Question

Enumerate the important infections during pregnancy which cause maternal and fetal morbidity and mortality.

Hint:

Infections like UTIs, CMV, rubella, hepatitis, and HIV can cause significant maternal and fetal morbidity, emphasizing the importance of prenatal screening and appropriate vaccination.

Answer 1

Step 1: Important Infections During Pregnancy that Cause Maternal and Fetal Morbidity and Mortality.
Various infections during pregnancy can lead to significant maternal and fetal complications, ranging from mild illness to severe morbidity or mortality. The important infections include:
(1) Urinary Tract Infections (UTIs):
- Causative Organisms: Most commonly caused by Escherichia coli. UTIs during pregnancy can lead to pyelonephritis, preterm labor, and low birth weight. Untreated UTIs are also associated with maternal sepsis.
(2) Cytomegalovirus (CMV):
- CMV infection during pregnancy can lead to congenital CMV in the fetus, causing neurological defects, sensorineural hearing loss, and growth restriction. Primary maternal infection increases the risk of fetal infection.
(3) Toxoplasmosis:
- Toxoplasma gondii infection can result in miscarriage, preterm birth, or fetal brain damage (e.g., hydrocephalus, chorioretinitis) if contracted during pregnancy. It is commonly acquired through contact with cat feces or undercooked meat.
(4) Rubella (German Measles):
- If a pregnant woman contracts rubella (especially in the first trimester), it can result in miscarriage, stillbirth, or congenital rubella syndrome, characterized by deafness, cataracts, and heart defects in the infant.
(5) Hepatitis B and C:
- Hepatitis B can cause chronic liver disease and cirrhosis in the mother, and vertical transmission can lead to chronic HBV infection in the newborn. Hepatitis C is less likely to be transmitted but can cause maternal liver damage.
(6) Human Immunodeficiency Virus (HIV):
- HIV can lead to maternal immunodeficiency, severe infections, and AIDS. Vertical transmission to the fetus can result in congenital HIV infection, though treatment during pregnancy can reduce the risk of transmission.
(7) Group B Streptococcus (GBS):
- GBS infection can lead to neonatal sepsis, meningitis, and pneumonia. Pregnant women are screened for GBS at 35-37 weeks gestation, and antibiotics are given during labor to prevent transmission.
(8) Syphilis:
- Treponema pallidum infection can result in miscarriage, stillbirth, prematurity, and congenital syphilis (with skin lesions, hearing loss, and neurodevelopmental issues).
(9) Chickenpox (Varicella Zoster Virus):
- Varicella infection during pregnancy can cause fetal varicella syndrome, leading to limb defects, growth restriction, and cicatricial skin lesions. Women who have not had chickenpox should be vaccinated before pregnancy.
(10) Parvovirus B19 (Fifth Disease):
- In pregnant women, Parvovirus B19 infection can cause hydrops fetalis (severe edem and miscarriage. It is particularly dangerous in the second trimester.
(11) Zika Virus:
- Zika virus infection during pregnancy is associated with microcephaly, neurological defects, and congenital Zika syndrome. It is transmitted by mosquitoes and sexual contact.