infections during pregnancy

TORCH

toxoplasmosis

other infections (syphllis, hep b)

rubella

cytomegalovirus

herpes

VIRAL INFECTIONS

cytomegalovirus transmission

saliva and urine

fetal newborn complications short term

• jaundice

• thrombocytopenia

fetal newborn complications long term

• hearing loss

• seizures

• developmental delays

nursing education for cytomegalovirus

wash hands and avoid sharing utensils

rubella (measles) transmission

respiratory droplets

congenital complications

• congenital measles

• hearing impairment

• cataracts

• heart defects

• developmental problems

• pregnancy loss

• microencephalopathy

nursing considerations for rubella

• administer MMR vaccine after delivery, not while pregnant

varicella (chicken pox and shingles) maternal complications

• varicella pneumonia

• encephalitis

fetal complications

• congenital varicella syndrome

• miscarriage

• fetal death

• growth restrictions

nursing education for varicella

avoid during pregnancy

herpes simplex virus (STI)

painful genital lesions

newborn complications

• skin, eye, and mouth lesions/infections

• CNS infection (herpes in spine and brain)

management for mon with herpes

• acyclovir (valtrex)

• antiviral therapy and 36 weeks

• assess for lesions and prodromal during labor

active genital lesion during brith will make the newborn

have an increased risk of transmission

if mom has lesions or no lesions

no lesions/ no prodromal: possible vaginal birth

lesions or prodromal: c-section

parvovirus (fifth disease) s/s:

• slapped cheek rash

• malaise

• joint pain

• fever

most contagious before rash appears

pregnancy complications from fifth disease

• fetal anemia

• hydrops fetalis

hep b transmission

blood and bodily fluids

newborn concern and hep b

may become chronic

nursing interventions for hep b during pregnancy

standard precautions

what and when does baby need to receive after 12 hours

hep b vaccine and HBIG with the 1st 12 hours of life

can a hep b mom breastfeed

yes it is safe as long as newborn receives hep b and HBIG

HIV transmission fetus to newborn

• during pregnancy

• labor

• birth

• breastfeeding

mom cannot breastfeed

nursing management for HIV during pregnancy

• reinforce antiretroviral therapy before they conceive

• screen for HIV

• limit invasive procedures that increase risk ton exposure for baby

mom and baby need to be on antiretroviral therapy

viral load with pregnancy and HIV

if below 1,000: vagnial delivery

if higher than 1,000: c-section at 38 weeks

NON VIRAL INFECTIONS

toxoplasmosis transmission

• cat feces

• undercooked meat

• contaminated soil

fetal complications

• can stay dormant and baby can come out healthy but they can develop stuff later on

• miscarriage

• cornearintis

• seizures

• liver/spleen enlargement

• neuro developmental delays

patient should not be around cats, outside in the garden, or easting undercooked meat

group b strep

bacteria that colonize maternal vagina or rectum without causing symptoms

maternal compliations

• uti

• chorioamnionitis

• endometritis

• premature rupture of membranes

babies can come out healthy but have complications 2 weeks later

newborn complications (SMP)

• sepsis

• pneumonia

• meningitis

screening for group b strep

• vaginal and rectal swab at 36-37 weeks

treatment for group b strep

• IV antibiotics during labor

• penicillin

• antibiotic 4 hours b4 birth

tuberculosis transmission

airborne

TB pregnancy complications

• IUGR

• prenatal mortality increases

chorioamnionitis

infection of the amniotic fluid and fetal membranes

risk factors for chorioamnionitis

• prolonged rupture of membranes

• frequent vaginal exams

• ascending infection

s/s of chorioamnionitis

• maternal fever and tachycardia

• uterine tenderness

• foul smelling amniotic fluid and discharge

• possible fetal tachycardia

nursing interventions for chorioamnionitis

• record time membrane ruptured

• limit vaginal exams

• administer prescribed antibiotics

• monitor mom and fetus HR

longer membranes rupture=increased concern for ascending infection

listeriosis prevention

• avoid unpasteurized milk and foods

• avoid soft cheese that is unpasteurized

• avoid raw or undercooked meat

pregnant client with fever, diarrhea, and neuro symptoms after suspected food exposure=listeriosis

vaccines to give and not to give during pregnancy

give: Tdap, inactivated flu

dont give: MMR, HPV, varicella