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TAS Perinatal Medicine ✅ > Congenital Infections ✅ > Flashcards

Congenital Infections ✅ Flashcards

(54 cards)

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1
Q

What is a congenital infection?

A

An infection acquired by the fetus transplacentally

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2
Q

What do the consequences of a congenital infection depend on?

A
  • Nature of the infection

- Gestation when it is acquired

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3
Q

Other than transplacentally, how else might a foetus become infected by it’s mother?

A
  • Ascending infection

- Direct contact with infected secretions during delivery

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4
Q

When is the risk of congenital defects from rubella infection highest?

A

In the first trimester

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5
Q

Why is the risk of serious congenital defects following rubella infection highest in the first trimester?

A

It interferes with early embryogenesis

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6
Q

Give 6 congenital infections

A
  • CMV
  • Toxoplasmosis
  • Rubella
  • Syphilis
  • Varicella zoster
  • Parvovirus B19
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7
Q

What can congenital rubella infection cause when contracted in the first trimester?

A
  • Heart defects
  • Cataracts
  • Deafness
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8
Q

Why is congenital rubella now very rare?

A

Prevented by paternal vaccination

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9
Q

What are the features of congenital rubella infection?

A
  • Eye involvement
  • CNS involvement
  • Congenital cardiac defects
  • Sensorineural deafness
  • Pneumonitis
  • Bone involvement
  • Rash
  • IUGR
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10
Q

What are the eye features of congenital rubella infection?

A
  • Glaucoma
  • Cataracts
  • Chorioretinitis
  • Microphthalmia
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11
Q

What are the CNS features of congenital rubella infection?

A

Microcephaly

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12
Q

What congenital cardiac defects are associated with congenital rubella infection?

A
  • PDA

- Pulmonary artery stenosis

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13
Q

What bone pathology can occur in congenital rubella infection?

A

Viral osteodystrophy

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14
Q

Which feature of congenital rubella infection differentiate it from congenital CMV or toxoplasma?

A
  • Glaucoma
  • Congenital cardiac defects
  • Greater degree of IUGR
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15
Q

What is the most common congenital infection?

A

CMV

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16
Q

What is the incidence of congenital CMV?

A

0.5-1 per 1000 live births

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17
Q

What % of mothers seroconvert CMV during pregnancy?

A

1-2%

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18
Q

What is the mother-to-infant transmission rate of CMV?

A

40%

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19
Q

Is the risk to the infant higher in primary CMV during pregnancy or reactivation?

A

Much higher in primary infection

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20
Q

What % of infants with congenital CMV are severely affected?

A

5-10%

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21
Q

What are the features of congenital CMV?

A
  • Eye involvement
  • CNS involvement
  • Sensorineural deafness
  • Hepatosplenomegaly
  • Pneumonitis
  • Bone involvement
  • Rash
  • IUGR
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22
Q

What are the eye features of congenital CMV infection?

Study These Flashcards
A

Chorioretinitis

23
Q

What are the CNS features of congenital CMV infection?

Study These Flashcards
A
  • Periventricular calcification

- Microcephaly

24
Q

What bone pathology can occur in congenital CMV infection?

Study These Flashcards
A

Viral osteodystrophy

25
Which features of congenital CMV infection differentiate it from congenital rubella or toxoplasma?
- Periventricular calcification | - Pneumonitis more significant
26
What % of infants with congenital CMV infection are asymptomatic?
80-90%
27
What % of infants with asymptomatic CMV infection develop sensorineural deafness?
10-15%
28
Why is it important to diagnose sensorineural deafness caused by congenital CMV infection?
Treatment with oral valganciclovir has been shown to reduce the severity of hearing loss
29
How is congenital CMV infection diagnosed?
Viral DNA detection by PCR amplification
30
What samples can be used for PCR in the diagnosis of congenital CMV infection?
- Amniotic fluid - Fetal or infants blood - Urine - Cerebrospinal fluid - Saliva collected at less than 3 weeks of age
31
How long will an infant with congenital CMV continue to excrete CMV in the urine?
Several months
32
Is congenital toxoplasmosis common?
Not in UK
33
Does congenial toxoplasmosis develop from primary maternal infection or maternal re-infection?
Usually primary maternal infection
34
How does the time that CMV is contracted impact the severity of fetal abnormalities?
The earlier it is contracted, the more severe the fetal abnormalities
35
At what stage of pregnancy is the transmission rate of congenital toxoplasmosis highest?
Second trimester
36
What are the features of congenital toxoplasmosis?
- Eye features - CNS features - Hepatosplenomegaly - Pneumonitis - Bone features - Rash - IUGR
37
What are the eye features of congenital toxoplasmosis?
- Chorioretinitis - Microphtalmia - Cataracts
38
What are the CNS features of toxoplasmosis?
- Learning difficulties - Microcephaly - Peripheral calcification - Hydrocephalus - Hypotonia - Seizures
39
What bone pathology may be seen in congenital toxoplasmosis?
Epiphyseal plate anomaly
40
Which features of congenital toxoplasmosis differentiate it from congenital rubella or CMV?
- Peripheral calcification - Hypotonia - Seizures - Hydrocephalus - No sensorineural deafness - Epiphyseal plate anomaly
41
How does congenital toxoplasmosis present when it is acquired in the second trimester?
It is usually sub-clinical, presenting later in childhood with choric-retinitis or with seizures or learning problems
42
Why is congenital syphilis rare?
As mothers are routinely screened
43
How can congenital syphilis be prevented in mothers with a pre-existing syphilis infection?
Antibiotic treatment given for more than 4 weeks before delivery
44
What is the problem with primary syphilis infection during pregnancy?
There is a very transmission rate and high risk of miscarriage and stillbirth
45
What clinical features are specific to congenital syohils?
- Rash - Desquamation of soles of hands and feet - Metaphyseal bone lesions in infancy
46
Why is it uncommon for mothers to develop chickenpox?
Most are immune
47
What can congenital VZV cause?
Congenital varicella fetopathy, including marked scarring of the skin
48
When is the risk of congenital VZV highest?
If there is maternal viraemia shortly before birth
49
Why is the risk of congenital VZV highest when there is maternal viraemia shortly before birth?
The infant will not have received protection from the transfer of maternal antibodies
50
What is true of most cases of maternal infection with parvovirus B19?
The foetus is unaffected
51
What can parvovirus B19 infection during pregnancy sometimes cause?
Severe fetal anaemia
52
What can severe fetal anaemia caused by parvovirus B19 infection lead to?
Fetal hydros
53
How is anaemia in the foetus monitored in congenital parvovirus B19 infectioN?
Middle cerebral artery velocity waveform on Doppler USS
54
How is severe foetal anaemia caused by parvovirus B19 treated?
Intrauterine transfusion

TAS Perinatal Medicine ✅ (16 decks)

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