Viral illness in pregnancy Flashcards
What causes congenital rubella syndrome
Rubella virus during first 20 weeks pregnancy
Risk highest before 10 weeks gestation
When should pregnant women be given the MMR
After giving birth - live vaccine, cant have while pregnant
Features of congenital rubella syndrome
Congenital deafness
Congenital cataracts
Congenital HD - PDA + pulmonary stenosis
Learning disability
Why is VZV dangerous in pregnancy
causes more severe cases in mother eg varicella pneumonitis, hepatitis or encephalitis
Foetal varicella syndrome
Severe neonatal varicella infection
How to test for immunity to chickenpox
IgG level for VZV - if present, immunity present
What happens when pregnant non immune woman exposed to chicken pox
IV varicella immunoglobulins as prophylaxis against chickenpox
Within 10 dyas of exposure
What treat with if chickenpox rash presents in pregnancy
Oral aciclovir IF present within 24 hours and more than 20 weeks gestation
When does congenital varicella syndrome occur
When infection occurs in first 28 weeks
Typical features of congenital varicella syndrome
Foetal growth restriction
Microcephaly, hydrocephalus + LD
Scars and signifcant skin changes located in specific dermatomes
Limb hypoplasia (underdeveloped limbs)
cataracts and inflammation in eye (chorioretinitis)
Features of congenital CMV
Foetal growth restriction
Microcephaly
Hearing loss
Vision loss
LD
Seizures
How is CMV spread
Infected saliva or urine of asyptomatic children
when mother infected can cause CMV congenital
What is parvovirus B19 infection also known as
Fifth disease, slapped cheek syndrome and erythema infectiosum
What is the course of slapped cheek syndrome
Parvovirus infection starts with non-specific viral symptoms. After 2 – 5 days, the rash appears quite rapidly as a diffuse bright red rash on both cheeks, as though they have “slapped cheeks”. A few days later a reticular mildly erythematous rash affecting the trunk and limbs appears, which can be raised and itchy. Reticular means net-like.
How long before rash are children infective with parvovirus B19?
7-10 dyas before
What kind of rash is in slapped cheek syndrome?
reticular mildly erythematous rash affecting the trunk and limbs appears, which can be raised and itchy
What is significant exposure to parvovirus classed as
classed as 15 minutes in the same room, or face-to-face contact, with someone that has the virus.
Complications of parvovirus B19 in pregnancy
esp in first or secnd trimesters:
-miscarriage or foetal death
-Severe foetal anaemia
-Hydrops fetalis (foetal HF)
-Maternal pre-eclampsia- ike syndrome
What is foetal anaemia caused by
Parvovirus infection of erythoid progenitor cells in foetal bone marrow and liver -> faulty RBC w shorter life span -> HF and hyrdrops fetalis
What is mirror sydnrome
Rare complication of severe foetal HF - hydrops fetalis
Triad of:
Hydrops fetalis
Placental oedema
Oedema in mother
Also features HPTN and proteinuria
What do women suspected of parvovirus infection need tests for
IgM - tests for acute infection within past four weeks
IgG - long term immunity to virus after prev infection
Rubella antibodies
Treatment is supportive
Congenital zika syndrome
- Microcephaly
- Fetal growth restriction
- Other intracranial abnormalities, such as ventriculomegaly and cerebellar atrophy
What should pregnant women that may have contracted the zika virus have done
Viral PCR
antibodies to zika virus
What should pregnant women that may have contracted the zika virus have done
Viral PCR
antibodies to zika virus
Fo positive parvovirus and zika virus cases what should do to manage
Refer to foetal medicine for close monitoring of pregnancy
No treatment
