COVID In Pregnancy and Perinatal Infections

What does G mean in G2P1

How many pregnancies

What does P mean in G2P1

How many births after 20 weeks

Covid19 Pregnancy Risks

More likely to be in an ICU, need a ventilator, and die from illness.

Gestational diabetes and obesity increase the risk for severe illness. African American and Hispanic women at a higher risk

Treatment in Pregnant Women with Covid

Target pulse ox greater than 95. Prone or semi prone position, padding the uterus to avoid compression of the aorta and inferior vena cava, steroid injections, acetaphinomen and ibuprofen or antivirals

Yes

Can a woman breastfeed her baby if she has covid?

Toxoplasmosis (T in TORCH)

Diseased caused by a parasite, can get it from eating undercooked meats or being exposed to cat feces

HIV (O in TORCH)

Can be given to baby if mom is not taking antibiotics correctly, most fetal infections occur in the third trimester, during or after birth

Syphilis (O in TORCH)

Sexually transmitted disease from bacteria. Get it from direct contact with dores during anal, vaginal or oral sex. On the rise of babies being infected during birth

Parvovirus B19/Fifths Disease (O in TORCH)

Mild rash caused by a virus. Spreads through saliva and mucus when an infected person coughs or sneezes

Varicella/Chicken Pox (O in TORCH)

Highly contagious disease caused by a virus. Getting this once in your life or getting vaccinated against the disease gives you immunity for life

Zika (O in TORCH)

Virus spread by an infected mosquito in areas where the virus is common. Can also be passed through sex with an infected person

Rubella (R in TORCH)

Mild disease when not pregnant. Can be devastating to the fetus if contracted in pregnancy, rare due to MMR vaccine

AKA German Measles

Cytomegalovirus (C in TORCH)

Most common congenital viral infection, sensorineural loss is the most common sign of this in newborns

Herpes Simplex Virus (H in TORCH)

Poses the most serious risk to the newborn. Transmission occurs at birth and can range from a rash to severe disease of the newborn

Group B Strep Infection

25% of pregnant women have this in rectum and/or vagina. 1 out of 100-200 newborns will be affected by this which can be life threatening. All pregnant women are screened at 35-37 weeks or a positive UTI during pregnancy will be treated the same.

IV ATBS like penicillin G will be given during labor to prevent transmission

HIV Therapeutic Management

Oral antiretroviral drugs twice daily from 14 weeks until birth. IV administration during labor and an oral syrup for newbord in first 6 weeks of life

Hepatitis B

Universal screening of pregnant women for all pregnancies. Infants will be given a vaccine and immune globulin within 12 hours of birth if mother is positive for this.

Routine vaccination happens for all babies within the first 24 hours

STIs

More than 30 different bacteria, viruses, and parasites that can be transmitted through sexual contact. Can lead to later complications in women such as PID or infertility.

Chlamydia

Most common bacterial STI in the US, majority asymptomatic. Caused by a parasite and treated with doxycycline or azithromycin. Can manifest as mucopurulent vaginal discharge, urethritis, bartholinitis, endometritis, salpingitis, dysfunctional uterine bleeding

Gonorrhea

Second most reported infection in the US, highly contagious and reportable to health departments. Almost exclusively transmitted via intercourse. Treated with antibiotics

Genital Herpes Simplex

Recurrent lifelong viral infection, no cure for it but only antiretroviral therapy to reduce or suppress symptoms, shedding, and recurrent episodes.