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Physiology > Screening for infectious disease in pregnancy > Flashcards

Screening for infectious disease in pregnancy Flashcards

1
Q

Name the two types of screening

A

Universal- everybody is screened

selected- only people who have risk factors

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2
Q

what is screening

A

process of identifying apparently healthy people who may be at increased risk of a disease or condition
in pregnacy screening looks at the unborn baby- to see any defects eg downs

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3
Q

name three screenings that pregnant women go through

A

HIV
hepatitis B
syphilis

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4
Q

when was HIV screening introduced for pregnant women,

A

1999, 2000 all pregnant women where offered the screening, 90% uptake by 2002

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5
Q

what is HIV

A

a retro-virus, which, if left untreated, leads to immunosuppression and eventually to acquired immune deficiency syndrome (AIDS)

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6
Q

How is HIV transmitted

A

it is present in body fluids such as blood, semen, vaginal secretions and breast milk,
transmitted through unprotected sexual intercourse, direct contact with the blood of an infected person, sharing infected needles, from mother to child during pregnancy, at birth or when breast feeding

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7
Q

what are CD4 cells

A

T-helper cells, are white blood cells which plays an essential part in the human immune system
Made in the spleen, lymph nodes and thymus gland

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8
Q

Role of CD4 cells

A

to detect pathogens and send signalsto other types of immune cells, including CD8 killer cells, to destroy the infectious particles

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9
Q

How dose HIV effect the CD4 cells

A

When HIV enters the body it targets and invades the CD4 cells in the blood.
Once inside the CD4 cell the virus begins a the replication process to produce new HIV virons. When completed, the new virons break through the cell wall and out into the bloodstream, destroying the CD4 cell.
this process is reprted to allow the virus to spread

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10
Q

Normal CD4 cell count in a normal person compared to someone with HIV

A

Normal- between 500 and 1,500 cells per ml of blood
HIV- this number falls, and can if it falls to a level where the immune system is no longer able to function adequately and the person becomes susceptible to opportunistic infections and HIV related cancers

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11
Q

How can HIV be transferred to the child during pregnancy

A

Mother-to-child vertical transmission, but this is rare, in an untreated mother this is 25%, in a treated mother it is 0.5% of the child being born with HIV

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12
Q

Name a way in which a child can contract HIV from the mother after birth

A

From breastfeeding, thus formula is recommend for mothers with HIV

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13
Q

when was hep B screening introduced in the UK

A

1988 - selected screening
1999- universal screening
programme fully implemented in 2000

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14
Q

What is hepatitis B (Hep B)

A

an infectious inflammatory illness of the liver caused by the hepatitis B virus, two phase, acute and chronic,
it is called a silent disease and is easy to pass on

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15
Q

name to the phases of hep B

A

acute and chronic

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16
Q

what dose having high CD4 cell count mean

A

high immunity

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17
Q

How dose Hep B replicate

A

enters a liver host cell, alters it’s DNA and replicates, this condition is easy to pass and is nicknames the silent disease

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18
Q

what dose Hep b cause

A

inflammation of the liver

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19
Q

what is acute Hep B

A

new infection, 1-4 months symptoms- 90% will clear on it’s own after a few weeks- this gives the persons an immunity to re-infection

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20
Q

How are P women with HIV advised to help it not spread to the child

A

only use formula milk-

and antiretroviral therapy- most common therapy used in P women

21
Q

what is chronic hep B

A

infection that has not cleared after 6 months- person becomes a lifelong carrier, 20% will develop cirrhosis (scarring of the liver which increases cancer risk
issues are worse if contracted as a baby then an adult

22
Q

what is cirrhosis

A

issue of chronic Hep B- scarring of the liver which increases cancer risk

23
Q

how is Hep B transmitted

A 
through all body fluids
perinal transmission( m to child)
24
Q

is Hep b preventable

A

yes by vax

25
Q

what are some of the signs and symptoms of hep B

A 
Fever, fatigue, pain
loss of appitie 
nausa, vomiting,
pale and light stools
dark yrine
26
Q

is hep b a greater risk at a younger age

A

yes. 90% of infected infents will be chronic
50% 1-5 becme Chronic
5-20% 19+ will be C

27
Q

is the risk increased if the mother has hep B

A

Yes if the mother has hep B then the risk is increased, but it depends on the mothers stauts, with no intervention 90% of B will be born with Hep compared to 10% with M with hep

28
Q

what is perianal transmission

A

can result in an acute or chronic infection,Without vaccination, 95% will have a sub-clinical infection (C carriers for life), 40% risk of death from cirrhosis/cancer

29
Q

can be perianal transmission be halted

A

yes by a vax at the correct time,
The mode of delivery and breastfeeding does not affect mother to child transmission if the baby receives appropriate management

30
Q

what is syphilis

A

infectious disease, caused by bacteria,
transmitted through sexual contact, M to C in fetus and delivey,
4 stages

31
Q

what are the 4 stages of Sy

A

primary and secondary where a person is symptomatic and highly infectious
latent- infection found on lower levels
tertiary where syphilis re-activates and serious health complications are common

32
Q

what stage of Sy presents the highest risk in P

A

primary and secondary- 70-100% risk
Latent- 40%
Late-10%
most risk in first two stages

33
Q

what issues can Sy cause

A

miscarriage, still birth, birth defects eg hearing loss and neurological impairment

34
Q

babies born with congincal SY when do they display symptoms and what can it cause

A

symptoms at w5, if untreated it can cause neurological impairment eg hearing loss

35
Q

what are the 3 reasons for a positive screening

A

current infection
past sy infection
false positive due to other infection eg treponmal

36
Q

what is the treatment for Sy

A

P women with a positive test should be referred to fetal medicine by 26 weeks

37
Q

name some of the disease that are not usally screened (can be if at high risk)

A 
rubella susceptibility
• chlamydia
• cytomegalovirus
• group B streptococcus
• hepatitis C
• toxoplasmosis
• chickenpox (varicella susceptibility)
• parvovirus B19
38
Q

what is Rubella

A

not common disease, viral infection, can be dorment, transmitted via droplets from coughing
50% of infected People will show no symptoms

39
Q

what is congenital rubella syndrome

A

very rare, occurs when the virus that causes rubella disrupts the development of an unborn baby, depending on how early in P it was contracted depends on the severity of the birth defects

40
Q

How can rubella effect p women

A

it can be passed to the F without any issues, But if a woman gets rubella shortly before getting pregnant or during the first three months of pregnancy, it is very likely to result in miscarriage or congenital anomalies known as congenital rubella syndrome (CRS).

41
Q

when is CRS greater risk

A

The earlier in the pregnancy, the greater the risk
infection if the first 10w- risk as high as 90% and can causes many B defects
11-16w- 10-20%- few B defects
17-20w- very rare- hearing loss

42
Q

what is Cytomegalovirus

A

common virus-50% of Uk pop have it in their lifetimes
flu like symptoms- can be dormant
40% of pw are suceptablie at time pf p
main risk is when caught the first time
40% of b being infected- 90% of these show no Symptomes at birth

43
Q

how is Cytomegalovirus transmitted

A

only passed when active
through body fluid, close contact
Pregnant women can pass an ‘active’ CMV infection on to their unborn baby- usally from children saliva

44
Q

how can cytomegalovirus be active

A

you catch the virus for the first time – young children often get CMV for the first time at nursery
•the virus has ‘re-activated’ – because you have a weakened immune system
•you’ve been re-infected – with a different type (strain) of CMV

45
Q

what are some of the symptoms of Cytomegalovirus

A 
hearing issues
small head size, small size in genral
seizures
jondice 
enlarged livers + spleen
pneumonia
•a rash of small, purplish spots
low birth weight
46
Q

how can Cytomegalovirus be prevented

A

washing hands

avoid face kissing

47
Q

what is Toxoplasmosis

A

infection caused by parasites which affect warm bodied animals,
can be caught by eating raw meat, unpasteurised milk chesses, unwashed F+V
infection In P can causes damage to the B
Once caught your are immune for life, no symptoms
only 4 in 10 of such infections will pass to the baby

48
Q

what issues can Toxoplasmosis

A

still birth, miss-carriage, damage to B brain and other organs,

49
Q

How can Toxoplasmosis be passed in P

A

through the placenta,
infected matter entering human body fluids- lambing
transplanted organs, blood ect
through inhaling the parasite eggs

Physiology (10 decks)

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