Intrauterine Infection
Intrauterine Infection
Intrauterine Infection
Hepatospleno
megaly
+ + + +
Jaundice + + + +
Adenopathy
+ - - +
Pneumonitis
+ + + +
Rubella CMV HSV TOXOPLAS
Clinical sign MA
Microceph _ ++ + +
aly
Hydroceph + + + ++
alus
Intracranial _ ++ _ ++
calcifications
Hearing + + _ _
deficits
Clinical Rubella CMV HSV Toxoplasmosis
sign
Skin lesions
+ + + +
purpura
Vesicles _ + ++ _
Maculopap _ _ + +
ular rash
CNS: + + + +
Meningo-
encephalitis
TORCH INFECTIONS
Toxoplasmosis
Rubella
Cytomegalovirus
Herpes/Hepatitis
Toxoplasma gondii
CONGENITAL INFECTION:
Infection usually occurs after 1ry maternal infection,
recurrence is extremely rare.
Neonatal symptomatic disease is usually severe, and is
characterized by a triad of HYDROCEPHALUS,
CHORIORETINITIS and I.C. CALCIFICATIONS.
3 Inhalation of oocysts.
toxoplasmosis in cord
serum or infant serum is diagnostic; IgM
Treatment(during pregnancy)
=>macrolides and amoxicillin
( tetracycline is contraindicated).
Pregnant women can be treated during the
third trimester with oral erythromycin, for
seven to 14 days depending on the dose
used.
Newborn infants can be treated with
erythromycin liquid for 10–14 days at a
dosage determined by their body weight.
Gonococcal Infection
Risks to neonate include ophthalmia
neonatorum and systemic neonatal
sepsis
Possible increased risk of preterm
premature rupture of the membrane
Recommended Therapy =Ceftriaxone
125 mg IM once or Cefexime 400 mg
PO once plus Erythromycin base 500
mg POQID x 7days
Cytomegalovirus
Cytomegalovirus (CMV) is a very common virus in the
herpes virus family. It is found in saliva, urine, and other
body fluids and can be spread through sexual contact or
other more casual forms of physical contact like kissing. In
adults, CMV may cause mild symptoms of swollen lymph
glands, fever, and fatigue. Many people who carry the virus
experience no symptoms at all.
PCR.
3. Microcephaly or hydrancephaly.
INTRA-PARTUM
INFECTION :
Always symptomatic and frequently
fatal particularly with primary
maternal infection.
The risk of intra-partum transmission
increases with ruptured membranes
more than 4 hours.
Intra-partum and post-natal infection
may present with:
Mortality 30%.
fatigue
rash
abdominal pain
loss of appetite
nausea
vomiting
joint pain
HEPATITIS C:
HIV can be detected using a blood test and is part of most prenatal
screening programs.
Primary
Without treatment, this will usually
Early Latent
< 4 years
May be associated with reactivation of secondary
symptoms
Risk of infection to the fetus is 40%
Late Latent
> 4 years
Not infective sexually, but risk of fetal
If not treated in first 3 stages, 1/3 of patients will go
onto tertiary syphilis
involving the CNS and CV systems
Congenital Infection:
Can infect the fetus as early as 6 weeks, Clinical manifestations
not seen until fetal immunocompetence develops around 16 weeks
The clinical spectrum of fetal infection includes stillbirth and
neonatal death
After birth, there can be early and late congenital syphilis
Early => develops 10 to 14 days after birth and includes a rash,
hepatosplenomegaly,and jaundice
Late => develops if not treated during early neonatal phase