Perinatal Infections

by Veronica Gillispie, MD, FACOG

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    Now we will discussed perinatal infections. So perinatal infections are better known as the TORCHeS. That stands for Toxoplasmosis Others Rubella CMV Herpes and HIV and S stands for syphilis. Let's talk about those in a little bit more detail. So toxoplasmosis is transmitted to the fetus through the cat feces. So this is one of the reasons that we tell pregnant moms, they should not deal with their kitty litter. The O sites are passing to the kitty litter, and if mom comes in contact with that, she can contract toxoplasmosis that's can pass to the fetus to the placenta. The diagnosis is made serologically. And what affects it's going to have on the fetus. Well the fetus can develop chorioretinitis and hydrocephalus. But it is treatable. We do give a medication. We can either give pyrimethamine or we can give another name for that is Daraprim. And we give sulphadiazine along with those medications. So varicella also known as chicken pox. Transmission is through respiratory droplets. So if there is coughing or sneezing and mom comes in contact with that, she can develop varicella. The diagnose is again made through blood work. And the affects on the fetus where chorioretinitis is one. Encephalitis is another one and muscle atrophy. Unfortunately there is no treatment if mom contracts varicella during the pregnancy. So Rubella. And this is a common appearance of rubella. Transmission again is through cough or sneezing though those water droplets. We diagnose this serologically as well. And as far as the affects on the fetus, congenital hearing loss is one of the biggest ones. It's actually one of the most common causes of hearing loss that comes from infection. Also babies can develop cataracts or something called a Blueberry Muffin rash. And that's what this looks...

    About the Lecture

    The lecture Perinatal Infections by Veronica Gillispie, MD, FACOG is from the course Antenatal Care. It contains the following chapters:

    • Perinatal Infections
    • Toxoplasmosis
    • Rubella
    • CMV
    • HIV
    • Syphilis

    Included Quiz Questions

    1. Contact with cat feces
    2. Sharing needles
    3. Unprotected intercourse
    4. Children with chicken pox
    5. People non-immune to rubella
    1. With pyrimethamine and sulfadiazine
    2. With penicillin
    3. With penicillin only after sensitization to the antibiotic
    4. There is no treatment for toxoplasmosis during pregnancy
    5. With sulfadiazine only
    1. Chorioretinitis
    2. Hearing loss
    3. Hepatomegaly
    4. "Blueberry muffin" rash
    5. Cataracts
    1. Respiratory particles
    2. Skin contact
    3. Sexually transmitted
    4. Animal feces
    5. Unwashed fruits and vegetables
    1. There is no treatment for rubella during pregnancy.
    2. Penicillin
    3. Sensitization with penicillin, then penicillin treatment
    4. Antiviral
    5. Pyrimethamine
    1. Body fluids
    2. Skin contact
    3. Coughing/sneezing
    4. Animal feces
    5. Uncooked meats
    1. Amniotic fluid test
    2. Maternal blood test
    3. Fetal blood test
    4. There is no test for CMV; should treat empirically
    5. Dark field microscopy
    1. Seizures
    2. Cataracts
    3. Muscle atrophy
    4. Rash
    5. Hepatomegaly
    1. Start antiviral therapy at 36 weeks gestation, and delivery by cesarean section if she has any lesions at time of delivery.
    2. Start antiviral therapy from the first trimester to continue throughout pregnancy until normal vaginal delivery.
    3. Start antiviral therapy only if she has any active herpes lesions.
    4. Deliver via cesarean section no matter if lesions are visible or not.
    5. Start antiviral therapy at 24 weeks gestation, and deliver by cesarean section if she has any lesions at the time of delivery.
    1. Viral load less than 1,000
    2. Viral load less than 10,000
    3. Only if undetectable viral load
    4. Women who have HIV should only deliver via cesarean section no matter what the viral load is
    5. Viral load less than 100,000
    1. Syphilis
    2. Herpes
    3. HIV
    4. Toxoplasmosis
    5. Rubella

    Author of lecture Perinatal Infections

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG

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