Teratogenic And Congenital Viral Infections

Front 1

1. What are 3 main pathways for the spread of infection from mother to fetus?
2. What are the outcomes to infection?

Back 1

1. Amnionic (via vagina- ascending) & Transplacental & Acquisition at birth
2. Normal, infection (born w/ disease, will be chronic through life), fetal death, malformation

Front 2

1. What does TORCH stand for? (what is it associated w/?)

Rubella and cytomegalovirus can cause syndromes from teratogenic to abortion to generalized

Herpes & varicella can cause abortion/still birth as well but less frequently

Back 2

1. Toxoplasmosis, Other (varicella, parvovirus, syphilis), Rubella (german measles), Cytomegalovirus, HSV-2 (birth defects)

Front 3

1. What is B-19?
2. How is rubella (german measles) transmitted? (Effect of infection if older than 1 yr?)
3. How does rubella reach the fetus if mother is infected? (effect in fetus?)

Back 3

1. A DNA virus that attacks erythropoietic cells
2. Respiratory (rash/fever)
3. Transplacental (cell death, growth disruption, and impaired differentiation- worse in 1st trimester)

Front 4

Congenital rubella syndrome can cause:
-spontaneous abortion/still birth
- mental retardation
- deafness most common
- chronic persistent infection

Back 4

Congenital CMV syndrome:
Hearing defects and deafness are major sx
Mental retardation and eye defects can occur
Severe CNS involvement leads to death in small %

Front 5

1. How do you dx CRS?
2. Rx CRS?
3. What is the most common congenital infection?
4. How is 3 acquired?

Back 5

1. Hx of maternal infection, physical abnormalities (eye/heart), deafness/retardation, serology, PCR of urine/throat culture
2. no therapy, mb abort, vaccine for prevention, but do not vaccinate the pregnant woman- it is a live vaccine
3. CMV
4. transplacentally or perinatally - both lead to long-term viral shedding but only transplacental is associated with serious disease

Front 6

1. How is CMV transmitted?
2. What percentage of congenital CMV infectio will have severe neurologic complications?
3. Dx CMV?
4. Rx for CMV?

Back 6

1. Orally, sexually, or by blood and congenitally - most common in the world
2. 10% of the 1% of all births
3. physical findings, virus isolation, PCR, serology (after mother Ab leaves)
4. No approved therapy (but mb gancyclovir or passive immunization, or vaccine)

Front 7

1. What type of herpes is most commonly acquired by infants?
2. Dx it?
3. Rx for congenital HSV?

Back 7

1. HSV-2
2. Virus isolation from tissue, immunohistology, PCR - it destroys the brain
3. IV acyclovir (still high mortality), caesarean to avoid exposure

Front 8

HSV-2:
causes generalized, systemic infection in neonates leading to aggressive encephalitis

Back 8

Varicella-Zoster Virus
Est. permanent latent infections (zoster after 1st exposure)
Maternal exposure to HVZ:
Early in pregnancy: abortion, fetal varicella syndrome
At any stage: death, herpes zoster during 1st yr of life
Near term: Congenital varicella or neonatal varicella

Front 9

1. A perinatal infection with HVZ leads to what?
2. Rx 1?
3. How can a fetus get HIV?
4. How can you reduce transmission to fetus?

Back 9

1. disseminated infection w/ ecephalitis - mortality is high & CNS impairment is common
2. Anti HVZ Ig and Acyclovir
3. Transplacentally or from breast milk
4. Maternal Rx w/ anti-HIV drugs

Front 10

1. What does parvovirus B19 do in children?
2. What about congenitally?

Back 10

1. some redness
2. can cause fetal death- no Rx