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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

Management of HSV during pregnancy?

-Primary infection at term: LUSC and acyclovir
-Recurrent lesions at term: LUSC