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Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
Infectious diseases in pregnancy
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Infectious diseases in pregnancy

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  • 1. Infectious diseases in pregnancy Khalid Sait Professor Faculty Of Medicine King Abdulaziz University
  • 2. HIV in pregnancy •  USA 1-5% Canada 1/5000 •  Risk to the baby 25 % •  Risk increase in HIV patient with low CD4 count and high viral load.
  • 3. HIV in pregnancy •  Prenatal care: Counseling CD4 count in first and second trimester Torch and STD screen in first and third trimester Pap smear twice eight week apart Watch for IUGR Zidovudine ( ZDV) during pregnancy and labor and to the infant reduce the risk to 7.2 %
  • 4. HIV in pregnancy •  Intrapartum management: Avoid scalp PH , Internal scalp electrode and ARM. May be there is benefit from C.S.
  • 5. HIV in pregnancy •  Post partum: No breast feeding Encourage contraception
  • 6. Hepatitis in pregnancy •  Exposed pregnant women should be immunize with immunoglobulin 0.02 ml/kg IM Neonatal infection in HBsAg positive mother: Maternal status Neonatal infection rate HBeAg positive 90 % HBe Ag negative 10-20 % Anti Hbe positive 0-10 % Acute HBV in ist trimester 10-20 % Acute HBVin third trimester or with in 1 month of delivery 80-90 % Infant required HBIG and HBV with in 12 hours of delivery
  • 7. Parvovirus in pregnancy •  Fifth disease , childhood exanthum ( slapped cheeks) •  Can cause intrauterine infection and lead to fetal hemolysis and fetal anemia and then non immune hydrops •  IgG immune •  IgM acute infection(watch the baby )
  • 8. Rubella in pregnancy •  Rubella specific IgM that present for four weeks or rise fourfold in IgG •  Congenital rubella syndrome 1st month 50 % risk Second month 25 % risk Third m 10 % risk Second trimester 1 % risk
  • 9. Toxoplasmosis in pregnancy •  Four fold rise in IgG •  IgM be present for many years •  Non pregnant infected women should delay pregnancy for 6 months •  Congenital infection can occur but often is a symptomatic •  90 % of symptomatic neonate will be neurologically impaired •  Treatment with 3 g spiramycin daily apparently reduced the severity of congenital toxoplasmosis
  • 10. Varicella in pregnancy •  Pneumonia associated with 10 % mortality •  Fetal risk 2-5 % (rare in second half pf pregnancy) •  Neonatal risk: mild if maternal infection was 5-20 days before delivery 30 % risk of neonatal disseminated VZV if maternal infection was less than 5 days before delivery or 2 days post partum they need VZIG •  Maternal exposure: Check for immunity if not immune give VZIG 125 iu/10 kg with in 96 hours of exposure
  • 11. CMV and pregnancy •  Four fold rise in CMV titer considered evidence of acute infection •  Fetal risk of congenital CMV: 40 % in first trimester 30 % in second trimester 25 % of children have squeal Third trimester infection is usually with out squeal
  • 12. Listeria infection and pregnancy •  High risk of preterm labor and Choriamnioties •  Treatment: Iv ampicillin and gentamycin
  • 13. Group B streptococcal infection and pregnancy •  Most common cause of neonatal sepsis in USA •  Vaginal colonization in 5-40 % of pregnant women •  Only 1-2 % of neonate develop sepsis •  Early onset infection ( first 2 days of life) mortality up to 37 % majority in preterm infant •  Late onset infection Onset 6-90 days after delivery mortality up to 25 % Frequently cause endomytrities A symtomatic bacturia is cause of pyelonephritis and preterm labor
  • 14. Group B streptococcal infection and pregnancy •  Prevention: 1- Intrapartum antibiotic prophylaxsis to all women with positive culture 2- If no culture is available we should treat risk factors: 1- preterm labor 2- ROM > 18 H 3- previous baby with GBS disease 4- Maternal fever

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