Flashcards in Infectious disease in Pregnancy Deck (51)
What antenatal inectious disease screening tests should be routinely conducted?
-HBV / HCV
-Syphilis (TPHA / TPPT)
-Chlamydia (urine PCR / swab)
What are the routes of transmission?
Intervention if maternal HBsAg +ve?
Administer HepB immune globulin (HBIG) and vaccine to infant at birth (prevents carriage in 95%)
Syphilis maternal +ve intervention?
Treat with penicillin and consult with STI specialist
HIV maternal +ve intervention?
-Antiretroviral therapy for mother and infant
-greatly reduces vertical transmission
-consult HIV specialist
Chlamydia +ve intervention?
-Treat woman and sexual partners to prevent intrapartum transmission
HCV maternal +ve, child intervention?
Follow up infant for infection at 12 months; treat mother
Intervention if mother GBS +ve?
Intrapartum chemoprophylaxis to prevent neonatal GBS infection
Rubella virus family?
Rubella virus genus?
Rubella virus structure?
What is the reservoir for the rubella virus?
Humans only reservoir
When does rubella peak?
Winter - spring
How is rubella transmitted?
Droplet and direct contact
Rubella incubation period?
14 - 23 days
When is virus present in relation to rash?
7d before to 14d after
Clinical features of rubella?
-Mild or asymptomatic
-Generalised maculopapular rash
-Low grade fever
What are the features of congenital rubella syndrome?
-blueberry muffin rash
-radiolucent bone disease
-congenital heart disease (i.e. PDA)
When is risk of damage by rubella virus greatest?
-Vaccinate if -ve (or post partum if pregnant)
No Rx for pregnant woman infected with rubella.
Which syphilis stage is most likely to result in congenital syphilis?
Primary (90%) transmission.
-early latent 40%
Features of congenital syphilis?
-Hepatosplenomegaly / LAD
What are the non-treponeal tests?
Ig to cellular lipids and lecithin
Positive 4-8/52 post infection
What are the treponemal tests?
TPHA, TPPA, FTA-Abs
-positive slightly earlier
-positive for life
-don't reflect disease activity
What is the most valuable marker for congenital syphilis?
IgM (90% cases positive)
What is the structure of HBV?
dsDNA virus with glycolipid envelope
What is the most important determinant of HBV transmission?
HBeAg status of the mother
If given with 2-12h of delivery = 95%
What determines risk of maternal foetal HIV transmission?
-Viral load and CD4 count
-Duration of ruptured membranes (4h)
-Mode of delivery