Infectious diseases in pregnancy
Dr Khalid Sait
HIV in pregnancy
• USA 1-5% Canada 1/5000
• Risk to the baby 25 %
• Risk increase in HIV patient with low CD4
count and hi...
HIV in pregnancy
• Prenatal care:
Counseling
CD4 count in first and second trimester
Torch and STD screen in first and thi...
HIV in pregnancy
• Intrapartum management:
Avoid scalp PH , Internal scalp electrode
and ARM.
May be there is benefit from...
HIV in pregnancy
• Post partum:
No breast feeding Encourage
contraception
Hepatitis in pregnancy
• Exposed pregnant women should be immunize with
immunoglobulin 0.02 ml/kg IM
Neonatal infection in...
Parvovirus in pregnancy
• Fifth disease , childhood exanthum
( slapped cheeks)
• Can cause intrauterine infection and lead...
Rubella in pregnancy
• Rubella specific IgM that present for four
weeks or rise fourfold in IgG
• Congenital rubella syndr...
Toxoplasmosis in pregnancy
• Four fold rise in IgG
• IgM be present for many years
• Non pregnant infected women should de...
Varicella in pregnancy
• Pneumonia associated with 10 % mortality
• Fetal risk 2-5 % (rare in second half pf pregnancy)
• ...
CMV and pregnancy
• Four fold rise in CMV titer considered
evidence of acute infection
• Fetal risk of congenital CMV:
40 ...
Listeria infection and pregnancy
• High risk of preterm labor and
Choriamnioties
• Treatment:
Iv ampicillin and gentamycin
Group B streptococcal infection
and pregnancy
• Most common cause of neonatal sepsis in USA
• Vaginal colonization in 5-40...
Group B streptococcal infection
and pregnancy
• Prevention:
1- Intrapartum antibiotic prophylaxsis to
all women with posit...
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Infectious+diseases+in+pregnancy

  1. 1. Infectious diseases in pregnancy Dr Khalid Sait
  2. 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. 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. 4. HIV in pregnancy • Intrapartum management: Avoid scalp PH , Internal scalp electrode and ARM. May be there is benefit from C.S.
  5. 5. HIV in pregnancy • Post partum: No breast feeding Encourage contraception
  6. 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. 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. 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. 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. 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. 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. 12. Listeria infection and pregnancy • High risk of preterm labor and Choriamnioties • Treatment: Iv ampicillin and gentamycin
  13. 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. 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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