Infection in Pregnancy Flashcards
(24 cards)
what viral load and CD4 count is safe to deliver vaginal if mother has HIV?
cd4 count >350
<50 viral load
who looks after you in pregnancy with HIV confirmed status
a doctor who specialises in HIV
an obstetrician (a doctor who specialises in the care of pregnant women)
a specialist midwife
a paediatrician
viral load of how much means c-section is recommended HIV+ women?
400> viral load
chorioamnionitis
pPROM
triad: maternal pyrexia, maternal tachycardia, foetal tachycardia
UTI in pregnancy
1st line?
2nd line?
Nitrofurantoin 50mg QDS 7 days
but not in 3rd trimeseter
2) Cefalexin
trimethoprim contraindicated because it is a folate antagonist - but can give in 3rd trimester
Syphilis Mx?
IM stat benzylpenicillin
refer to GUM
toxoplasmosis 1st line?
1 - spiramycin (3-week course of 2-3g OD) which may reduce the risk of
transmission to the foetus
if foetus has toxoplasmosis confirmed?
pyrimethamine and sulfadiazine 12 months with folic acid
what can toxoplasmosis cause in infant?
mental retardation
convulsions
spasticities
visual impaired
with cytomegalovirus in pregnancy how can you treat antenatally?
no antenatal treatment available
> audiology /opthalmology F/U
> offer TOP
herpes simplex virus if primary illness
ensure aciclovir from 36 weeks
if active infection / vesicles c section
if no active then vaginal
how is HSV diagnosed?
PCR
can you give the VCV vaccine in pregnancy?
no it is a live vaccine
When do you give oral aciclovir in suspected chickenpox infection
> 20 weeks and after 7 days of contact
have a rash
AND no immunoglobulins obvs
when do you manage chickenpox - pregnancy with VZIG
varicella zoster immunoglobulin given if <20 weeks
exposed to chickenpox
NO immunoglobulin
<10 days since exposure
what is the biggest risk with parovirus?
foetal hydrops - suppresses anaemia
specialist
30% risk of transmission
if foetal hydrops detected?
Foetal blood sampling and intrauterine red blood cell transfusion, which may
reduce the foetal mortality rate.
how is syphilis , HIV and hep B detected for pregnancy?
HBsAg
PCR?- HIV
syphilis antibodies IgM?
listeria monocytogenes mangement?
IV amoxicillin 2mg every 6 hours - 14 days
mx of hep ?
refer to hepatologist
High HBV viral load - DNA >10IU/mL
offer TENOFOVIR
neonate Hep B high risk
IVIG - wihtin 24 hours
vaccine, birth, 4 weeks, 12 months
baby HIV when to test?
birth
discharge
6 weeks
6 months
Group A streptococcus
beta haemolytic
Lancefield group A
IV benzylpenicillin infusion during labour
then neonate pencillin and gentamicin
