TORCH and Anemia

Question 1

Total iron requirement for a pregnancy is 1000 mg. Diet rarely meets pregnancy needs

2nd & 3rd Trimester:
Hgb - <11 mg/dL
HcT - <33

Answer 1

Iron deficiency

Question 2

Maternal Symptoms for Iron deficiency

Answer 2

Pallor
Fatigue
Lethargy
HA
PICA for various substances
Microcytic Hypochromic RBC’s

Question 3

Essential for formation of RBC’s cell duplication and placental and fetal growth. Maternal needs 2x during pregnancy r/t need for more erythrocytes, plus placental and fetal growth. Caused by nutritional deficiencies (folate), hemolytic anemias, Mal-absorption, and specific medication.

Answer 3

Folic Acid Deficiency

Question 4

Folic Acid Deficiency Maternal Symptoms

Answer 4

Presence of megaloblast (large immature erythrocytes)
Increased risk for spontaneous abortion, abruptio placentae, and fetal abnormalities.

Question 5

Autosomal recessive disorder. The defect cause erythrocytes to assume an “S” shape. They tend to clump together & occlude small BV’s. The disease is characterized by chronic anemia, susceptibility to infection and recurring episodes of sickle cell crisis.

Answer 5

Sickle Cell

Question 6

Sickle Cell maternal symptoms

Answer 6

pregnant may precipitate sickle crisis
1. jaundice r/t decrease bone marrow function and massive erythrocyte dysfunction
2. pain r/t major infants in joints and all major organs

Question 7

Hep B maternal effects

Answer 7

fever
rash
arthralgia
abdominal pain
liver enlarged and tender

Question 8

Hep B transmission

Answer 8

1. transplacental
2. body fluids: blood, saliva, vaginal secretions, semen, and breast milk
3. contaminated needles or blood transfusion

Question 9

Hep B management

Answer 9

all pregnant women are screened for HbSAG at risk clients prescreened in 3rd trimester

Question 10

AIDS maternal effects

Answer 10

Antepartum: a increase incidence of other STDs offered the option of ZDV

Intrapartum: external EFM preferred avoid use of fetal scarp electrodes or blood sampling.

Postpartum: breast feeding contraindicated universal precautions for mom and baby

Question 11

AIDS transmission

Answer 11

1. sexual intercourse
2. parenteral
3. perinatal exposure of an infant to an infected mom

Question 12

AIDS management

Answer 12

prevention
safe sex practices
barrier contraceptives
ZDV

Question 13

Group B streptococcus (GBS) gram positive bacteria Management

Answer 13

IV antibiotics to mom in labor

Question 14

Group B streptococcus (GBS) transmission

Answer 14

1. colonized in the rectum, vagina, cervix, and urethra of women
2. ascends after ROM or during birth

Question 15

Toxoplasmosis (Protozam) Maternal

Answer 15

1. flu-like symptoms
2. lymphadenopathy
3. spontaneous abortions

Question 16

Toxoplamosis (Protozam) transmission

Answer 16

1. raw meat
2. infected animal (cat) feces
3. transplacental

Question 17

Varicella Zoster (chicken pox) Transmission

Answer 17

1. direct contact
2. respiratory droplets

Question 18

Varicella Zoster (Chicken Pox) maternal

Answer 18

preterm labor
encephalitis
varicella pneumonia

Question 19

Rubella (German measles) transmission

Answer 19

1. transplacental
2. direct contact
3. respiratory droplets

Question 20

Rubella maternal

Answer 20

rash
fever
malaise
spontaneous abortions in 1st trimester

Question 21

cytomegalovirus a herpes virus. becomes latent after primary infection periodic reactivation and shedding

Answer 21

CMV

Question 22

CMV transmission

Answer 22

1. transplacental
2. body fluids

Question 23

CMV maternal

Answer 23

flu-like symptoms
cervical discharge

Question 24

CMV management

Answer 24

no effect tx. therapeutic abortion considered if primary infection occurs in 1st 20 weeks of pregnancy

Question 25

TORCH Infections =

Answer 25

Toxoplasmosis (Protozoan)
Varicella Zoster (Chicken Pox)
Rubella (German Measles
Cytomegalovirus (CMV)
Hepatitis B
AIDS
Group B Streptococcus (GBS) Gram + Bacteria