partum vaccination.
Risks of Toxoplasmosis during pregnancy?
brain damage, choroido-retinitis (may not be present until later in life)
Congenital toxoplasmosis is caused by?
toxoplasma gondii - a protozoon
Syphilis clinical features present at what age? can cause?
multi system - some evident at birth and some not till child is 5-15
Symptoms of varicella in a newborn?
skin loss, scarring, unilateral limb bud development, microcephaly
When does fetal damage in varicella result?
First 20 weeks- but only 1%!
Define antenatally, perinatally and postnatally transmission to babies using examples.
A = transplacental, Pe = exposure to maternal blood e.g. infected birth canal Po = Breast milk (just HIV)
Name 3 ways you can combat risk of giving HIV from mother –> child
1- don’t breast feed
2 - antiretrovirals for mother (reduces viral load) decreases amount of virus in birth canal and maternal blood so delivery safer
3- caesarean
What has the UK done to decrease chances of transmisson HIV from mother to baby
now opt out for screening for HIV of mother
Risk of Hep B to baby from mother? How do we treat this?
neonatal infection can lead to miscarriage. vaccinate baby.
When is a baby high risk of Hep B?
When the mother is E antigen +ve
Why do we not screen for Hep C infections in antenatal women?
We dont have a vaccination so couldnt cure anyway- and very low rate of hep C
What can E coli and BH Strep cause in pregnancy and how?
neonatal septicaemia / meningitis. acquired from birth canal. (BH strep can also cause pneumonia)
Where is Group B Strep (haemolytic) usually found and how is it transferred to the baby in pregnancy? How is this prevented?
Usually found in GI flora, can colonise in perineum/ vagina. IV antibiotics during delivery
Significance of timing in prenatal maternal chickenpox (late pregnancy)
If mother gets chicken pox rash >7 before baby is born shes had time to make antibodies that can cross the placenta to the baby. If the mother develops chicken box and then has the baby in under 7 days then the baby will not receive the mothers antibody
Symptoms of baby with neonatal HSV?
50% dont have skin lesions. Internally disseminated - lung liver brain. Baby usually fine at birth - 5 days later fever etc..
What is opthalmia neonatorum caused by? what can it cause?
gonorrhoea and chlamydia - acquired when born. infected birth canal of mother . can cause pneumonia
How would you treat a newborn baby thats likely to have caught the mothers chicken pox?
VZIg prophylaxis
What is Cytomegalovirus?
Herpes
