Perinatal Infections Flashcards
Thrombocytopenia
Periventricular calcification
Hepatosplenomegaly
SNHL
CMV
Diffuse intracranial calcifications
Hydrocephalus
Chorioretinitis
High CSF protein
Toxoplasmosis
Skeletal abnormalities
Pseudoparalysis
Persistent rhinitis
Maculopapular rash hands, feet, nappy
Syphilis
Catarcacts, glaucoma, salt and pepper retinopathy CHD (PDA) Radiolucent bone disease SNHL Blueberry muffin rash
Rubella
Vesicles CSF pleocytosis Thrombocytopenia Transaminase derangement Conjunctivitis
HSV
Vesicular skin lesions
Microcephaly
Varicella
Microcephaly ++
Intracranial calcification
Arthrogryposis / spasticity
SNHL
Zika
When is congenital CMV risk period?
First 6 mths
When is congenital rubella risk period?
Up to 16 weeks (mostly first 8 weeks)
When is congenital HSV risk period?
Throughout pregnancy - intra-partum for neonatal HSV infection
When is congenital Parvo risk period?
Up to 20 weeks
When is congenital syphilis risk period?
Throughout - increased risk as pregnancy progresses
Primary -> highest risk
Secondary -> moderate risk
Latent -> low risk
When is congenital toxo risk period?
Throughout
Highest risk of infection 3rd trimester
Highest risk of fatal abnormality due to infection 1st trimester
When is congenital VZV risk period?
<12/40 = 0.4%
12-18/40 = 2%
>28/40 never reported
When is congenital Zika risk period?
Up to 20 weeks
Most common congenital infection with highest burden of disease?
Congenital CMV
Transmission rate of CMV in pregnancy?
30-50%
Most common cause of non-hereditary SNHL?
Congenital CMV
Test of choice for neonatal CMV?
Urine CMV PCR
Primary transmission for Hep C in children?
Vertical
Risk of perinatal transmission in Hep C pos mother?
5%
Risk of vertical transmission of HSV in pregnancy?
50-65% if first episode primary
25% if first episode non-primary
2% if recurrent
Mortality of skin/eye/mouth vs CNS vs disseminated neonatal HSV?
<10% skin, eye, mouth
50% CNS disease
80% disseminated disease
Risk of HIV transmission in pregnancy?
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
Congenital rubella acquired pre 12/40?
Congenital rubella syndrome
Congenital rubella acquired 12-18/40?
SNHL
Congenital rubella acquired after 18/40?
Usually asymptomatic
Should rubella non-immune woman be vaccinated during pregnancy?
No. Live vaccines contra-indicated
Maternal VZV >7 days pre delivery?
No mx req for neonate
Maternal VZV 7 days pre - 2 days post delivery?
Give baby zoster IG
Maternal VZV >2 days post delivery?
Treatment dependant on neonatal RFs
- if <28/40 or <1kg give ZIG
Conjunctivitis within 5 days of birth
Gonorrhoea
Conjunctivitis 5-15 days after birth
Chlamydia
Baby at 8 weeks of age, PHx conjunctivitis (untreated). Paroxysms of cough and increased WOB. Afebrile/low grade fever. CXR bilateral infiltrates. Pathogen?
Chlamydia
