Infections In Pregnancy Flashcards
(33 cards)
What are the complications of infections
→ spontaneous abortions
→ perinatal death
→ abnormal growth
→ fatal anomalies : choriorenitis, hydrocephalus and microcephalic , cerebral calcification
Modes of transmission
- Transplacental • latrogenic • Ascending
* perinatal • breast milk • nosocomial
Describe trans placental infection
Spread haematogencusly via placenta
Follows primary or re-activated infection
Can be blood borne, virus_bacteria or parasite
Asymptomatic or vague
Fetal however- preterm labour, growth restriction and developmental delays
Intra-amniotic infection
Dx: fever uterine tenderness,leucocytosis
Histologically → chonoamnionitis more common
Due to ascending infection - polymicrobial or blood born-CMV, rubella, HIV
Affect baby with: increased (preterm delivery) PTD, palsy, endometrisis
Rx: a/b and delivery
What is ascending infection
Vaginal flora - low pathogenicity- polymicrobial
E.g enterococci, staphylococci and streptococci, coliforms
Ureaplasmos and mycoplasma
Perinatal infection
- Infection acquired around time of delivery→ fetus had contact with lesions or blood
- colonisation and infection group B strephemolytaic strep, e-coli, HIV, HSV, gennococal and chlamydia conjunctivitis
Risk factors for neonatal infections
- Prolonged rapture of membranes
- Prematurity
- traumatic birth - difficult pregnancy
- indwelling devices
- broad spectrum a/b
Group B streptococci labs and treatment
What specimens → urine, CSF, Blood
Gram stain results→ gram positive cocci in chains
Latex agglutination → group B bett hemolytic
Treatment → penicillin /ampicilin + amnogycoside for 21 days
Prevention GBS
Give penicillin to women with risk factors:
- previous delivery GBS
- GBS during pregnancy
- deliver befor 37 weeks
- rupture of membranes of more than 18 hours
- Intra party temp of more than 38c
How is lm transmitted
Contaminated food → cheese, milk and raw vegetables and meat
What are the clinical signs in mother and baby of LM
Mother → bacteraemia, CNS infection
Baby → early → granalomatosis infantsepticum
Late → bacterial meningitis
What is treatment of LM
Ampicillin and amino-glycoside
How to prevent LM
It immune compromised avoid soft cheeses, left over foods should be thorouly warmed, wash raw vegetables look veggies and meat properly
Gonorrhoea _ what is aetology
N. Gonorrhoea
What is the effect of gonorrhea
- PROM
- preterm labour
- Chorioamnionitis
- endometritis
How does gonorrhoed affect neonates
40% have gonococcal ophthalmia neonatorum
80%. Asymptomatic
How do you treat mother to prevent (gono) neonatal infection
Give cefflasone
Rx: ceffriaxone 25-50mg iv 1 dose
What prophylaxis do you give baby to prevent (Gono)
Erythromycin or chloramphenicol
What are complications of Gono
Corneal ulcers → blindness
How to diagnose (gono)
→ eye swab
→ gram neg cocci on microscopy
→ culture en selective media
Alternatively PCR
How does chlamydia affect pregnant
PROM Preterm labour Chorioamnionitis Endometritis Conjunctivitis Pneumonia Most Asymptomatic
How to treat clam
Azithromycin
What causes syphilis
T palladium
Mode of transmission for syph
Transplacental from 15 weeks
