OB Infections & Meds Flashcards
Signs & Symptoms of Vaginitis
vaginal discharge, foul odor, irritation, itching, dyspareunia (painful intercourse)
Bacterial Vaginosis
- what is it?
- S/Sx
- what med is it treated with?
vaginal infection r/t change in vaginal flora; overgrowth of anaerobic bacterial & rise in vaginal pH (greater than 4.5)
- S/sx: vaginal discharge, foul odor
- TX: Flagyl (potential teratogen) & clindamycin
Vulvovaginal Candidasis
- what is it?
- S/Sx
- what meds is it treated with?
yeast / fungal infection
- S/Sx: itching, red rash, “cheese” like discharge
- TX: Diflucan (not used during pregnancy) & topical antifungals such as Nystatin
- may cause newborn thrush inside mouth or on skin
Trichomonas
- what is it?
- S/Sx
- what meds is it treated with?
most commonly curable STI
- S/Sx: often asymptomatic, frothy discharge, foul odor, itching, “strawberry spots” or reddened areas on cervix
- TX: Flagyl, abstinence until both partners are cured
Chlamydia
- S/Sx
- diagnosis
- most common?
- can cause?
- TX?
- pregnancy concerns?
- S/Sx: often asymptomatic in females, itching / burning, purulent discharge, dull pelvic pain, bleeding between periods & cervical inflammation
- Diagnosis: culture
- infection of the cervix is most common
- may cause PID or infertility
- TX: axithroymycin, Doxycycline, abstinence until both partners are cured
- pregnancy concerns: newborn infection (particularly of eyes) & greater risk of tubal pregnancy (ectopic pregnancy)
Gonorrhea
- S/Sx
- Diagnosis
- TX
- Pregnancy concerns
- S/Sx: GREEN DISCHARGE, often asymptomatic until further complications arise such as PID, purulent discharge, urinary frequency, swelling, pelvic pain, eroded cervix
- Diagnosis: culture
- TX: Cefriaxin, Azithromycin, abstinence until cured
Herpes Genitalis
- is it cured?
- which strain for most cases of genital herpes?
- S/Sx
- TX
- concern for pregnant woman approaching delivery?
- not cured; recurring lifelong infection
- HSV 2 strain for most cases of genital herpes
- S/Sx: vesicles may be present in vaginal / perineal area, pain, inflammation, flu like symptoms
- TX: Acyclovir –> antiviral given to reduce the incidence of recurrence
- concern for pregnant woman: baby infected w HSV (life threatening) –> neonatal death, neuro problems, blindness
indication for C section delivery!!
Symphylis
- primary symptoms
- secondary symptoms
- may be acquired through…
- TX
- pregnancy concerns
- primary symptoms: fever, weight loss, malaise (take place & disappear in about 4 weeks)
- secondary symptoms: plaque like warts (skin condylomata), arthritis, inflammation of the liver & spleen, hoarseness in throat, rash on hands or feet- may be acquired through sexual contract, contact w exudate, or transplacentally
- TX: Benzathine Pencillin G
- pregnancy concerns: IUGR, preterm birth, still birth
HPV
- S/Sx
- link between what type of cancer?
- cause
- transmission
- TX
- Vaccine
- S/Sx: often asymptomatic, presence of GENITAL WARTS, cervical dysplasia
- link between HPV & cervical cancer
- cause: 60 genotypes r/t HPV
- transmission: sexual conduct
- Transmission: sexual conduct
- TX: Podophyllin (teratogenic), surgical removal or cryotherapy
- Vaccines: Garadasil given to 9-26 year olds
HIV / AIDS
- what is it?
- S/Sx
- Screening
- TX
- pregnancy implications
- lethal, lifelong viral disease
- S/Sx: may be associated w wasting syndrome (tremendous weight loss), candidiasis & HSV
- screening: enzyme-linked immunosorbent assay (ELISA) test
- TX: antiretrovital therapy
- pregnancy implications:
- elective C/S delivery prior to ROM
- avoid breastfeeding
- newborn oral antiviral treatment
*child may have immunosuppression, failure to thrive, neuro problems
perinatal infections are most harmful during which trimester?
first trimester
toxoplasmosis
- transmission
- how can it affect the developing fetus
- TX
- transmission: ingestion of undercooked meat / contract w infected cat litter
- how it can affect the developing fetus: spontaneous abortion / death, convulsions / coma, microcephaly (small head) / hydrocephalus (accumulation of fluid), growth restriction
TX: prompt treatment w Spiramycin
Rubella
- transmission
- at greatest risk for which severe effects in fetal development during the first trimester?
- TX
- transmission: maternal / fetal
- at greatest risk for: cataracts, deafness, heart defects, mental retardation, cerebral palsy
- TX: prevention (MMR vaccine)
Cytomegalovirus (CMV)
- transmission
- most common cause of?
- fetal / newborn complications
- TX
- transmission: may cross placenta or through exposure during delivery
- most common cause of intrauterine infection
- fetal / newborn complications: death, mental retardation, hearing problems, microcephaly / hydrocephaly, Hemolysis (can lead to anemia / high bilirubin levels)
- TX: none
Group B streptococcus
- what is it?
- tested when?
- transmission
- TX
- maternal / newborn concerns
- bacteria found as part of the normal flora of some women
- tested at 36 weeks gestation
- transmission: during delivery
- TX: PCN or Ampicillin therapy during labor if +
if unable to treat during labor, neonate will be treated - maternal / newborn concerns: infection for mom, infection / stillbirth / death for baby
