Obstetrics and Parenatal Infections

Question 1

Name 3 risk factors modifying infective risk in pregnancy for the mother

Answer 1

Increased susceptibility, May alter clinical presentation, Many drugs contraindicated in pregs

Question 2

Name 3 risk factors modifying infective risk in pregnancy for the baby

Answer 2

infection can severely affect fetal development, immune system not fully mature, congental infections - long term consequences

Question 3

UTIs in pregnancy usually express which symptoms? they can lead to?

Answer 3

asymptomatic + pyelonephritis

Question 4

What is varicella pneumonia?

Answer 4

chicken pox in adults! much more dangerous if pregnant

Question 5

Dangers of a rash in pregnancy?

Answer 5

Could be rubella (small risk in UK) or parvovirus b19

Question 6

Danger of CMV in pregnancy ?

Answer 6

severe -bilat deafness 10%. minor 5% unilat deafness. 85% not affected

Question 7

Why is CMV so common?

Answer 7

mother asymptomatic (unless recurrent)

Question 8

Describe how the timing of a pregnant womans rubella infection can affect the baby

Answer 8

1st trimester - many defects e.g. CNS / heart and eye - CRS (congenital rubella syndrome)
12-18 weeks - deafness most common
after 18 weeks - no risk

Question 9

How is rubella prevented?

Answer 9

MMR vaccination at a young age. antenatal screening, post partum vaccination.

Question 10

Risks of Toxoplasmosis during pregnancy?

Answer 10

brain damage, choroido-retinitis (may not be present until later in life)

Question 11

Congenital toxoplasmosis is caused by?

Answer 11

toxoplasma gondii - a protozoon

Question 12

Syphilis clinical features present at what age? can cause?

Answer 12

multi system - some evident at birth and some not till child is 5-15

Question 13

Symptoms of varicella in a newborn?

Answer 13

skin loss, scarring, unilateral limb bud development, microcephaly

Question 14

When does fetal damage in varicella result?

Answer 14

First 20 weeks- but only 1%!

Question 15

Define antenatally, perinatally and postnatally transmission to babies using examples.

Answer 15

A = transplacental, Pe = exposure to maternal blood e.g. infected birth canal Po = Breast milk (just HIV)

Question 16

Name 3 ways you can combat risk of giving HIV from mother –> child

Answer 16

1- don’t breast feed
2 - antiretrovirals for mother (reduces viral load) decreases amount of virus in birth canal and maternal blood so delivery safer
3- caesarean

Question 17

What has the UK done to decrease chances of transmisson HIV from mother to baby

Answer 17

now opt out for screening for HIV of mother

Question 18

Risk of Hep B to baby from mother? How do we treat this?

Answer 18

neonatal infection can lead to miscarriage. vaccinate baby.

Question 19

When is a baby high risk of Hep B?

Answer 19

When the mother is E antigen +ve

Question 20

Why do we not screen for Hep C infections in antenatal women?

Answer 20

We dont have a vaccination so couldnt cure anyway- and very low rate of hep C

Question 21

What can E coli and BH Strep cause in pregnancy and how?

Answer 21

neonatal septicaemia / meningitis. acquired from birth canal. (BH strep can also cause pneumonia)

Question 22

Where is Group B Strep (haemolytic) usually found and how is it transferred to the baby in pregnancy? How is this prevented?

Answer 22

Usually found in GI flora, can colonise in perineum/ vagina. IV antibiotics during delivery

Question 23

Significance of timing in prenatal maternal chickenpox (late pregnancy)

Answer 23

If mother gets chicken pox rash >7 before baby is born shes had time to make antibodies that can cross the placenta to the baby. If the mother develops chicken box and then has the baby in under 7 days then the baby will not receive the mothers antibody

Question 24

Symptoms of baby with neonatal HSV?

Answer 24

50% dont have skin lesions. Internally disseminated - lung liver brain. Baby usually fine at birth - 5 days later fever etc..

Question 25

What is opthalmia neonatorum caused by? what can it cause?

Answer 25

gonorrhoea and chlamydia - acquired when born. infected birth canal of mother . can cause pneumonia

Question 26

How would you treat a newborn baby thats likely to have caught the mothers chicken pox?

Answer 26

VZIg prophylaxis

Question 27

What is Cytomegalovirus?

Answer 27

Herpes