What does that baby have?
Is there treatment for maternal or fetal CMV infection?
Counseling our mom's with decreasing/eliminating risk of acquisition of Toxoplasmosis
What is avoiding handling contaminated cat feces and consumption of undercooked meats/dairy/produce/water, and working in soil with gloves?
The most common congenital infection?
What is CMV (0.2-2.2% of all neonates)?
Is routine screening for toxoplasmosis indicated?
IgM + low avidity IgG CMV
Chorioretinitis and subsequent severe visual impairment, hearing loss, severe neurodevelopmental delay, rash, ascites, periventricular calcifications, ventriculomegaly, seziures
What is congenital Toxoplasmosis?
What is 3 months due to risk of mild varicella infection?
What infections typically give you lifelong immunity (IgG+)?
Parvovirus B19, Varicella zoster, Toxoplasmosis
Fever, malaise, maculopapular pruritic rash that becomes vesicular
What is Primary varicella zoster?
IgM neg, IgG+ Parvovirus B19
What is previous exposure and immunity?
Nonimmune hydrops fetalis, stillbirth
Parvovirus B19
Rate of fetal loss is 8-17% <20wk GA and 2-6% >20wk GA
Consumption of cysts in undercooked meat from infected animals, insect-contaminated foods, contact with oocysts from feces of infected cats
What is Toxoplasmosis?
How to treat acutely infected pregnant woman with toxoplasmosis
What is Spiramycin (To reduce transplacental parasitic infection)?
Transient aplastic crisis with underlying hemoglobinopathy
What is Parvovirus B19 virus?
Pregnant women with acute Parvovirus B19 infection based on serologies should be monitored for the development of fetal ___.
What is fetal anemia?
Serial ultrasonography every 1-2 weeks for 8-12 weeks after exposure with MCA doppler assessment for ascites, placentomegaly, cardiomegaly, hydrops fetalis, impaired fetal growth.
Skin scarring, limb hypoplasia, chorioretinitis, microcephaly
What is congenital varicella syndrome (0.4-2%)?
Neonatal VZV associated with high neonatal death rate when maternal dz develops from 5 days before delivery to 48h PP (relative immaturity of neonatal immune system)
Overall risk of transmission after acute Parvovirus B19
15-30%
Fetus is particularly vulnerable to dz transmission and severe complications in the 2nd trimester (rapid changes in fetal hematopoiesis)
10-20% of pregnant women with Varicella infection will develop ____
What is Pneumonia?
Maternal mortality is estimated to be as high as 40%
IgM negative and IgG + Toxoplasmosis
What is remote infection?
No concern for fetal transmission in an immunocompetent woman
Varicella needs to be diagnosed with laboratory testing. T/F?
What is FALSE.
Clinical findings include classic pruritic, vesicular rash and so lab testing is not indicated, if indicated a sample from unroofed skin lesion can be tested via PCR assay.
Pregnant women should have varicella immunity status documented in early pregnancy by a hx of previous infxn or vaccination.
Jaundice, petechiae, thrombocytopenia, hepatosplenomegaly with abdominal/liver calcifications, growth restriction, myocarditis, nonimmune hydrops, cerebral ventriculomegaly
What is symptomatic congenital CMV?
30% of severely infected infants die, 65-80% survivors have severe neurologic morbidity
Overall risk of transmission to fetus with primary CMV
What is 30-40%
Risk of transmission greatest in the 3rd trim
More serious fetal sequelae occur after infxn during 1st trim)
0.15-2% risk of transmission with recurrent infxn
Testing that is indicated for pregnant woman when fetal toxoplasmosis is suspected.
What is Amniocentesis?
Usually culture or PCR of the amniotic fluid is indicated.
Asymptomatic cervical lymphadenopathy, fever, malaise, night sweats, myalgias, hepatosplenomegaly
What is Toxoplasmosis?
VZIG (varicella-zoster immune globulin)
Maternal treatment with acyclovir has not been shown to ameliorate or prevent fetal affects of congenital varicella syndrome. More for symptomatic treatment.