Perinatal Infections

Question 1

Thrombocytopenia
Periventricular calcification
Hepatosplenomegaly
SNHL

Answer 1

CMV

Question 2

Diffuse intracranial calcifications
Hydrocephalus
Chorioretinitis
High CSF protein

Answer 2

Toxoplasmosis

Question 3

Skeletal abnormalities
Pseudoparalysis
Persistent rhinitis
Maculopapular rash hands, feet, nappy

Answer 3

Syphilis

Question 4

Catarcacts, glaucoma, salt and pepper retinopathy
CHD (PDA)
Radiolucent bone disease
SNHL
Blueberry muffin rash

Answer 4

Rubella

Question 5

Vesicles
CSF pleocytosis
Thrombocytopenia
Transaminase derangement
Conjunctivitis

Answer 5

HSV

Question 6

Vesicular skin lesions

Microcephaly

Answer 6

Varicella

Question 7

Microcephaly ++
Intracranial calcification
Arthrogryposis / spasticity
SNHL

Answer 7

Zika

Question 8

When is congenital CMV risk period?

Answer 8

First 6 mths

Question 9

When is congenital rubella risk period?

Answer 9

Up to 16 weeks (mostly first 8 weeks)

Question 10

When is congenital HSV risk period?

Answer 10

Throughout pregnancy - intra-partum for neonatal HSV infection

Question 11

When is congenital Parvo risk period?

Answer 11

Up to 20 weeks

Question 12

When is congenital syphilis risk period?

Answer 12

Throughout - increased risk as pregnancy progresses
Primary -> highest risk
Secondary -> moderate risk
Latent -> low risk

Question 13

When is congenital toxo risk period?

Answer 13

Throughout
Highest risk of infection 3rd trimester
Highest risk of fatal abnormality due to infection 1st trimester

Question 14

When is congenital VZV risk period?

Answer 14

<12/40 = 0.4%
12-18/40 = 2%
>28/40 never reported

Question 15

When is congenital Zika risk period?

Answer 15

Up to 20 weeks

Question 16

Most common congenital infection with highest burden of disease?

Answer 16

Congenital CMV

Question 17

Transmission rate of CMV in pregnancy?

Answer 17

30-50%

Question 18

Most common cause of non-hereditary SNHL?

Answer 18

Congenital CMV

Question 19

Test of choice for neonatal CMV?

Answer 19

Urine CMV PCR

Question 20

Primary transmission for Hep C in children?

Answer 20

Vertical

Question 21

Risk of perinatal transmission in Hep C pos mother?

Answer 21

5%

Question 22

Risk of vertical transmission of HSV in pregnancy?

Answer 22

50-65% if first episode primary
25% if first episode non-primary
2% if recurrent

Question 23

Mortality of skin/eye/mouth vs CNS vs disseminated neonatal HSV?

Answer 23

<10% skin, eye, mouth
50% CNS disease
80% disseminated disease

Question 24

Risk of HIV transmission in pregnancy?

Answer 24

20-30% intrauterine
70-80% intrapartum
Breastfeeding least common in resource-wealthy countries
MAJORITY of transmission late gestation - intrauterine due to weaker vast integrity of placenta and intra-partum

Question 25

Congenital rubella acquired pre 12/40?

Answer 25

Congenital rubella syndrome

Question 26

Congenital rubella acquired 12-18/40?

Answer 26

SNHL

Question 27

Congenital rubella acquired after 18/40?

Answer 27

Usually asymptomatic

Question 28

Should rubella non-immune woman be vaccinated during pregnancy?

Answer 28

No. Live vaccines contra-indicated

Question 29

Maternal VZV >7 days pre delivery?

Answer 29

No mx req for neonate

Question 30

Maternal VZV 7 days pre - 2 days post delivery?

Answer 30

Give baby zoster IG

Question 31

Maternal VZV >2 days post delivery?

Answer 31

Treatment dependant on neonatal RFs

- if <28/40 or <1kg give ZIG

Question 32

Conjunctivitis within 5 days of birth

Answer 32

Gonorrhoea

Question 33

Conjunctivitis 5-15 days after birth

Answer 33

Chlamydia

Question 34

Baby at 8 weeks of age, PHx conjunctivitis (untreated). Paroxysms of cough and increased WOB. Afebrile/low grade fever. CXR bilateral infiltrates. Pathogen?

Answer 34

Chlamydia