STORCH

Syphilis

• up to 70% of fetuses become infected if mother has 1ary or 2ary syphilis during pregnancy

• spectrum

  • severe fetal infection causing intrauterine death

  • congential syphilis

    • Early

      • maculpapular rash

      • hepatitis/splenomegaly

      • mucous pathches

      • lymphadenopathy

      • bone abnormal

      • active neurosyphilis

    • Late

      • Hutchinson’s signs

        • intersitial kearatitis

        • sensorineural deafness

        • teeth

        • clutton’s joints

        • gumma

        • paresis

Toxoplasmois

• Protozoan

• acquired from exposure to cat faeces

• eating uncooked meat

• primary infection often asymptomatic

• glandular fever like illness

  • atypical lymphocytes

• Eye infections

• Infection during 1st trimester

  • severe fetal damage

    • 10-25% of infections are transmitted

• classic tetrad

  • hydrocephalus/microcephaly

  • chorioretinitis

  • convulsions

  • cerebral calcifications

• Prevention:

  • meat and cat faeces

  • avoid eating rare steaks, hamburgers

  • handwashing with soap and water essential

  • avoid cats + cat litter

  • sandpits covered

CMV

• herpes virus

• 1/200 pregnancys

• 40% fetal infaction

• 90% asymptomatic

• features

  • microcephaly

  • blindness and deafness

Rubella

• togovirus

• incubation 203 weeks

• painful joints common in adults

• clinical syndomre

  • cardiovascular defects

  • eye defects

  • deafness

• diagnosis based on serology

• vaccine cannot be given during pregnancy as live vaccine

Varicella

• droplet spreasd

• incubation 2weeks

• if infection \< 20wk

  • small risk congneital varicella syndrome

  • hypoplastic limbs, scarring nad CNS anomalies

• if exposed: varicella zoster antibody

• if not immuneL

  • Caricella zoster immune globulin shoule be administered

• Neonatal chicken pox

  • may be very severe

  • VZIG given to baby asap if mother develops chicken pox

  • if duing first month of life -> IV aciclovir

Parvovirus B19

• acute aplastic crisis

  • sickle-cell

• 15% of infections during pregnancy fetus becomes chronically infected

  • persisnent anaemia

  • non-immune hydrops detalis

• virus is not teratogenic

Listeria

• domestic/wild animals

• grow in refrigerated food

  • meat

  • eggs

  • dairy

  • soft cheeses

  • malaise, headhace, fever, backahce, conjunctivitis, diarrhoea

  • newvborn

    • early onset

      -sepsis wihtin 2 days of birth

      • premature

      • signs fo resp distress

      • rash

    • late

      • meningoencephalitis

Affecting baby at birth

Herpes Simplex

• devastatin neonatal infection

  • involvment skin

  • liver cns

  • mortality = 75%

  • if aciclovir admin rapidly

    • reduced to 40%

• LSCS provide protection to infant as long as no more than 4 hours elapse

d since ROM

GpB strep

• commensal in gut

• carriage asymptomatic

• infants at risk

  • premature

  • undergone delivery after prolonged ROM

  • growth restricted

  • birth asphyxia

  • 1-4 weeks of age