Maternal Health and Infectious Disease Flashcards
Give the definition for maternal mortality
and causes in descending order of rate
The annual number of deaths related to or aggravated by pregnancy/childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site
Cardiac disease –> neurological –> Sepsis –> psychiatric –> haemorrhage –> amniotic fluid embolism –> malignancies
What are common diseases pregnant woman. can get?
STORCHH:
- Syphillis
- Toxoplasmosis
- Other
- Rubella
- Cytomegalovirus
- Herpes simplex virus
- HIV
What are the 3 main tests in pregnancy and their treatment?
1) HIV - treated w antivirals
2) HEP B - early vaccinations for the baby
3) Syphilis - penicillin
Not rubella
Describe the structure and presentation of rubella and congenital rubella?
RUBELLA Virus (1970)
- 60nm in size, spherical, moderately infectious by droplet spread esp when rash is present
Presentation:
- malaise, fever, off food, raised cervical glands and a rash on the face and upper trunk, runny nose. Many cases are sub-clinical
CONGENITAL RUBELLA:
- Risk is highest in the first 8 weeks, less risk after 20weeks
- Causes miscarriage, stillbirth, growth retardation.
- Hearing loss, cataracts, heart problems, microcephally, hepatosplenomegally, jaundice
Serology and PCR for investigations
Treatment= rubella vaccine BEFORE pregnancy
What was the effect of covid on pregnant women?
Increases premature births, infant mortality and maternal mortality in mothers who didnt take the vaccine
What do you do if a pregnant woman comes in contact to or has vesicular rash?
What is the risk of this with chickenpox?
- VZV IgM (recent infection) and IgG (longstanding infection) tests.
- Speak to on call microbiology
- May need treatment with VZV Immunoglobulin im
There is a risk of VZV spreading throughout the body (disseminated disease) in pregnant women who develop chickenpox.
What is congenital varicella?
- Characteristic scarring skin lesions known as cicatrix occur
- Limb abnormalities
- Ocular defects: chorioretinitis, cataracts
- CNS abnormalities: microcephaly
What is Slapped Cheek Disease?
Aka erythema infectiosum caused by human parvovirus B19, 18nm
Only replicates in rapidly dividing cells
Presentation: non-specific viral illness for 5-7 days. Once the rash appears=on the mend and not infectious.
Can cause hydrops fetalis in pregnancy
What are 3 hydrops fetalis symptoms
- Worst outcome for the baby in middle of the pregnancy
- Causes profound anemia in developing baby which can lead to HF
1) Placental thickening
2) Excess amniotic fluid
3) General edema
4) Abnormal fluid in abdominal cavity, heart or lungs
Give examples of a (flat, not raised) non-vesicular rash and describe the approach to a patient in contact
Define being in contact
For example parvovirus, measles, rubella
- Prompt blood tests for IgM (recent infection) and IgG (previous infection) of the relevant virus
- Liase with microbiology, also test booking bloods
- For Parvovirus; regular scans, consider intrauterine blood transfusion
In contact = same room as infected person for prolonged period (15 mins)/ face to face contact, main source of infection from household
What is the action that needs to be taken with a woman getting sepsis postpartum? (Sepsis Six)
1.O2 to keep sats above 95%
2. Blood cultures, FBC, U&E, LFT, coagulations, glucose,
3. Lactate measurement
4. IV fluids bolus 20ml/Kg normal saline. If no response repeat unless there are signs of pulmonary oedema
5. IV antibiotics w/in 1hr. Do not wait for investigation results.
6. Monitor; resp rate, 02 sats, BP, heart rate, temp, fluid balance, urinary output.
What is a common Group A strep infection?
Streptococcus pyogenes can cause:
- Scarlett fever
- Tonsillitis
- Rheumatic fever
- Erysipelas, Endocarditis
- Post puerperal infection,
Gam positive in chains
Colonies cause beta-haemolysis on blood agar
