Infections in Pregnancy

Question 1

Zika pregnancy findings

Answer 1

microcephaly
ventriculomegaly
intracerebral calcifications

Question 2

Zika testing

Answer 2

within 1 week of symptoms
RT PCR in serum or urine

MAC-ELISA or PRNT - test within 12 weeks of symptoms

Question 3

When does Zika infect pregnancy

Answer 3

1st trimester greatest risk

5% risk at 2-3rd trimester

Question 4

Congenital Varicella

Answer 4

Risk of fetal injury is
less than 2% even
when maternal
infection occurs in the
first half of pregnancy
 Usual manifestation
is circular limb scars

Question 5

Effect of Herpes Zoster

Answer 5

It poses no risk to the
baby because of the
protective effect of
maternal antibody

Question 6

Varicella ppx

Answer 6

Prophylaxis after exposure
 VZIG – not readily available in United
States
 Acyclovir 800 mg 5 x daily or valacyclovir 1000 mg TID

Question 7

Neonatal Varicella

Answer 7

 Disseminated
mucocutaneous
infection
 Visceral infection- hepatic toxicity

Question 8

Gestational age risk for transmission of parvo

Answer 8

1st trimester 5-10%
13-20 wk <5%
>20 week < 1%

• can cause direct myocardial injury

Question 9

Hep A

Answer 9

rare risk to baby or mother

IGM for acute infection

Question 10

Hep B Testing

Answer 10

If viral load is > 6 log 10 copies/mL (1,000,000) or >
5.2 log 10 IU/mL:
 Tenofovir, 300 mg p.o. daily with food
 32 weeks until delivery