clinical pearls about viral infections with pregnancy

1. Viral infections
with pregnancy
OSAMA AKL
MRCOG INSTRUCTOR
Ass. Specialist Gyn & Obs Elmahalla general hospital

2. AGENDA
VZV
HBV
HSV
HIV
toxoplasmosis
Hepatitis
HPV

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3varicella

5. Source of infection
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90 % of uk citizens are immune
Infection in chicken pox can occur from :
A case of chicken pox :
in close contact with them
 face to face with them for at least 5 minutes (droplet)
 in the same room with them for at least 15 minutes.(droplet)
A case of exposed shingles
no problem with lactation
Women who receive the vaccine should not get pregnant within 3 m.

6. If chicken pox occurred with pregnancy
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If another
exposure
occurred after 3
weeks of the
IVIG : give
another dose

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Treatment : no ttt in pregnancy
Lactation : benefits more than risk

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A
parasite
Not a
virus

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Safe with pregnancy

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28. HPV
• DNA virus
• Commonest STI
• lifetime risk of infection of up to 80% in exposed individuals.
• Usually asymptomatic and spontaneously clear within two years.
• 50-60% of women develop serum antibodies to HPV after infection.
•The prevalence declines with age but increases with increasing number of
sexual partners.
•Genital HPV is acquired through intimate skin to skin contact, not just
penetrative sexual intercourse.
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29. A.Soft non-keratinised warts :
A.Podophyllin
B.Podophyllotoxin
C.trichloroacetic acid.
B.Keratinised lesions :
Cryotherapy
Excision
Electrocautery
 Intravaginal :Cryotherapy, electrosurgery and
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30. Viral Hepatitis
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31. Post exposure prophylaxis
 Specific hepatitis B immunoglobulin 500 IU intra- muscularl y (HBIG) may be administered
to a non - immune contact after a single unprotected sexual exposure or parenteral
exposure/needlestick injury if the donor is known to be infectious. This works best within
12 h, ideally should be given within 48 hand is of no use after more than seven days
 An accelerated course of hepatitis B vaccnie (at 0, 1, 3 weeks or 0, 1, 2 months with a
booster at 12 months in either course) should be offered to all non-immune sexual and
household contacts, including to those given HBIG. Vaccination theoretically will provide
some protection from disease when started up to six weeks after exposure
 Contacts who have previously been vaccinated and achieved immunity can have a single
booster dose, with no HBIG
 Avoid sexual contact, especially unprotected penetrative sex, until vaccination as been
successful (anti -HBs titres >101.U./ I.)
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32. Genital Herpes
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