Infections in pregnancy
(Redirected from Infection in pregnancy)
Jump to navigation
Jump to search
STI
All pregnant women should be screened for STIs, since they are some of the key causes of problems:
- Herpes simplex - neonatal herpes is rare, but has a 50% mortality. Transmission occurs through vaginal delivery, thus if there is any sign of HS, the mum gets a c-section.
- Syphilis - caused by Treponema pallidum, this can lead to congenital disease, or stillbirth. Treatment prevents foetal damage, but doesn't reverse it.
- HIV - Vertical transmission to the foetus happens in 15%, but retroviral treatment can dramatically reduce this.
- Hepatitis B - Can cause neonatal hepatitis, but can be prevented with administration of immunoglobulin.
- Chlamydia - As well as causing PID and infertility, is linked to prematurity and neonatal conjunctivitis.
- Gonorrhoea - Same as chlamydia, but less common.
Non STI
- β-haemolytic streptococcus - about 20% of pregnant women have this in their genital tract. 75% of their babies get the disease, and 1 in 100 get neonatal sepsis; the commonest cause of severe sepsis in babies. With screening, antibiotics can be given in birth, preventing most deaths.
- Herpes zoster - chickenpox in pregnancy can be fatal to the mother. Transfer to the foetus is rare, but infection before childbirth can cause neonatal infection, and this has a high mortality. It's bad!
- Rubella - maternal infection in early pregnancy causes foetal abnormalities, such as deafness, cardiac disease and mental retardation. After 16 weeks, the risk is very low. Vaccine is contraindicated in pregnancy.
- Parvovirus - known as 'slapped cheek'. Usually caught from children. Causes anaemia and death in 10% of affected foetuses, usually before 20 weeks. Some problems can be treated with in utero transfusion.
- CMV - usually subclinical. Infection at any point causes neonatal infection in 40%. Problems in the child are rare, but can be prevented with neonatal treatment of the infection.
- Bacterial vaginosis - Can cause preterm labour, which antibiotics can prevent.
- Listeriosis - rare, but its the reason pregnant mums should avoid soft cheeses, since it can cause foetal death.
- Toxoplasmosis - pretty rare, and there are a few nasty sequallae, but they are very rare.