-
vertical (peri-natal) infection transmission
(1-3)
from parent to offspring
- transplacentally
- transvaginally
- breast milk
-
transplacentally
transvaginally
breast milk
tp= TORCH infections
- tv= contact with body fluids and vaginal secretions after ROM and during delivery
- = sti's, HIV, GBS
bm= HIV and TB and CMV
-
TORCH acronym
- Toxoplamosis
- Other infections: Hep B, HIV
- Rubella
- Cytomegalovirus (CMV)
- Herpes Simplex Virus: types 1 and 2 (HSV)
-
Toxoplasmosis
mode of trans
sources
- flu like symptoms, can cause preterm labor or miscarriage
- baby effects= IUGR, microcephaly, neurological
trans= Transplacental
- sources= CAT FECES
- = raw meat
-
Hep B
can cause liver disease in baby in unTx
- mom w/ active Hep B: State mandated Hep B immunoglobulin w/n 12 hrs after birth AND Hep B vaccine series
- causes jaundice, fever, rash
- can result in stillbirth or miscarriage
trans= tp, tv
-
antepartum Hep B testing
- std of care
- HBsAg: blood test for Hep B surface antigen
ON ALL Women
-
Recombinvax / Energix-B
- Hep B vaccine
- series of 3
- -birth
- -1 month
- -4 months
- IM vastus lateralis
- requires maternal consent
-
Rubella:
mode of trans
testing
maternal effects
trans= tp
test= IgM titre for immunity
effect= 3 day rash, fever, HA
-
rubella:
1st vs 2nd vs 3rd trimester
- 1st= teratogenic
- = congenital anomalies (cataracts, deaf, heart defects)
- =microcephaly
- =MR
- =cerebral palsy
- 2nd= deaf
- =systemic infections
- =IUGR
- =rash
3rd= NO teratogenic effects
-
instruct mom to avoid pregnancy for 1 month after receiving the Rubella vaccine
instruct mom to avoid pregnancy for 1 month after receiving the Rubella vaccine
-
Cytomegalovirus CMV
trans= all 3
- causes mono like symptoms in mom
- may have cervical discharge
- miscarriage or stillbirth
- baby:
- IUGR
- microcephaly
- rash
- jaundice
- hearing and learning disabilities
-
-
Herpes Simplex Virus
trans= tv and tp
miscarriage, stillbirth, PTL, sequela of virus
-
delivery of mom w/ active and non-active Herpes
active= C/D
- non= vaginal possible if NO open lesions
- = NO ARTIFICIAL rupture, scalpe electrodes, etc.
-
HIV
transmission
maternal effects
trans= all 3
- mom= prego can inc progression rate of disease
- = inc risk for infects
-
HIV Dx and Tx
- Dx= initial screen for HIV antibodies
- Western Blot or immunofluorescence assay
Mom Tx= Zidovudine / AZT = DOC
- Baby Tx= AZT severely dec. risk of HIV+
- = repeat antibody testing every few months through 2yrs old
- = infants will seroconvert (-) w/n 15 months
-
Listeriosis
get from eating soft cheezes
- causes fever, ms aches, n/diarrhea
- can cause miscarriage, stillbirth, PTL, infection in newborn
Prego women 20X's more likely to get List. b/c of change in immune system
Tx= antibiotics
-
signs of hypovolemia after trauma may not be present until loss exceeds 1500 mL
signs of hypovolemia after trauma may not be present until loss exceeds 1500 mL
-
nursing actions in trauma
- focus on maternal stabilization
- assess FHR, movement, and uterine contractions
- position women on side
fetal tachycardia is 1st sign on infection
-
Hydatidiform molar pregnancy
abnl development of placental cells overgrow in uterus
no viable fetus
severe abd pain
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