Chest Diseases and Congenital Viral Infections in Pregnancy

Question 1

What are the common chest diseases in pregnancy?

Answer 1

Pneumonia, Asthma, Tuberculosis (TB)

Question 2

What are common pathogens responsible for pneumonia in pregnancy?

Answer 2

Streptococcus pneumoniae, COVID-19 (viral), fungal organisms

Question 3

What is the risk of pneumonia in pregnancy on fetal outcomes?

Answer 3

May lead to hypoxaemia, acidosis, and preterm birth

Question 4

How is pneumonia in pregnancy investigated?

Answer 4

Chest X-ray, CT scan, full blood count, sputum culture

Question 5

How is pneumonia managed in pregnancy?

Answer 5

Antimicrobials, antivirals; vaccine covers 23 serotypes

Question 6

What are the key features of asthma in pregnancy?

Answer 6

Chronic inflammatory airway disorder with reversible airway obstruction; unaffected by pregnancy

Question 7

What are the foetal effects of maternal asthma?

Answer 7

Fetal hypoxaemia

Question 8

What drugs are contraindicated in asthma during labour?

Answer 8

Ergometrine and prostaglandins

Question 9

How is an acute asthma attack managed during pregnancy?

Answer 9

Nebulization or inhaler with spacer

Question 10

What are the key features of tuberculosis (TB) in pregnancy?

Answer 10

Major concern worldwide, re-emerging, affects immunocompromised and poor; same presentation as non-pregnant

Question 11

What investigations are used for diagnosing TB in pregnancy?

Answer 11

Sputum test, chest X-ray, FBC, skin test, GeneXpert

Question 12

What is the treatment regimen for TB in pregnancy?

Answer 12

RIPE therapy: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol; DOTS strategy

Question 13

Is breastfeeding contraindicated during TB treatment?

Answer 13

No, breastfeeding is allowed if sputum is negative

Question 14

How can a foetus be infected with viruses during pregnancy?

Answer 14

Haematogenous, ascending, iatrogenic (e.g., amniocentesis), endometrial (e.g., IUCD)

Question 15

List features of chorioamnionitis.

Answer 15

Uterine tenderness, maternal fever, fetal/maternal tachycardia, foul/discoloured liquor

Question 16

What is the most common congenital viral infection?

Answer 16

Cytomegalovirus (CMV)

Question 17

What are the foetal effects of congenital CMV infection?

Answer 17

CNS damage: microcephaly, choroidoretinitis, optic atrophy, deafness, mental retardation

Question 18

What is the mode of transmission of toxoplasmosis?

Answer 18

Faeco-oral; via Toxoplasma gondii

Question 19

What is the classic tetrad of congenital toxoplasmosis?

Answer 19

Hydrocephaly, microcephaly, chorioretinitis, cerebral calcifications (convulsions)

Question 20

What is the treatment for toxoplasmosis in pregnancy?

Answer 20

Sulphadiazine and pyrimethamine (avoid in 1st trimester)

Question 21

What organism causes rubella?

Answer 21

Togavirus

Question 22

What is Gregg’s triad?

Answer 22

Congenital heart defect, eye defect (e.g., cataract), deafness

Question 23

How is rubella diagnosed?

Answer 23

Serology: Positive IgM or fourfold IgG rise between acute and convalescent samples

Question 24

What is the treatment and prevention of rubella in pregnancy?

Answer 24

Symptomatic treatment; prevention via vaccination before pregnancy

Question 25

What are the foetal effects of varicella-zoster virus in pregnancy?

Answer 25

<20 weeks: hypoplastic limbs, CNS anomalies; perinatal period: severe complications

Question 26

When is varicella-zoster immunoglobulin given to the neonate?

Answer 26

If maternal infection occurs 2 days before to 5 days after delivery

Question 27

How is varicella diagnosed and managed in pregnancy?

Answer 27

Clinical diagnosis; antiviral treatment and VZ immunoglobulin

Question 28

What placental signs are associated with congenital syphilis?

Answer 28

Villus thickening, vasculitis, increased placental size

Question 29

What are early signs of congenital syphilis?

Answer 29

Lesions on palms/soles, osteochondritis, epiphysitis (pseudoparalysis)

Question 30

What is the risk of herpes simplex virus (HSV) in neonates?

Answer 30

Devastating neonatal infection affecting skin, liver, CNS; 75% mortality

Question 31

What delivery mode is advocated for women with active HSV lesions?

Answer 31

Caesarean section

Question 32

What are the foetal effects of parvovirus B19 infection?

Answer 32

Fetal anaemia, non-immune hydrops foetalis

Question 33

How is parvovirus B19 diagnosed in pregnancy?

Answer 33

Virus-specific IgM in maternal serum

Question 34

Is there a specific treatment for parvovirus B19 in pregnancy?

Answer 34

No specific treatment available