Flashcards in Infectious disease in Pregnancy Deck (51)
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1
What antenatal inectious disease screening tests should be routinely conducted?
-HBV / HCV
-HIV
-Rubella (Abs)
-Syphilis (TPHA / TPPT)
-Chlamydia (urine PCR / swab)
-GBS
-Asymptomatic bacteriuria
-VZV (Abs)
2
What are the routes of transmission?
-Transplacental
-Intrapartum
-Postpartum
3
Intervention if maternal HBsAg +ve?
Administer HepB immune globulin (HBIG) and vaccine to infant at birth (prevents carriage in 95%)
4
Syphilis maternal +ve intervention?
Treat with penicillin and consult with STI specialist
5
HIV maternal +ve intervention?
-Antiretroviral therapy for mother and infant
-greatly reduces vertical transmission
-consult HIV specialist
6
Chlamydia +ve intervention?
-Treat woman and sexual partners to prevent intrapartum transmission
7
HCV maternal +ve, child intervention?
Follow up infant for infection at 12 months; treat mother
8
Intervention if mother GBS +ve?
Intrapartum chemoprophylaxis to prevent neonatal GBS infection
9
Rubella virus family?
Togavirus
10
Rubella virus genus?
Rubivirus
11
Rubella virus structure?
ssRNA, enveloped
12
What is the reservoir for the rubella virus?
Humans only reservoir
13
When does rubella peak?
Winter - spring
14
How is rubella transmitted?
Droplet and direct contact
15
Rubella incubation period?
14 - 23 days
16
When is virus present in relation to rash?
7d before to 14d after
17
Clinical features of rubella?
-Mild or asymptomatic
-Generalised maculopapular rash
-Generalised lymphadenopathy
-Low grade fever
-Polyarthralgia
18
What are the features of congenital rubella syndrome?
Neurobiological fx:
-meningoencephalitis
-behavioural
-mental retardation
-deafness
Other fx:
-blueberry muffin rash
-thrombocytopenia
-radiolucent bone disease
-congenital heart disease (i.e. PDA)
-cataracts
19
When is risk of damage by rubella virus greatest?
20
Rubella prevention?
-Screen antepartum
-Vaccinate if -ve (or post partum if pregnant)
No Rx for pregnant woman infected with rubella.
21
Which syphilis stage is most likely to result in congenital syphilis?
Primary (90%) transmission.
-early latent 40%
-late latent
22
Features of congenital syphilis?
-Stillbirth
-Hepatosplenomegaly / LAD
-Snuffles
-Osteochondritis syphilitica
-Hutchinson's teeth
-Hereditary gumma
23
What are the non-treponeal tests?
VDRL, RPR
Ig to cellular lipids and lecithin
Positive 4-8/52 post infection
24
What are the treponemal tests?
TPHA, TPPA, FTA-Abs
-positive slightly earlier
-positive for life
-don't reflect disease activity
25
What is the most valuable marker for congenital syphilis?
IgM (90% cases positive)
26
What is the structure of HBV?
dsDNA virus with glycolipid envelope
27
What is the most important determinant of HBV transmission?
HBeAg status of the mother
28
HBIG efficacy?
If given with 2-12h of delivery = 95%
29
What determines risk of maternal foetal HIV transmission?
-Viral load and CD4 count
-Duration of ruptured membranes (4h)
-Mode of delivery
30
