T7 - L4 childhood and pregnancy Flashcards
what affect may an infection have on pregnancy?
- miscarriage
- congenital anomalies
- fetal hydrops
- fetal death
- preterm delivery
- preterm rupture of the membranes
which infections can be transmitted from mother to baby during pregnancy (in utero)?
TORCH
- Toxoplasmosis.
- Others (syphilis, HIV, coxsackie virus, hepatitis B, varicella-zoster).
- Rubella.
- Cytomegalovirus disease.
- Herpes simplex disease.
what route of transmission do infections take to a baby in utero?
haematogenous
by the blood
which neonatal infections can be acquired during passage through the birth canal?
- Group B Streptococcus
- Herpes simplex virus (HSV)
- Gonorrhoea
- Chlamydia
- Human immunodeficiency virus*
- Hepatitis B virus*
Symptomatic UTI in pregnancy is frequently preceded by what?
asymptomatic bacteriuria
what is Asymptomatic bacteriuria in pregnancy?
larger than normal numbers of bacteria are present in the urine
what happens if Asymptomatic bacteriuria is left untreated?
at least 30% of women with ASB will develop acute pyelonephritis
what is a cost effective approach to preventing pyelonephritis?
Screening for ASB
what is IAP?
Maternal intrapartum antibiotic prophylaxis
- the most effective means to reduce neonatal GBS infections and the burden of the disease
who is IAP offered to?
- Women with a previous baby with neonatal Group B Streptococcal disease
- Women with GBS in current pregnancy
- Women who are pyrexial in labour should be offered broad-spectrum antibiotics including an antibiotic for prevention of neonatal EOGBS disease
women in labour who are pyrexial should be offered what?
broad-spectrum antibiotics including an antibiotic for prevention of neonatal EOGBS disease
what are Intra-amniotic infections?
Intra-amniotic infection is infection of the chorion, amnion, amniotic fluid, placenta, or a combination.
Infection increases risk of obstetric complications and problems in the fetus and neonate.
what is a major cause of perinatal morbidity and mortality?
Intra-amniotic infections
what is Chorioamnionitis?
to inflammation of umbilical cord, amniotic membranes/fluid, placenta
(Intra-amniotic infections)
what are risk factors of intra-amniotic infections?
- rupture of membranes
- amniocentesis,
- cordocentesis,
- cervical cerclage,
- multiple vaginal examinations,
- Bacterial vaginosis
what is the pathogenesis of intra-amniotic infections?
Bacteria present in the vagina cause infection by ascending through the cervix
Haematogenous (via blood ) infection is rare e.g. Listeria monocytogenes
what are causative organisms of intra-amniotic infections?
Group B Streptococcus
Escherichia coli
Genital Mycoplasma
what is the management of intra-amniotic infections?
antimicrobials and delivery of the foetus
antimicrobials should be administered at the time of diagnosis (not after delivery)
what is Puerperal endometritis?
infection of the womb during puerperium affects ~5% of pregnancies
NB: Puerperal sepsis remains a major cause of maternal death
what are the risk factors of Puerperal endometritis?
- caesarean section,
- prolonged labour,
- prolonged rupture of membranes,
- multiple vaginal examinations
what are clinical features of Puerperal endometritis?
- fever
- uterine tenderness
- purulent, foul-smelling lochia
- increased white cell count
- general malaise
- abdopain
what are causative organisms of Puerperal endometritis?
Escherichia coli
Beta-haemolytic Streptococci
Anaerobes
what is the treatment for Puerperal endometritis?
Broad-spectrum intravenous antimicrobials - continued until the patient has been apyrexial for 48 h
why are children more susceptible to infections?
- hand to mouth behaviours
- lack of hygiene skills
- not fully immunised
- Children have close physical contact/do not practice much social distancing
