Infections in Pregnancies
UTI (2%)
GBS (30%)
Syphillis (<0.1%)
Toxoplasmosis (1%)
Rubella
HSV
Hepatitis B
Hepatitis C
CMV (1%)
HIV
Varicella
Source
Llewellyn-Jones 9th Ed 2010
- Bladder + ureter mm relax --> dilates --> urinary stasis
- Asymtomatic bacteriuria = 6%
- 30% will become symptomatic
- Risk of LBW foetus, prem, postpartum endometritis
- Screen T1. 85% E coli
- Rx: Augmentin then screen again.
- Pyelonephritis
- Usually >20/40
- Rx: Cephalosporin/ Augmentin
GBS (30%)
- Lower vagina/ rectum of 27% of women
- Risk neonatal sepsis, 30% mortality
- Screen @ 36/40
- Benzylpenicillin/ Clindamycin/ Erythromycin
Syphillis (<0.1%)
- 50% Congen syphillis if <15/50, death 30%
- Screen: Reagin test
- Rx: Benzylpenicillin
Toxoplasmosis (1%)
- Usually asymptomatic
- Risk: M/C, congen inf (eyes/ CNS damage)
- Avoid cat faeces, eat cooked meat, wash veggies
- Rx: Pyrimethamine + sulfadiazine + folic acid
Rubella
- Risk: Cataract, deaf, heart and many organs
- Immunisation 3mo before pregnancy
- If infected during pregnancy, consider abortion
HSV
- If inf during preg but healed by labour, NVD
- If present during labour, CS
- Neonate only need aciclovir if clinically ill/ +ve culture
Hepatitis B
- Baby at risk: Hep B Ig + vaccine @ birth, 1y, 6y
Hepatitis C
- Vertical transmission 3-7%
- Treat after labour
CMV (1%)
- Usually asymptomatic
- Risk: foetal mortality, congenital abnormality
HIV
- 30% risk of vertical transmission
- Rx: anteretroviral drugs
- CS reduce vertical transmission by 50%
Varicella
- Maternal immune sys less efficient
- Risk: Mo - pneumonia; Baby - congen abnormalities
- Rx: VZV immunoglobullin, aciclovir
Source
Llewellyn-Jones 9th Ed 2010