Obstetrics and Gynaecology · MU Sofia

24. Infections in pregnancy

Explains why infections in pregnancy threaten the fetus and newborn, and introduces the TORCH group of congenital infections. A table sets out each infection's effect on the fetus and its key management, from rubella and CMV to listeria. Bacterial infections follow, covering asymptomatic bacteriuria, group B streptococcus, chorioamnionitis and bacterial vaginosis, then routine antenatal screening and the timing of greatest risk.

Inside: 3 sections · 1 table · 15 flashcards · 2 min

Topic 24 of 61 in the MU Sofia syllabus for Obstetrics and Gynaecology (Dental Medicine, Year 4). The free AceMed note covers it in 3 sections, about 148 words (2 min of reading), with 15 flashcards.

In this note

  1. Introduction
  2. Main infections
  3. Bacterial infections

Introduction

Infections in pregnancy matter because they can harm the fetus (miscarriage, anomalies, preterm birth, stillbirth) or the newborn during birth. The classic group of congenital infections is TORCH: toxoplasmosis, other (syphilis, varicella, parvovirus B19, listeria, HIV), rubella, CMV, herpes.

Bacterial infections

  • Asymptomatic bacteriuria (2–7%): screen with urine culture and treat, because it leads to pyelonephritis and preterm labour.
  • Group B streptococcus: leading cause of early neonatal sepsis; give intrapartum IV penicillin to carriers or women with risk factors (preterm labour, prolonged rupture of membranes, fever, previous affected baby).
  • Chorioamnionitis: fever, maternal and fetal tachycardia, tender uterus, offensive liquor; broad-spectrum antibiotics and delivery.
  • Bacterial vaginosis is linked with preterm birth; treat when symptomatic.

Routine antenatal screening

HIV, hepatitis B, syphilis, rubella immunity (in many countries), urine culture; others depending on risk.

Most congenital infections are worst in early pregnancy, when the organs are forming; herpes and varicella are worst near delivery.

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