W04: Infections in Preg, Multiple Gestation, Eclampsia, Growth Chart Flashcards
CHICKENPOX in PREGNANCY
fever, malaise, vesicular rash
48hr prior to rash => crusted lesions (infective period)
- for adults = higher morbidity: hepatitis, pneumonitis, encephalitis
for IMM COMPR. & PREGNANT PEOPLE - congenital infection in first 28w = FOETAL VARICELLA SYNDROME
- check history for chicken pox
- check. serum IgG
> offer VZ immunoglobulin (if non-immune)
> oral aciclovir if mild and within 24hr rash onset OR
IV aciclovir
PARVOVIRUS B19 in PREGNANCY
- common mild febrile, erythema of cheeks but MOST ADULTS are asymptomatic
- imm compromised and pregnancy
- foetal anemia, cardiac failure, hydrops fetalis, fetal death
rarely: pre-eclampsia with oedema
TOXOPLASMOSIS in PREGNANCY
a
What is shingles
Reactivation of dormant chickenpox virus in sensory nerve root ganglion since infection
HIV in PREGNANCY
- screened
- risk of pre-eclampsia, miscarriage, low birth wt, and PRETERM
- birth scan offered to HIV+ mothers
MDT input - LFT monitored
Hep B in PREGNANCY
- screened
- vertical transmission as well as bodily fluids
- acute = severe pres.
- fetal acquisition and cirrhosis and hepatocellular ca. risk
- chronic HBV with high. viral load
> TENOFOVIR monotherapy - Hep B vaccine given to at risk
> Hep B immunoglobulin for babies with positive mothers
+ accelerated imm. schedule
Hep C in PREGNANCY
- severe hepatitis; chronic liver disease; risk to liver ca.
- associated with hx of IVDU
- vertical transmission
- higher risk of vertical transmission when HIV(+)
- nil preventative methods, nil tx (dt teratogenic)
- vaginal birth relatively safe
Syphilis in PREGNANCY
- spirochete treponema pallidum; direct contact (sexual contact)
- increasing prevalence
- preg = risk of miscarriage, stillbirth, hydrops fetalis, growth restriction, congenital infection
- congenital infection = first 2y of life presentation
- urgent referral
- HUTCHINSONS TRIAD
> abx
intramuscular penicillin
! LT sequelae
! nil protective antibodies thus re-infection possible
Aims of HIV Tx
combined anti-retroviral treatment
> Viral load <50 HIV RNA copies/ml = allows vaginal delivery
> reduce risk of vertical transmission
> improve mother’s health
Classification of Syphyllis
1º = ulcer painless = chankry
2º = 4-10w progression
3º = 20-40y
What is HUTCHINSONS TRIAD
a triad in late congenital syphilis consisting of
notched incisors
interstitial keratitis
and eighth cranial nerve deafness.
> penicillin
Multiple Births: Reasons
- 1+ egg during 1 menstrual cycle
- Zygote divides after fertilisation => identical twins
- IVF tx => 1+ embryo to uterus
Amnioncity
No. of amnions (inner membranes) surrounding babies in a multiple pregnancy
Chorionicity
No. of outer membranes surrounding babies in multiple pregnancy.
Types of Twin Pregnancy
Are described by amniocity and chorionicity and are detected by fetal USS
Lambda sign = 2 placentas = dichorionic diamniotic twins
T sign = 1 placenta = monochorionic diamniotic twins
