Infections In Pregnancy (types, causes, and treatment)
Mar 02, 2023
Infections in pregnancy are common and a serious problem that can have significant consequences for both the mother and the developing fetus. They can lead to maternal complications such as preterm labor, premature rupture of membranes, and chorioamnionitis. They can also result in adverse fetal outcomes such as congenital anomalies, intrauterine growth restriction, stillbirth, and neonatal sepsis.
For NEET PG aspirants it is important to have a thorough understanding of infections in pregnancy, their diagnosis, management, and prevention. Read this blog further to get a quick overview on this important Obstetrics and Gynecology topic for NEET PG exam.
Refers to passage of an infectious agent from mother to her fetus through
During labor or delivery or
Preterm rupture of membranes (PROM)
Obstetrical manipulations (Like Internal Podalic Version (IPV), Forceps, Vacuum may enhance the risk of Neonatal Infections)
Spread of an infectious agent from one individual to another
Secondary Attack Rate
Probability that infection develops in a susceptible individual following contact with an infectious person.
DNA Herpes virus
MC perinatal infection in the developing world
Up to 85% of poor and 50% of higher classes are seropositive by the time of pregnancy.
Women who develop primary CMV infection during pregnancy [were seronegative before pregnancy], are at greatest risk to have an infected Fetus.
Maternal Infection Features
10-15% of infected adults have
Features of Immuno Compromised
Mononucleosis - like syndrome
30-36% in 1st Trimester
30-40% in 2nd Trimester
40-72% in 3rd Trimester
(Only 5-10% neonates demonstrate this syndrome)
Growth restriction, Microcephaly
Mental retardation, Sensorineural deficits
Jaundice, Hemolytic anemia
Nucleic Acid Amplification Testing (NAAT) of Amniotic Fluid
Gold standard for Dx of Fetal infection
Despite the high infection rate with primary infection in the 1st half of pregnancy, most Fetuses develop normally.
If recent infection is confirmed → Offer Amniotic fluid CMV
Pregnancy termination may be an option for some
Oral Valacyclovir 8gm daily is tried on mother
No Vaccine for CMV is available
Varicella Zoster Infections
90% of adults have serological evidence of immunity
Primary infection → Varicella or Chickenpox
Transmitted by direct contact with an infected individual
Incubation period → 10 to 21 days
1 to 2 days flu like prodrome followed by Pruritic Vesicular lesion that crust after 3 to 7 days
Period of communicability → 1 day before the onset of rash until lesions become crusted
Predominantly d/t VZV (Pneumonia) in pregnancy
Risk Factors - Smoking, > 100 cutaneous lesions point towards poor prognosis
If there is reactivation of primary Varicella years later, it leads to Herpes Zoster or Shingles
U/L dermatomal Vesicular eruption
a/w severe pain
not more frequent or severe in pregnant women
Congenital Varicella syndrome rarely develops in cases of Maternal Herpes Zoster
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