Infections in Pregnancy

What are TORCH infections?

a group of infections that may cause fetal anomalies

TRUE or FALSE: TORCH infections are usually easy to catch ahead of time.

false; they’re usually asymptomatic for mom

Which five infections are included in TORCH?

toxoplasmosis, other infections, rubella, cytomegalovirus, + herpes

What is toxoplasmosis?

a parasitic infection from cat feces

How do you prevent toxoplasmosis?

wash your hands!

What is the treatment goal for HSV 1+2?

suppress the virus using antiviral meds

When can you start treatment for HSV?

36 weeks

How is HSV transfered to baby?

in the birth canal

How are UTIs treated during pregnancy?

antibiotics

What is the main sign of bacterial vaginosis?

thin, watery discharge w/ a fishy odor

What is the main concern with bacterial vaginosis?

can cause preterm birth

Why do we screen for STIs in everyone?

they need to be treated ASAP!

When is HIV screened for?

1st prenatal appointment

What is the treatment goal for HIV?

to suppress the viral load

How do we treat infants born to moms with HIV?

antiretroviral meds for 4-6 weeks after birth

Which action increases the risk of HIV transmission?

breastfeeding

Which type of virus is cytomegalovirus?

herpes virus

What are some symptoms of cytomegalovirus?

fatigue, muscle aches, + sore throat (all mild!)

When does cytomegalovirus pose the greatest risk to baby?

1st trimester

Which fetal issues can be caused by cytomegalovirus?

birth defects, hearing loss, low birth weight, microcephaly, + delays in motor development

How is cytomegalovirus treated?

antivirals

How can you prevent cytomegalovirus?

handwashing + limiting time spent around others who are sick

What is cervical insufficiency?

painless, premature dilation of the cervix during the 2nd trimester

What is the main concern with cervical insufficiency?

high risk of miscarriage or premature birth

What is the major sign of cervical insufficiency?

pink-tinged discharge

How is cervical insufficiency corrected?

cervical cerclage (suturing the cervix closed during 2nd trimester)

What are some care considerations for patients coming in for maternal trauma?

• place a wedge under the hip

• increased need for oxygen

• risk for placental abruption r/t abdominal trauma

• may need Rh injection if mom is Rh-negative

When should you not place a wedge under one hip in a trauma case?

in case of spinal cord injury

What does TRAUMA stand for in maternal trauma?

T-triage

R-resuscitation

A-assessment (abc’s)

U-ultrasound/uterine evaluation

M-management + monitoring

A-activate transport or transfer

How do you perform CPR on a pregnant woman?

displace the uterus manually or with a wedge under one hip, then do chest compression slightly higher on the sternum

Can you perform the heimlich maneuver on a pregnant woman?

no; perform chest thrusts instead of sub-diaphragmatic thrusts