Infections in Pregnancy Flashcards
(89 cards)
What virus is responsible for chickenpox?
Varicella zoster virus (VSV)
What type of antibody is produced after a primary infection of chickenpox?
IgG
What are the clinical features of chickenpox?
It typically presents with fever, malaise and a pruritic maculopapular rash
The rash characteristically becomes vesicular and crusts before healing
What are the five complications of chickenpox if contracted during pregnancy?
Pneumonia
Hepatitis
Encephalitis
Fetal Varicella Syndrome
Neonatal Varicella Infection
What is the incubation period for chickenpox?
10-21 days
When is chickenpox infectious?
48 hours prior to the rash
UNTIL
The vesicles have crusted, which is usually five to seven days after the rash starts
How to we determine the immunity status of a pregnant woman?
We can collect a blood sample and test for IgM and IgG antibodies to varicella zoster
A positive result indicates immunity against the virus
How do we manage patients who have encountered an infectious person however describe previous primary varicella zoster infection?
No further action is required as they should have immunity
How do we manage patients who have encountered an infectious person however don’t describe previous primary varicella zoster infection?
IgG testing is required to confirm the immunity status
If not immune, the woman should be given zoster immunoglobulin (VZIG) as prophylaxis
This should be given within 10 days of contact.
How do we manage patients who develop chickenpox and present within 24 hours of rash onset (>20 weeks’ gestation)?
We should prescribe oral aciclovir
How do we manage patients who develop chickenpox and present after 24 hours of rash onset (>20 weeks’ gestation)?
We advise symptomatic treatment and hygiene to prevent secondary bacterial infection
What is congenital varicella syndrome?
It is subsequent reactivation of the virus in utero as herpes zoster
When does congenital varicella syndrome occur?
When the fetus is infected by maternal varicella in the first 28 weeks of gestation
What are the four clinical features of congenital varicella syndrome?
Skin Scarring
Eye Defects, such as cataracts and chorioenitis
Limb Hypoplasia, which affects limbs ipsilaterally
Neurological Abnormalities, such as microcephaly and hydrocephalus
In which circumstance is varicella of the newborn at high risk?
If maternal chickenpox occurs within the last 4 weeks of pregnancy
What are the three routes of varicella infection of the newborn?
Transplacental
Vaginal
Direct contact after birth
What is shingles?
Varicella zoster virus reactivation
Can women be infected with chickenpox from individuals with shingles?
Yes
What is parvovirus B19?
Single stranded DNA virus
How is parvovirus B19 transmitted?
Respiratory droplets
Blood
Vertical transmission to the foetus
What are the clinical features of parvovirus B19?
It starts with non-specific viral symptoms, such as malaise, headaches, fever, etc
After 2-5 days, a bright red rash appears diffusely on both cheeks
A few days later a reticular mildly erythematous rash affecting the trunk and limbs appears, which can be raised and itchy
What is the incubation period for parvovirus B19?
4-20 days
When is parvovirus B19 infectious?
From 7-10 days prior to the rash onset
They are not infectious once the rash has appeared
How do we determine the immunity status of a pregnant women to parvovirus B19?
We collect a blood sample and conduct a viral serology, where we check for the presence of IgM antibodies and IgG antibodies
