TORCH infections
Toxoplasma
Others
- Syphilis
- HIV
- Hep B
- Varicella
Rubella
CMV
Herpes
If Mother gets Rubella after 16wks - Nothing to fetus
But if 10-11 wks - Increased chances of fetal abnormalities
Common points :
1. 50 - 60 % are asymptomatic
2. If symptomatic :
Infectivity
1. All of them - at time of delivery.
2. Rubella - 2 peaks -
If HIV to mother -
Note : in HIV cases -
CMV
Herpes
If Mother gets Rubella after 16wks - Nothing to fetus
But if 10-11 wks - Increased chances of fetal abnormalities
Common points :
1. 50 - 60 % are asymptomatic
2. If symptomatic :
- IUGR
- Failure to thrive
- Anaemia
- HepatoSpleenomegaly
- Thrombocytopenia
- Rash
- Cholestasis
Infectivity
1. All of them - at time of delivery.
2. Rubella - 2 peaks -
- 10-11 wks
- At time of delivery
If HIV to mother -
- Zidovudine after 14 wks pregnancy
- then For delivery - do elective LSCS
- If in labor - intrapartum Nevirapine
- Neverapine to child (oral) x 4-6wks
Diagnosis is based on Serology :
1. IgM - is made by the child itself
2. IgG - is transmitted from mother
Considered marker only if :
- IgG persists 6-9 months
- or increases in titre
Note : in HIV cases -
- No IgM in child
- IgG persisting >18months is taken as marker. (not 6-9 months)
Thus for 1st 18 months : (as Child of HIV mother will be having +ve ELISA)
- p24 assay
- PCR (best but difficult)
- Viral Culture
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