Congenital and Perinatal Infections

Question 1

What is a prenatal infection?

Answer 1

an infection that is acquired or carried by the mother which is transmitted to the developing fetus

Question 2

What is a perinatal infection?

Answer 2

an infection transmitted around the time of delivery

Question 3

What is a postnatal infection?

Answer 3

an infection acquired after delivery from the family/health care workers/community

Question 4

What is vertical transmission?

Answer 4

transmission from mother to fetus/baby - either transplacental or via breast milk

Question 5

What is horizontal transmission?

Answer 5

from one person/baby to another

Question 6

What is an ascending infection?

Answer 6

where vaginal organisms ascend to produce a fetal infection - more common when the membrane is ruptured

Question 7

What are some of the possible effects of an infection on the fetus?

Answer 7

the mother’s infection without transmission to the fetus can cause premature delivery or fetal death - the transmission of the infection to the fetus can cause end organ damage in the fetus or chronic infection in the fetus

Question 8

What family is the varicella zoster virus from?

Answer 8

herpesviridae

Question 9

How does chicken pox spread?

Answer 9

either respiratory or direct contact with vesicles

Question 10

What are the possible complications of chicken pox?

Answer 10

secondary bacterial infection, pneumonitis, acute cerebellar ataxia

Question 11

Why is a primary infection of varicella more severe in pregnant women?

Answer 11

because pregnancy makes you immunocompromised

Question 12

What are the symptoms of congenital varicella syndrome due to an infection in the first trimester?

Answer 12

limb hypoplasia, cicatricial scarring, microcephaly, cataracts, mental retardation, gastrointestinal and genitourinary abnormalities

Question 13

What is perinatal varicella?

Answer 13

where mum gets an infection with varicella -7 to +2 days from delivery which is then transmitted to the neonate and causes disseminated infection

Question 14

Who is given prophylactic VZIG?

Answer 14

susceptible pregnant women, infants whos mother has varicella around the time of delivery, immunocompromised patients and premature babies

Question 15

What is the treatment for acute varicella?

Answer 15

acyclovir

Question 16

What type of vaccine is the varicella vaccine?

Answer 16

live attenuated virus

Question 17

What family is cytomegalovirus from?

Answer 17

herpesviridae

Question 18

Where does cytomegalovirus stay latent?

Answer 18

in white blood cells

Question 19

What is the transplacental route of infection for CMV?

Answer 19

haematogenous

Question 20

What are the perinatal routes of infection for CMV?

Answer 20

genital secretions, saliva, breast milk

Question 21

Why is the second baby of a family more likely to get congenital CMV?

Answer 21

because the first child can acquire CMV at day care and pass it on to the pregnant mum

Question 22

What are the symptoms of CMV infection from horizontal transmission in newborns?

Answer 22

hepatomegaly, respiratory distress, atypical lymphocytosis

Question 23

What is congenital CMV?

Answer 23

babies are born with CMV due to mum acquiring a primary infection during pregnancy or a reactivation during pregnany - a primary infection has much higher risk of transmission to the fetus

Question 24

What are the symptoms of congenital CMV?

Answer 24

rash, hepatomegaly, microcephaly, calcification around ventricles, small brain - but only about 10% are symptomatic

Question 25

What is the most common long term sequelae of congenital CMV?

Answer 25

sensory neural deafness

Question 26

What is IgG avidity and why is it a useful test?

Answer 26

IgG avidity tests how strongly the antibody and antigen bind - can be useful to determine how recent the infection was

Question 27

How do you confirm a fetal infection with CMV?

Answer 27

PCR of amniotic fluid

Question 28

What is the treatment for symptomatic neonates with CMV?

Answer 28

ganciclovir

Question 29

What family is the rubella virus from?

Answer 29

togavirus

Question 30

Where does the rubella virus shed?

Answer 30

in nasopharyngeal secretions

Question 31

What are the symptoms of rubella?

Answer 31

low grade fever, lymphadenopathy, exanthem, arthritis

Question 32

What is the classical triad of congenital rubella syndrome?

Answer 32

opthalmological (cataracts, glaucoma, retinopathy), cardiac (PDA, PA stenosis) and auditory (sensorineural deafness)

Question 33

What does parvovirus B19 cause?

Answer 33

slapped cheek syndrome

Question 34

What does parvovirus B19 cause in the fetus?

Answer 34

anemia which causes hydrops foetalis due to cardiac failure

Question 35

What is the treatment for hydrops foetalis?

Answer 35

intrauterine transfusions

Question 36

What does a primary infection of HSV during pregnancy cause?

Answer 36

abortion

Question 37

What does a primary infection of HSV near delivery cause?

Answer 37

skin-eye-mouth disease, encephalitis or disseminated

Question 38

What is the treatment for HSV?

Answer 38

aciclovir and cesarean section if there are lesions at time of delivery

Question 39

What are the outcomes of congenital syphilis?

Answer 39

stillbirth, premature delivery or babies can be born symptomatic

Question 40

Why are pregnant women advised not to change cat litter?

Answer 40

avoid risk of toxoplasmosis

Question 41

What are the symptoms of toxoplasmosis for the baby?

Answer 41

rash, chorioretinitis, hydrocephalus

Question 42

What is the treatment for babies born to mothers with hepatitis B?

Answer 42

treatment with vaccine and immunoglobulins within 12 hours of delivery to reduce the risk of them becoming chronic carriers

Question 43

What is tested for in antenatal screening test?

Answer 43

rubella, syphilis, hepaititis B, hepatitis C, HIV, varicella, CMV, toxoplasma gondii