Perinatal infections

Question 1

What are the clinical manifestations of perinatal toxoplasmosis infection?

Answer 1

1.Intracranial calcifications
2. Chorioretinitis
3. Hepatosplenomegaly
4. Hearing loss
5. Mental retardation

Question 2

When is transmission of perinatal toxoplasmosis the highest in pregnancy?

Answer 2

3rd trimester (60%)

Question 3

When is transmission of perinatal toxoplamosis the lowest in pregnancy?

Answer 3

1st trimester (15%)

Question 4

When is the severity of disease for perinatal toxoplasmosis the highest in pregnancy?

Answer 4

1st trimester

Question 5

When is the severity of disease for perinatal toxoplasmosis the lowest in pregnancy?

Answer 5

3rd trimester

Question 6

What are the clinical manifestations of perinatal cytomegalovirus infection?

Answer 6

1. Chorioretinitis
2. Hepatosplenomegaly
3. IUGR
4. Fetal hydrops

Question 7

When is transmission of perinatal cytomegalovirus the highest in pregnancy?

Answer 7

3rd trimester

Question 8

When is transmission of perinatal cytomegalovirus the lowest in pregnancy?

Answer 8

1st trimester

Question 9

When is the severity of disease for perinatal cytomegalovirus the highest in pregnancy?

Answer 9

1st trimester

Question 10

When is the severity of disease for perinatal cytomegalovirus the lowest in pregnancy?

Answer 10

3rd trimester

Question 11

How does the parvovirus work during pregnancy?

Answer 11

Replicates in the bone marrow and causes anemia, heart failure and hydrops

Question 12

What is the vertical transmission rate for parvovirus?

Answer 12

25%

Question 13

What is the vertical transmission rate for cytomegalovirus?

Answer 13

3%

Question 14

What are the effects if you get parvovirus infection in the 1st trimester?

Answer 14

spontaneous abortion

Question 15

What are the effects if you get parvovirus infection in the 2nd or 3rd trimester?

Answer 15

IUFD or hydrops

Question 16

How does parvovirus present during pregnancy?

Answer 16

Most are asymptomatic infections

Could have rash, arthritis, flu like symptoms

Question 17

How do you treat parvovirus infection in pregnancy?

Answer 17

weekly ultrasounds for 2 months post exposure/infection looking for hydrops

If hydrops present should receive transfusion

Question 18

What are the maternal effects of varicella infection during pregnancy?

Answer 18

1. Chickenpox
2. Varicella pneumonia
3. Encephalitis
4. Shingles

Question 19

What are the fetal effects of varicella infection during pregnancy?

Answer 19

1. Spontaneous abortion
2. IUFD
3. Varicella embryopathy

Question 20

What trimester is varicella pneumonia most common in?

Answer 20

3rd trimester

Question 21

How do you treat varicella pneumonia?

Answer 21

IV acyclovir and ICU admission

Question 22

When is there a high risk of mortality for the neonate with maternal varicella infection?

Answer 22

If infection occurs <5 days from delivery

Question 23

How do you diagnose varicella in pregnancy?

Answer 23

Clinical diagnosis
History of exposure and presence of rash
PCR of vesicular fluid
ELISA for IgM and IgG

Question 24

Can you give varicella vaccine during pregnancy?

Answer 24

No

Question 25

How long should you defer pregnancy if you have received the varicella vaccine?

Answer 25

1 month

Question 26

How do you contract the zika virus?

Answer 26

Transmitted via sex (vagina, oral, anal), materno-fetal, blood, body fluids

Question 27

What are the symptoms of zika virus?

Answer 27

Most women are asymptomatic Fever, rash, conjunctivitis, myalgia, arthralgia

Question 28

Who should be screened for zika virus during pregnancy?

Answer 28

1. Potential exposure 2. Symptoms 3. Traveled to endemic area

Question 29

How do you diagnose zika virus?

Answer 29

IgM testing and NAT of serum and urine

Question 30

What is the treatment of zika virus?

Answer 30

PREVENTION

Question 31

If contemplating conception after exposure to zika virus how long should you wait?

Answer 31

Female exposed-->8 weeks Male exposed--> 6 months

Question 32

What is the management if patient is positive for zika virus during pregnancy?

Answer 32

Serial ultrasounds for growth and anatomy MFM and ID consults Inform pediatric team

Question 33

What are the clinical symptoms for listeria in pregnancy?

Answer 33

GI or flu like symptoms

Question 34

What are the fetal effects of listeria infection during pregnancy?

Answer 34

Fetal loss Preterm labor

Question 35

What are the neonatal effects of listeria infection during pregnancy?

Answer 35

Sepsis Meningitis death

Question 36

How do you diagnose listeria infection during pregnancy?

Answer 36

Blood culture

Question 37

How do you treat listeria infection during pregnancy?

Answer 37

High dose IV ampicillin for 14 days

Question 38

How do you treat listeria infection during pregnancy if PCN allergic?

Answer 38

Trimethoprim with sulfamethoxazole

Question 39

How do you decide who needs testing and treatment for listeria infection in pregnancy?

Answer 39

Asymptomatic= no testing or treatment just observation for 2 months Mildly symptomatic, no fever= send blood culture and treat if positive Febrile with or without symptoms= test and treat simultaneously