Perinatal & postnatal infections

  • By: Terri
  • Date: May 26, 2010
  • Time to read: 2 min.

Include photos of the microbes.

Congenital infections are in utero infections from mother to foetus through transplacental. Mother’s symptoms are usually asymptomatic, mild or overt. However, effect on foetus is more varied:

  • no effect
    • common cold
    • localized infection
  • adverse effect
    • congenital infections
  • death
    • spontaneous abortion
    • syphilis
  • malformations
    • rubella
  • chronic infection
    • HIV
  • failure to thrive
    • rubella
    • toxoplasmosis
  • mental deficiencies
    • toxoplasmosis
  • hepatosplenomegaly
    • parvovirus
  • chronic infection
    • HIV

Prevention of congenital infections

  • antenatal screening tests
  • ToRCHeS programme
    • Toxoplasmosis
    • Rubelle
    • Cytomegalovirus (CMV)
    • herpes simplex virus (HSV)
    • syphilis
      • antibody detection (IgM/G)
      • antigen detection
      • PCR
  • HIV, HBs/HBe
  • Chlamydia, gonorrhea, group B strep

Prenatal infections

Happens before birth. Foetal membrane may rupture for 1-3 days. It is due to the infection of chorio-amniotic membrane from mother to foetus.

Source of infection

  • Normal flora of vagina & reproductive system
    • staph
    • strep
    • gram –ve bacteria
    • e. coli
    • coliforms
    • bacteroids
    • clostridium
  • Prenatal infections of the mother
    • localized infection of the genito-urinary tract
    • pyrexia of unknown origin (PUO)
  • Prenatal infections
    • stillbirth
    • premature
    • respiratory distress syndrome
    • deformities
    • low birth weight
  • Prenatal opportunistic infections of newborn
    • normal flora
    • neonatal sepsis
    • immunocompromised newborns
  • Viral pathogens
    • HIV
      • 20% of HIV mothers
      • transplacental
      • perinatal (blood)
      • postnatal (milk)
      • symptoms appear later
      • lymphadenopathy
      • poor weight gain
      • susceptible to other infections
    • Hep B virus
      • mother have HBs/HBs +ve
      • blood
      • 80-90% infected
      • HBsAg +ve after 2-5 months
        • HBs vaccine for prevention
    • Herpes Simplex Virus
      • severe & disseminated
        • hepatitis
        • pneumonitis
        • encephalitis
      • treatment: acyclovir
      • skin lesions
      • CNS signs: fits, bulging fontanelle
  • Bacterial pathogens
    • Neisseria gonorrhea
    • Chlamydia trachomatis
      • ophthalmia neonatorum
      • atypical pneumonia
    • Group B strep
      • normal flora
      • from respiratory route to placenta
      • septicaemia & meningitis
        • blood culture, cerebrospinal fluid
        • treatment: penicillin
    • Staph aureus
      • cellulitis
        • scalded baby syndrome
      • toxaemia

image

Scalded Baby Syndrome

Ophthalmia neonatorum

image

  • staphylococci
    • sticky eye
  • gonorrhea
    • STD
  • chlamydia
    • STD

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Postnatal infections

  • Respiratory distress syndrome
    • neonatal ICU
  • nosocomial infections
    • rotavirus
    • herpes simplex cirus
    • MRSA
  • respiratory tract –> septicaemia
  • neonatal tetanus
    • due to home delivery
      • traditional practice on umbilical cord
    • symptoms
      • classical tetanus symptoms (tetanospasm)
        • risus sardonicus (lockjaw)
        • opisthothonus (arched back)
  • infections to mother
    • puerperal sepsis (childbirth fever)
      • due to use of non-aseptic techniques during home delivery

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