Thursday, 11 November 2010

MRCP revision battle 46.5: Congenital infections

A few short notes on 5 infections mummies may have during pregnancy which can adversely affect the fetus...

Maternal rubella
  • fetus is nearly always affected if rubella occurs during first 7 weeks of gestation
  • fetus is nearly always OK if rubella occurs after 17 weeks of gestation
  • Effects of rubella on fetus:
    • sensorineural deafness
    • congenital cateracts
    • congenital heart disease
    • glaucoma

Maternal toxoplasmosis
  • fetus will only be affected if it is the first time the mother is exposed, unless she is immunosupressed
  • classical triad is:
    • cerebral calcification
    • hydrocelphalus
    • chorioretinitis

Maternal chickenpox
  • if this occurs during the 1st trimester risk of limb deformity
  • if mum has been in contact with chickenpox and is not sure if she is immune test for antibodies and if no natural immunity give immunoglobulin

Maternal CMV
  • at least 75% of fetus' exposed to CMV are undamaged
  • however, there is a risk of:
    • intracranial calcification
    • microcephaly
    • cardiac/GI abnormalities

Maternal Parvovirus B19
  • generally either fetal death or complete recovery

Now for a spot of rheumatoid factor