Congenital & Perinatal Infections

Question 1

When is?
Prenatal
Perinatal
postnatal/partum

Answer 1

Prenatal: before delivery
Perinatal: around time of delivery
postnatal/partum: after delivery

Question 2

eg. of perinatal infection?

Answer 2

group B strep

Question 3

What is vertical transmission?

Answer 3

mother to fetus via placenta

mother to baby via milk (CMV)

Question 4

What is horizontal transmission?

Answer 4

baby or person to another baby

Question 5

what is a non-specific effect of maternal infection? 2:

Answer 5

fetal death

premature delivery

Question 6

what is a specific effect of maternal infection? 3

Answer 6

benign: parvo
end-organ damage: rubella
chronic infection: hep B/C HIV

Question 7

VZV?

Answer 7

varicella zoster virus

Question 8

varicella zoster virus spread?

Answer 8

resp and direct contact

Question 9

complications of varicella: 3 main:

Answer 9

1. secondary bacterial infection
2. pneumonitis
3. acute cerebellar ataxia

Question 10

What is pupura fulminans?

Answer 10

varicella with Group A strep infection

Question 11

When is varicella in adults most severe?

Answer 11

pregnancy d/t immunosuppression

Question 12

when do most maternal deaths from varicella occur?

Answer 12

3rd trimester

Question 13

congenital varicella zoster virus syndrome?

Answer 13

baby can have shingles in utero, get scarring, short limbs etc.

Question 14

Perinatal Varicella dangerous to neonate?

Answer 14

25-30% mortality due to disseminated infection

Question 15

how to treat preg mom if she gets Varicella? 2 things

Answer 15

VZIG
Varicella Zoster immunoglobulin
Acyclovir

Question 16

cytomegalovirus microscopy?

Answer 16

multinucleate giant cells

Question 17

why cytomegalovirus latent infection?

Answer 17

can hide in our WBCs

Question 18

when does cytomegalovirus shed more?

Answer 18

primary infection

Question 19

when do people get cytomegalovirus in western vs. developing?

Answer 19

more as adults: developed

more as children: developing

Question 20

danger of toddlers getting cytomegalovirus?

Answer 20

Mom isn’t immune, could bring it home and infect her and cause problems with baby #2

Question 21

cytomegalovirus infected lymphocytes look?

Answer 21

reactive lymphocytes: enlarged darker cytoplasm/chromatin

Question 22

post-partum cytomegalovirus syndrome?

Answer 22

sepsis-like:
hepatomegaly
resp distress
atypical lymphocytosis

Question 23

when is more dangerous to fetus with mom’s cytomegalovirus? primary or reactivation

Answer 23

primary because 20-50% chance of fetal infection

reactivation happens in 10-30% but only 1-3% fetal infection

Question 24

3 ways to look for cytomegalovirus for dx in preg:

Answer 24

1. serology
2. avidity test
3. look in amniotic fluid

Question 25

screening for babies post partum who are normal at birth include 4 biggies:

Answer 25

auditory Ax
visual Ax
psychomotor
pneumonitis

Question 26

treatment for babies with cytomegalovirus at birth?

Answer 26

ganciclovir

Question 27

Rubella clinical presentation: 4

Answer 27

1. Fever - low-grade
2. lymphadenopathy - occipital, postauricular/cervical
3. exanthem
4. polyarthralgia

Question 28

highest risk of damage to fetus with Rubella at which age?

Answer 28

> 4/40 weeks (85% risk of damage)

Question 29

if fetus gets rubella >12/40, what defects only possible?

Answer 29

retinopathy

deafness

Question 30

classic triad for congenital rubella syndrome?

Answer 30

1. opthalmological: cataracts, glaucoma, retinopathy
2. cardiac
3. Auditory: deafness

Question 31

2 ways to Dx fetal Rubella?

Answer 31

serology

amniotic fluid

Question 32

Rubella prevention?

Answer 32

Vaccine pre

vaccine post

Question 33

Rubella vaccine during preg? why?

Answer 33

NOPE. because live attenuated

Question 34

Parvo Virus pathogenesis?

Answer 34

shortens RBC progenitors lifespans

Question 35

Parvo Virus presentation?

Answer 35

fever, rash (‘slapped cheek’), maculopapular rash

Question 36

congenital Parvo Virus? causes?

Answer 36

hydrops foetalis (anaemia)

Question 37

How to treat hydrops foetalis (anaemia)?

Answer 37

intrauterine transfusions

Question 38

Herpes Simplex Virus during preg?

Answer 38

abortion, preterm labour, IUGR

Question 39

Herpes Simplex Virus perinatal?

Answer 39

skin-eye-mouth
encephalitis
disseminated

Question 40

Herpes Simplex Virus management during preg?

Answer 40

Acyclovir for suppression

Question 41

Syphilis fetal prevention

Answer 41

antenatal screening

Question 42

Toxoplasma gondii from? 2 big sources

Answer 42

cats and cat litter

raw meat

Question 43

how many women are chronic carriers?

Answer 43

0.2%

Question 44

Hep B management infant?

Answer 44

vaccination

Hep B immunoglobulin post-partum

Question 45

Hep C usually co-infected with?

Answer 45

HIV

Question 46

Hep C intervention?

Answer 46

None

Question 47

HIV transmission %?

Answer 47

0-30% depending on viral load and membrane rupture

Question 48

Group B Strep acquisition how usually?

Answer 48

ascending
colonised at delivery
1% invasive out of 40-70% colonised babies

Question 49

Group B Strep symptoms?

Answer 49

penumonia

septicaemia

Question 50

Group B Strep treatment?

Answer 50

penicillin

gentamicin