Infections in Pregnancy

Chickenpox

Chickenpox is dangerous in pregnancy because it can lead to:

  • More severe cases in the mother (including varicella pneumonitis – a nasty lung infection).
  • Fetal varicella syndrome (causing developmental abnormalities – this occurs in 1% of cases of chickenpox in pregnancy)
  • Severe neonatal varicella infection (if mum is infected around delivery)

Establishing Immunity:

  • Mothers that have previously had chickenpox are immune and safe
  • If in doubt test IgG levels for immunity (positive = immune)

Post exposure to chickenpox

  • If previously had chickenpox they are safe
  • If not sure about immunity – test IgG levels (if positive then they are safe)
  • If not immune then give IV varicella immunoglobulins as prophylaxis against developing chickenpox. This should be given within 10 days.

If the chickenpox rash starts in pregnancy, they should be treated within 24 hours with aciclovir.

 

Rubella

Rubella in pregnancy can lead to Congenital Rubella Syndrome:

  • Sensorineural deafness
  • Congenital heath disease
  • Cataracts
  • Several other features

Women are offered screening at booking.

Pregnancy women should not receive vaccination as this is a live vaccine.

Non immune women should be offered the vaccine after giving birth.

 

Chorioamnionitis

This is an infection of the amniotic sac and amniotic fluid. This usually occurs in later pregnancy. This is a medical emergency and is life threatening for the

Presentation

    • Fever
    • Abdominal pain
    • Sepsis (tachycardia, tachypnoea, hypotension)
    • Evidence of fetal compromise on CTG

Management

    • Sepsis Six
    • Early delivery of the baby (by emergency caesarean if necessary)
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