Pregnancy Flashcards
Describe immune system changes that occur during pregnancy
Switch from Th1 (cell mediated immunity) to Th2 (antibody mediated/humoral)
- PsO can improve, eczema can flare
- increased risk infection
HPV risk during pregnancy
neonatal HPV
laryngeal papillomatosis
Treatment options for HPV during pregnancy
curette, cryotherapy,
CI - podophyllin, imiquimod, 5-FU
T/F lupus usually flares during pregnancy
T (60% will flare)
risk of neonatal lupus
occurs in 8-10% of children of Ro + Mothers
Can increase to 25% if highly symptomatic or prior neonatal lupus baby
CHB in 1-2% of children of Ro+ mothers
Clinical features of neonatal lupus
All skin signs present at birth or within first 3 months
spectacle-like/ racoon eye distribution/ forehead/temples/ cheeks/ neck erythema, slightly scaly, can be UV-exacerbated
Resolve over first year - can be atrophy, teles, alopecia
Haem - thrombocytopenia/ other
Liver - hepatomegaly/ cholestasis
Prevention of neonatal lupus
Increased risk in subsequent pregnancies
Oral steroids + HCQ in first trimester can reduce risk
List physiological changes during pregnancy
Pigment related - melasma, hyperpigmentation of nipples/areola/genitals, linear nigra Hair - hypertrichosis Nails - onycholysis, Beau's, fragility Striae distensae Spider naevi Pyogenic granulomas Increased size + number of naevi
Which conditions get worse during pregnancy?
Atopic dermatitis (HS, acne), autoimmune (SLE), EN, melasma, scleroderma
Which conditions improve during pregnancy
Psoriasis (HS, acne)
What are the considerations of VZV + pregnancy?
Increased complications in maternal infection (pneumonia, encephalitis)
Risk of foetal varicella syndrome (highest risk is 13-20 weeks gestation) — presents as microcephaly, neurological abnormalities, ocular abnormalities, skin scarring, limb defects
Risk of neonatal infection (if maternal infection 7 days prior - 2 days after delivery)
What are the risks of parvovirus in pregnancy?
Miscarriage, hydrops fetalis
