Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Perinatal Infections > Flashcards

Perinatal Infections Flashcards

1
Q

What problems does sustained pyrexial illness cause in 1st trimester?

A

Miscarriage

NTD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What problems does sustained pyrexial illness cause in T2/T3?

A

Preterm labour

Fetal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common cause of fetal or neonatal death?

A

Preterm labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two most common bacterial infections in pregnancy?

A

UTI, chorioamnionitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two most common causes of preterm labour?

A

Chorioamnionitis followed by UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes chorioamnionitis?

A

Low pathogenic commensalism anaerobic vaginal or bowel bacteria
Bacterial vaginosis
GBS (rarely in SA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does chorioamnionitis affect the mother and the etus?

A

The mother is usually asymptomatic

Infection causes inflammation in the baby, affecting the prostaglandin pathway, leading to preterm labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are complications of chorioamnionitis in the mother?

A

PPROM
Preterm labour
Endometritis
Septicaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the complications of chorioamnionitis in the baby?

A 
Congenital bacterial infection (due to colonization at birth or acute chorioamnionitis)
Early onset (7/7) meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is chorioamnionitis managed in mother and/or baby?

A

IVI ampicillin - crosses placenta

+/- gentamicin/ metronidazole (if septicaemic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common cause of puerpural sepsis?

A

GBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the indication if the baby is sick and proved to have GBS?

A

The mother is a carrier and needs prophylactic antibiotics in the next pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When are antibiotics effective in women with preterm labour?

A

PPROM

Mother ill- maternal fever in labour, clinical signs of bacterial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is chlamydial infection associated with in the newborn?

A

Eye infection

Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is gonorrhoeal infection associated with in the newborn?

A

Eye infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Regarding TB, what type is problematic and what is the management plan?

A

Cavitatory TB is the problem
Treat mother - no longer infectious after 2/52
Give baby INH prophylaxis if mother

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does primary symptomatic syphilis present?

A

Chancre

Painless regional lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does secondary syphilis present?

A 
Rash (palms and soles)
Also pedis
Snail track ulcers
Generalized adenopathy
Malaise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is latent syphilis still infectious to the fetus?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What tests are used in primary syphilis screening?

A

VDRL
RPR
Strip test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What tests are used in secondary syphilis screening?

A

FTA

TPHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the benefits of RPR?

A

Very cheap
Expressed as positive or negative
Rapid test available
Can be performed on CSF

23
Q

How is VDRL performed?

A

In lab.

Expressed as titre- rx if >1/16. If

24
Q

What are the benefits of the strip test?

A

Cheap
High sensitivity and specificity
Result in 5-20 min

25
Q

How is primary syphilis managed?

A

Benzathine benzyl penicillin 2.4mU IMI x 3 doses 1/week

26
Q

How is secondary or early latent syphilis managed?

A

Benzathine benzyl penicillin 2.4mU IMI x 3 (weekly)

27
Q

How is syphilis treated if penicillin allergy? What is the problem with this?

A

Doxycycline or erythromycin - may not protect fetus

28
Q

What are the signs of congenital syphilis?

A 
LBW, Preterm, UGA
HSM + Jaundice + Purpura + Anaemia
Blisters on palms and soles (contagious) + Peeling skin
Oedema
Osteitis
Pneumonia alba
29
Q

What is the neonatal rx of congenital syphilis?

A

If symptomatic or XR involvement: procaine penicillin 50000iU/kg for 19 days
(Congenital syphilis is equivalent to secondary in adults)

30
Q

When do you treat an asymptomatic baby for syphilis?

A

Mother asymptomatic but treated (latent)
Partially treated
Rx completed within last 4/52 pregnancy
Treated with erythromycin

31
Q

What do you use to treat an asymptomatic baby exposed to syphilis in utero?

A

Benzathine penicillin 50000iU/kg IMI stat

Equivalent to latent phase in adults therefore stat dose

32
Q

What are the TORCHES infections?

A

Toxo
Rubella
CMV
Herpes

33
Q

When does an infant contract congenital hep B and from what?

A

Contracted at delivery or after birth from blood or vaginal secretions

34
Q

When, according to national protocol, is an infant vaccinated against hep B?

A

At 1/12

35
Q

Which two clinical scenarios result in a different hep B vaccination protocol for the infant?

A

Mother known carrier

Acute hepatitis during pregnancy

36
Q

What is the management for an infant of a known hep B carrier or of mother with acute hep in pregnancy?

A

Baby gets extra vaccine at birth and hep B IgG if available

37
Q

What is seen on histology in a CMV infection?

A

Infected cells are swollen

Multinucleate giant cells

38
Q

What are the complications seen in the infant with congenital CMV infection?

A 
Seizures, mental retardation, microcephaly
Micropthalmia, Chorioretinitis
HSM, Blueberry muffin rash
Late onset neural deafness 
Pneumonitis
39
Q

How does rubella present?

A

Fever and flu-like symptoms
Red maculopapular rash, face to extremities
Lymphadenopathy, posterior auricular and suboccipital
‘3/7 day measles’ but not as severe (no encephalitis)
Self-limiting arthritis in young women

40
Q

How is rubella diagnosed antenatally?

A

Antenatal USS

Amniotic fluid culture

41
Q

What complications follow T1 rubella infection?

A

Malformations - cardiac

42
Q

What are the complications of rubella in pregnancy?

A

Seizures, mental retardation, microcephaly
Deafness
Micropthalmia, chorioretinitis, cataracts
HSM, blueberry muffin rash

43
Q

What are the signs of congenital toxoplasmosis?

A

Seizures, mental retardation, microcephaly
Encephalitis, peri ventricular hydrocephaly, intracranial calcification
Deafness
Micropthalmia, chorioretinitis

44
Q

When is the baby at increased risk of getting herpes?

A

If the mother has active herpes at delivery

If mother’s first infection is during pregnancy (no antibodies to cross placenta)

45
Q

How does the infant contract herpes?

A

Through exposure to infected maternal secretions at delivery or if prolonged ROM

46
Q

What is heroes treated with?

A

Acyclovir

47
Q

What duration of treatment is required before the baby is safe from herpes infection at delivery?

A

48 hours rx

48
Q

How does HIV affect the pathogenesis of herpes virus?

A

More viral replication and shedding

49
Q

Up until when does viral shedding occur?

A

Up to 6/52 after infection

50
Q

How is herpes diagnosis confirmed?

A

PCR, culture, serology

51
Q

How does herpes infection present in the newborn?

A

Local involvement of mouth, skin or eyes
Encephalitis
Disseminated herpes infection

52
Q

What signs on USS should raise suspicion regarding congenital infection?

A 
Symmetrical IUGR
Big placenta
Hydrops fetalis
Big liver or spleen
Brain calcifications
53
Q

What signs raise suspicion about congenital infections in a newborn?

A

SGA baby
Flat, unwell, poor feeding
Mother RPR positive and untreated, or unknown- always check
Heavy placenta (>1/7 baby’s weight)
Any specific signs or symptoms of individual infections

54
Q

What infections are of perinatal relevance?

A

Bacterial- UTI, chorioamnionitis, TB, gonorrhoea/chlamydia, syphilis
Viral - Hep B, CMV, rubella, herpes
Other- toxo

Obstetrics (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions