Viral illness in pregnancy Flashcards

1
Q

What causes congenital rubella syndrome

A

Rubella virus during first 20 weeks pregnancy
Risk highest before 10 weeks gestation

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2
Q

When should pregnant women be given the MMR

A

After giving birth - live vaccine, cant have while pregnant

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3
Q

Features of congenital rubella syndrome

A

Congenital deafness
Congenital cataracts
Congenital HD - PDA + pulmonary stenosis
Learning disability

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4
Q

Why is VZV dangerous in pregnancy

A

causes more severe cases in mother eg varicella pneumonitis, hepatitis or encephalitis
Foetal varicella syndrome
Severe neonatal varicella infection

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5
Q

How to test for immunity to chickenpox

A

IgG level for VZV - if present, immunity present

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6
Q

What happens when pregnant non immune woman exposed to chicken pox

A

IV varicella immunoglobulins as prophylaxis against chickenpox
Within 10 dyas of exposure

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7
Q

What treat with if chickenpox rash presents in pregnancy

A

Oral aciclovir IF present within 24 hours and more than 20 weeks gestation

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8
Q

When does congenital varicella syndrome occur

A

When infection occurs in first 28 weeks

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9
Q

Typical features of congenital varicella syndrome

A

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)

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10
Q

Features of congenital CMV

A

Foetal growth restriction
Microcephaly
Hearing loss
Vision loss
LD
Seizures

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11
Q

How is CMV spread

A

Infected saliva or urine of asyptomatic children
when mother infected can cause CMV congenital

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12
Q

What is parvovirus B19 infection also known as

A

Fifth disease, slapped cheek syndrome and erythema infectiosum

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13
Q

What is the course of slapped cheek syndrome

A

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.

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14
Q

How long before rash are children infective with parvovirus B19?

A

7-10 dyas before

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15
Q

What kind of rash is in slapped cheek syndrome?

A

reticular mildly erythematous rash affecting the trunk and limbs appears, which can be raised and itchy

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16
Q

What is significant exposure to parvovirus classed as

A

classed as 15 minutes in the same room, or face-to-face contact, with someone that has the virus.

17
Q

Complications of parvovirus B19 in pregnancy

A

esp in first or secnd trimesters:
-miscarriage or foetal death
-Severe foetal anaemia
-Hydrops fetalis (foetal HF)
-Maternal pre-eclampsia- ike syndrome

18
Q

What is foetal anaemia caused by

A

Parvovirus infection of erythoid progenitor cells in foetal bone marrow and liver -> faulty RBC w shorter life span -> HF and hyrdrops fetalis

19
Q

What is mirror sydnrome

A

Rare complication of severe foetal HF - hydrops fetalis
Triad of:
Hydrops fetalis
Placental oedema
Oedema in mother

Also features HPTN and proteinuria

20
Q

What do women suspected of parvovirus infection need tests for

A

IgM - tests for acute infection within past four weeks
IgG - long term immunity to virus after prev infection
Rubella antibodies
Treatment is supportive

21
Q

Congenital zika syndrome

A
  • Microcephaly
  • Fetal growth restriction
  • Other intracranial abnormalities, such as ventriculomegaly and cerebellar atrophy
22
Q

What should pregnant women that may have contracted the zika virus have done

A

Viral PCR
antibodies to zika virus

22
Q

What should pregnant women that may have contracted the zika virus have done

A

Viral PCR
antibodies to zika virus

23
Q

Fo positive parvovirus and zika virus cases what should do to manage

A

Refer to foetal medicine for close monitoring of pregnancy
No treatment