Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Herpes Varicella-Zoster (Shingles) Infection |Chickenpox Varicella Infection |Varicella Cerebral Vasculopathy |Herpes Viruses |Herpes Zoster Ophthalmicus (HZO) Shingles |MonkeyPox |Mumps |Measles |Rubella (German Measles) |Epstein-Barr Virus infection |Cytomegalovirus (CMV) infections |CMV retinitis infections |Toxoplasmosis
Infection | Clinical Presentation | Investigations | Treatment |
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Toxoplasmosis | Maternal infection may be asymptomatic or mild but poses risks to the fetus if contracted during pregnancy, including microcephaly, hydrocephalus, chorioretinitis, seizures, and developmental delays. | Maternal serology (IgM, IgG) for diagnosis, amniocentesis for PCR testing, fetal ultrasound to assess for hydrocephalus or other abnormalities. | Spiramycin is used to reduce fetal transmission, especially in early pregnancy. If fetal infection is confirmed, pyrimethamine and sulfadiazine may be given in the second or third trimester. |
Rubella | Infection during the first trimester increases the risk of Congenital Rubella Syndrome (CRS), potentially leading to heart defects (PDA, VSD), cataracts, microcephaly, hepatosplenomegaly, myocarditis, and interstitial pneumonia. Later infection in the third trimester is less harmful. | Maternal serology (IgM, IgG) to confirm recent infection, fetal ultrasound to evaluate for congenital abnormalities. | No specific treatment for rubella infection during pregnancy; preventative vaccination pre-pregnancy is advised. Infected neonates are managed supportively. |
Cytomegalovirus (CMV) | Fetal complications from maternal CMV infection include microcephaly, chorioretinitis, intracranial calcifications, developmental delays, haemolytic anemia, and hepatitis. | Maternal serology (IgM, IgG) and PCR testing for CMV DNA in amniotic fluid, fetal ultrasound to check for abnormalities such as microcephaly or calcifications. | There is no definitive treatment for CMV infection during pregnancy. Neonates with CMV may receive antiviral therapy (e.g., ganciclovir) for symptomatic management. |
Herpes Simplex Virus (HSV) | Maternal infection during pregnancy, especially if active at delivery, can lead to neonatal herpes, which may cause severe neurological damage if disseminated. Risks include abortion, prematurity, and congenital herpes. | Viral cultures or PCR of lesion swabs if maternal genital lesions are present, fetal ultrasound to assess for anomalies if infection is severe. | Acyclovir may be given in the last weeks of pregnancy to reduce active genital herpes at delivery. C-section is recommended if active lesions are present to reduce neonatal transmission. |
HIV | Vertical transmission of HIV can occur during the perinatal period, with increased risk factors including vaginal delivery, preterm birth, and maternal bleeding. Untreated neonatal HIV may lead to severe immunosuppression. | Maternal HIV serology (antibody and PCR testing), regular CD4 counts and viral load assessments, neonatal HIV PCR testing post-delivery. | Antiretroviral therapy (e.g., zidovudine) is administered during pregnancy, labour, and postnatally to the neonate. C-section may be recommended to reduce transmission. |