OB Week 3- Chapter 8

What infections are routinely screened for at the first prenatal visit?

Syphilis, hepatitis B, HIV, gonorrhea, and chlamydia.

What infection is screened for during the third trimester of pregnancy?

Group B streptococcus (GBS).

What does HIV attack in the body?

T lymphocytes (CD4 cells).

How can HIV be transmitted from parent to infant?

Placenta during pregnancy, exposure during birth, and breast milk.

What is the goal CD4 count during pregnancy for a client with HIV?

Greater than 500 cells/mm³.

What are complications of untreated HIV during pregnancy?

Preterm birth, low-birth-weight infant, and perinatal HIV transmission.

What screening test is commonly used first for HIV?

Enzyme immunoassay (EIA).

What test confirms a positive HIV screening result?

Western blot or immunofluorescence assay.

What medications should HIV-positive pregnant clients take?

Antiretroviral therapy (ART).

What medication is administered IV during labor for HIV?

Zidovudine.

What procedures should be avoided during labor for clients with HIV?

Artificial rupture of membranes, episiotomy, internal fetal monitoring, fetal scalp electrodes, fetal scalp pH sampling, vacuum extraction, and forceps delivery.

When is cesarean birth recommended for a client with HIV?

Viral load greater than 1,000 copies/mL.

Is breastfeeding recommended for clients with HIV in the United States?

No.

What adverse effect can ART cause?

Bone marrow suppression.

What laboratory values should be monitored while taking ART?

Hemoglobin, platelets, and white blood cells.

What STI is the most commonly reported in American women?

Chlamydia.

What organism causes chlamydia?

Chlamydia trachomatis.

What complications can untreated chlamydia cause during pregnancy?

PID, PROM, preterm labor, and postpartum endometritis.

What neonatal complications can result from chlamydia?

Conjunctivitis, ophthalmia neonatorum, and pneumonia.

What are common manifestations of chlamydia?

Dysuria, urinary frequency, spotting, vulvar itching, and gray-white discharge.

What physical assessment finding is common with chlamydia?

Mucopurulent endocervical discharge.

How is chlamydia diagnosed?

Endocervical swab culture or urine culture.

What is the recommended treatment for chlamydia during pregnancy?

Azithromycin PO single dose.

What is an alternative treatment for chlamydia during pregnancy?

Amoxicillin.

Which medications are contraindicated during pregnancy for chlamydia?

Doxycycline and levofloxacin.

What medication is routinely administered to newborns to prevent ophthalmia neonatorum?

Erythromycin eye ointment.

What organism causes gonorrhea?

Neisseria gonorrhoeae.

What complications can untreated gonorrhea cause during pregnancy?

PID, salpingitis, PROM, preterm birth, intrauterine infection, postpartum sepsis, and endometritis.

What neonatal complications can result from gonorrhea?

Neonatal sepsis, IUGR, and ophthalmia neonatorum.

What are common manifestations of gonorrhea?

Dysuria, pelvic pain, and purulent discharge.

What vaginal discharge is associated with gonorrhea?

Yellow-green discharge.

How is gonorrhea diagnosed?

Endocervical culture.

What is the primary treatment for gonorrhea during pregnancy?

Ceftriaxone IM.

What additional medication is often given with gonorrhea treatment?

Azithromycin.

What STI is caused by Treponema pallidum?

Syphilis.

What is the hallmark lesion of primary syphilis?

Painless chancre.

What rash is characteristic of secondary syphilis?

Red-brown maculopapular rash on palms and soles.

What findings occur during latent syphilis?

No symptoms.

What findings occur during tertiary syphilis?

Neurologic and organ damage such as blindness and coordination problems.

What tests are used to screen for syphilis?

VDRL and RPR.

What tests confirm syphilis?

Treponemal antibody tests.

What medication treats syphilis during pregnancy?

Benzathine penicillin G.

What should be done if a pregnant client with syphilis is allergic to penicillin?

Desensitization followed by penicillin treatment.

Which medications are contraindicated during pregnancy for syphilis?

Doxycycline and tetracycline.

How is hepatitis B transmitted?

Blood and sexual contact.

What hepatitis B test is included in prenatal screening?

HBsAg.

What complications can hepatitis B cause in pregnancy?

Fetal transmission, disability, and death.

What are common manifestations of hepatitis B?

Fatigue, malaise, abdominal discomfort, and anorexia.

What dietary recommendations are given for hepatitis B?

High-protein, low-fat diet with adequate fluids.

How can hepatitis B transmission be prevented?

Safe sex, hand hygiene, and avoiding sharing personal items.

What is Group B Streptococcus (GBS)?

A bacterial infection that can be transmitted to the newborn during labor and delivery.

When should pregnant clients be screened for GBS?

36 0/7 to 37 6/7 weeks gestation.

What complications can GBS cause in pregnancy?

Preterm labor, UTI, maternal sepsis, and endometritis.

What neonatal complications can result from GBS?

Pneumonia, respiratory distress syndrome, sepsis, and meningitis.

Which clients should receive intrapartum antibiotics for GBS?

GBS-positive clients, unknown GBS status with preterm labor, maternal fever, or ROM ≥18 hours.

What medications are most commonly used for GBS prophylaxis?

Penicillin G or ampicillin.

What STI is most commonly associated with genital warts?

Human papillomavirus (HPV).

Which HPV strains commonly cause genital warts?

Types 6 and 11.

What are complications of HPV during pregnancy?

Birth canal obstruction and cervical cancer.

What do genital warts look like?

Cauliflower-like lesions.

How is HPV detected during pregnancy?

Pap smear and physical examination.

Is the HPV vaccine recommended during pregnancy?

No.

What topical treatments are safe during pregnancy for genital warts?

Trichloroacetic acid (TCA) and bichloroacetic acid (BCA).

Which HPV medications are contraindicated during pregnancy?

Podophyllin, podofilox, sinecatechins, and imiquimod.

What procedure is recommended during pregnancy for genital warts?

Cryotherapy (cryosurgery).

What organism causes trichomoniasis?

Trichomonas vaginalis.

What discharge is associated with trichomoniasis?

Yellow-green frothy foul-smelling discharge.

What cervical finding is characteristic of trichomoniasis?

Strawberry cervix.

How is trichomoniasis diagnosed?

Wet mount showing trichomonads.

What medication treats trichomoniasis?

Metronidazole.

What teaching is important when taking metronidazole?

Avoid alcohol during treatment and for 3 days after.

What is bacterial vaginosis (BV)?

An overgrowth of normal vaginal bacteria causing infection.

What discharge is associated with BV?

Gray-white discharge with a fishy odor.

What test is positive in BV?

Positive whiff test.

What microscopic finding indicates BV?

Clue cells.

What complications can BV cause during pregnancy?

PROM, preterm birth, and postpartum endometritis.

What medications treat BV during pregnancy?

Oral metronidazole or oral clindamycin.

What causes candidiasis (yeast infection)?

Candida albicans.

What are risk factors for candidiasis?

Pregnancy, diabetes, antibiotics, obesity, and high-sugar diet.

What discharge is characteristic of candidiasis?

Thick white cottage cheese-like discharge.

What pH is associated with candidiasis?

Less than 4.5.

What microscopic findings indicate candidiasis?

Yeast buds, hyphae, and pseudohyphae.

What teaching should be provided for candidiasis?

Wear cotton underwear, avoid tight clothing, avoid douching, and consume yogurt with active cultures.

What medications are commonly used for candidiasis during pregnancy?

Clotrimazole and other topical antifungals.

What virus causes COVID-19?

SARS-CoV-2.

What complications can COVID-19 cause during pregnancy?

Preterm birth, stillbirth, respiratory complications, ICU admission, hypertension, hemorrhage, and coagulopathies.

What are common manifestations of COVID-19?

Cough, shortness of breath, fatigue, sore throat, congestion, and loss of taste or smell.

What test is commonly used to diagnose COVID-19?

Nasal swab antigen or PCR test.

What does TORCH stand for?

Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, and Herpes simplex virus.

How is toxoplasmosis commonly acquired?

Undercooked meat and cat feces.

What fetal complications can toxoplasmosis cause?

Prematurity, low birth weight, and severe eye and brain damage.

How can toxoplasmosis be prevented?

Proper handwashing, cooking meat thoroughly, and avoiding cat litter.

What are common manifestations of rubella?

Fever, rash, joint pain, and muscle pain.

Why is rubella dangerous during pregnancy?

It can cause congenital anomalies, miscarriage, and fetal death.

When should the rubella vaccine be given if needed?

Postpartum.

How is cytomegalovirus (CMV) transmitted?

Body fluids such as saliva, urine, semen, cervical secretions, breast milk, blood, and placenta.

What fetal complications can CMV cause?

Hearing loss, seizures, cerebral palsy, and developmental delays.

What is the most important prevention strategy for CMV?

Frequent hand hygiene.

What findings are associated with genital herpes (HSV)?

Painful blisters, itching, fever, malaise, and tender lymph nodes.

How is HSV diagnosed?

Culture of lesions.