Reproductive Infections Flashcards
What causes a UTI? What do they treat uti’s with?
What can a UTI lead to?
How can this affect PG?
Bacteria present in urine culture treated with antibiotics
Could lead to cystitis or a kidney infection.
That would cause premature birth and intrauterine growth restriction.
How to prevent cystitis/uti
contraception:
Avoid:
Do:
Change diaphragm method for contraception
Avoid bladder irritants such as alcohol or caffeine or carbonated beverages
Avoid holding pee in
Avoid sex
Do drink water
Do drinkn cranberry juice to help relieve UTI symptoms
Do wipe front to back
Do take all of your antibiotics for UTI infections
Vaginitis or Vaginosis types (3)
Vulvovaginal Candidiasis
Bacterial vaginosis/gardnerella
Trichomoniasis
Name for yeast infection
How is it spread?
General mucus appearance?
treatment meds?
risk in pregnancy?
treatment for newborn?
Vulva Candidiasis which is considered to be a vaginitis subtype
spread by contact
cottage cheese like mucus
tx: antifungals like miconazole
pill, creams, suppositories
If present for labor, newborn could be at risk for thrush or diaper dermatitis
but just give them antifungals
Bacterial vaginosis/ Gardnerella
Mucus appearance
Smell
How is it dx
Howo is it tx
Vaginosis is gray/yellow milky discharge
Smells like fish
dx by clue cells on slide of discharge
treated with metronadozaole or flagyl
Bacterial vaginosis/Gardnerella
risk to pregnancy?
PROM - pre-term rupture, PTC - preterm labor, and postpartum infections
Trichomoniasis
appearance
symptoms
Dx:
tx:
education for sex & substances:
green white frothy discharge
can have urinary symptoms or strawberries on cervix
Saline slide reveals a motile flagellated tail organism
Rapid test
Affirm test
Metronidazole (again) 2 grams
BUT you need to avoid coitus until infection is gone
Avoid alcohol
Chlamydia
bacteria
how common is this?
transmission
symptoms? in men?
what if it isn’t treated?
newborn risks
- treatment?
adult tx
chlamydia trachomatis
most common sti in us
sexual contact transmission
no symptoms or may have purulent discharge or dysuria . men may think they have uti
if not treated, then could lead to
PID, ectopic PG, tubal infertility in women
newborn risks include eye and lung infection
- need to do prophylaxis treatment with erythromycin
adults treated with Azithromycin or Doxycycline orally
Syphillis bacteria?
incubation?
transmission?
Syphillis caused by spirochete treponema pallidum
Incubation is 10-90 days meaning you can have it not know
sex, open wound, blood, or transplacentally during PG
Syphillis early signs
Chancre at site of organism entry (disappears after 4 weeks)
Fever
Wt loss
Malaise
Syphillis secondary signs
condylomata late (warts) rash arthritis hepatosplenamegaly tender lymph nodes iritis chronic ST with hoarseness
Blood test for syphillis
VDRL (less sensitive )
RPR
FTA-ABS (most effective but costly)
At what gestational week age will syphillis begin to affect the fetus
14 weeks
treatment if you’ve had syphillis symptoms for less than a year if pregnant
for unknown duration or more than year if pregnant
what if someone is allergic to pcn?
- 4 million u. PCN x3weeks IM
- 4 million PCN x3weeks
just have to desensitize them to it
treatment for syphillis if not pregnant
doxycycline or tetracycline
How long will the mom be positive for syphillis for after treatment
8 months for mom
3 months for baby
But it is ok as long as you see the load decrease. do titer.
PG effects of syphillis
small low birth weight of infant, preterm birth, or stillbirth
Gonorrhea
bacteria
transmission
dx
Gonorrhea
Neisseria gonorrhea
sexual contact transmission
swab culture
Gonorrhea
treatment
education
newborns?
- treatment
Ceftriaxone 250 mg IM
partner must be treated
Will have to retest in 3 months (both people)
Could have eye ophthalmia and pneumonia
- need eye ointment erythromycin but can do oral
What are TORCH infections?
A group of infections represented by the TORCH acronym. Toxoplasmosis Other such as Hep A ,B, C Rubella Cytomegalovirus Herpes
What is Toxoplasmosis cause?
What do Toxoplasmosis symptoms look like?
Caused by protozoa parasites that can be found in cats
Can have no symptoms or could have mono signs with a fever
How to avoid getting Taxoplosmosis?
Avoid eating undercooked meats
Don’t allow PG women to scoop litter w cat feces
Complications in PG if you get Taxoplasmosis?
Lots
hydrocephaly choriortenitis cerebral calcifications enlarged liver rash jaundice after birth
How to treatment Toxoplasmosis with meds
Pyrimethamine
sulfa and folic acid for 1 yr total
Why is an infection of Toxoplasmosis (or any infection) more worrisome if it occurs in the first trimester?
The younger the baby the more likely the infection will affect development
Rubella is what type of virus?
Rubella effects are greatest in which trimester? And to which systems?
It is the German measles virus but it has an immunization
First trimester
Hearing is main system but also the eyes, CNS, or cardiac
Cytomegalovirus is described as?
Cytomegalovirus is a transplacental infection due to active maternal infections going on
Neonate symptoms of cytomegalovirus?
rash liver is enlarged jaundice microcephaly IGM will be elevated
Cytomegalovirus treatment for newborn and mother
Antiviral to newborn
PG mother will be given CMV or a specific immunoglobulin
List Torch infections again
Toxoplasmosis Other hep a, b, c Rubella Cytomegalovirus Herpes
Different types of Herpes
1 - oral
2- genital
Herpes transmission
vaginal
anal
oral
generally any skin to skin contact with infected site
What do Herpes blisters feel , look, and act like?
When do blisters heel after they show up?
Painful vesicles that can last up to 20 days past exposure
Will heal in 2-4 weeks - but the virus isn’t gone. It remains dormant in nerve ganglia.
How can Herpes affect pregnancy?
May have to do C-section if there is an active break out at delivery.
Can also increase risk of spontaneous abortion , preterm labor, or IUGR ( slow growing fetus)
Treatment for PG mothers with herpes and when
antiviral therapy in the 3rd trimester to reduce fetal risks and c-section delivery