Urinary tract infections
German measles ( Rubella )
Cytomegalovirus
Toxoplasmosis
Hepatitis
Chlamydial infection
Human immunodeficiency virus (HIV) infection
Genital herpes
Syphillis
Kidney Diseases That Can Complicate Pregnancy
Regardless of the aetiology of the pregnant patient presenting with pre-existing renal disease, there are several generalisations which can be made.
First of all, the best time for consultation is prior to conception. At this time, some prediction of prognosis during pregnancy as well as formulating a plan of management during pregnancy can be discussed.
Screening patients with pre-existing renal disease during pregnancy should involve the frequent use of a carefully collected creatinine clearance . Any deterioration in creatinine clearance as the pregnancy progresses should warrant admission and evaluation for a reversible cause, such as urinary tract infections or dehydration.
Frequent ultrasounds of the foetus to monitor its growth as well as biophysical assessment may be required.
Patients should be instructed to weigh themselves frequently and to look for signs of increasing oedema (excess fluid in body cells/cavities which causes swelling). There are many cases now reported of patients who have previously undergone renal transplant who have successfully carried a pregnancy as well as cases of patients who have had renal dialysis performed throughout pregnancy.
Urinary Tract Infections During Pregnancy
A more common urologic problem during pregnancy is that of urinary tract infection . Asymptomatic bacteriuria (defined as two cultures of the same organism of greater than 103 colonies) has been found to occur in between 3-6% of pregnant patients. This rate is the same as that seen in non-pregnant individuals. The unique problem during pregnancy is that the presence of asymptomatic bacteriuria markedly increases the risk of pyelonephritis . As many as 30% of patients with asymptomatic bacteriuria may develop pyelonephritis, and in those patients who develop pyelonephritis, there is an increased risk of septic shock. As many as 10% of patients with pyelonephritis during pregnancy have been reported to suffer consequences of septic shock.
Rubella---
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Viral Infections in Childhood: Rubella
Description
Rubella Virus : The type (and only) species of RUBIVIRUS causing acute infection in humans, primarily children and young adults. Humans are the only natural host. A live, attenuated vaccine is available for prophylaxis. [1]
Rubella : An acute, usually benign, infectious disease caused by the RUBELLA VIRUS and most often affecting children and nonimmune young adults, in which the virus enters the respiratory tract via droplet nuclei and spreads to the lymphatic system. (From Dorland, 27th edition) [1]
Rubella Syndrome, Congenital : Transplacental infection of the fetus with rubella usually in the first trimester of pregnancy, as a consequence of maternal infection, resulting in various developmental abnormalities in the newborn infant. They include cardiac and ocular lesions, deafness, microcephaly, mental retardation, and generalized growth retardation.
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Neonatal Problems: Cytomegalovirus
Description
Cytomegalovirus Infections : Infection with CYTOMEGALOVIRUS, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults. [1]
Toxoplasmosis is an infection with the parasite Toxoplasma gondii . If a woman becomes infected during pregnancy the infection may pass through the placenta to the developing foetus. Women at risk of acute infection and secondary transmission to their foetus are those who are antibody-negative (were not previously exposed to T. gondii ) and whose culinary practices include the use of raw, previously unfrozen meat (e.g., some women of French or African descent, Inuit women) and women who travel to these regions during pregnancy, as well as women who handle kittens or previously uninfected cats and/or kitty litter during pregnancy.
Transplacental transmission following maternal infection may occur throughout pregnancy, although it is more common later in pregnancy. The severity of infection is inversely related to the gestational age at which transmission occurs.
Symptoms and Signs
Infection may result in symptomatic neonatal disease, either generalised or neurological; symptomatic disease occurring in the first months of life, usually neurological; sequelae or relapse later in childhood of a previously unrecognised infection, usually chorioretinitis; and subclinical infection. The vast majority of infants have subclinical infection. 40% of symptomatically infected infants show abnormalities in brain scans. Newborn Infection . The diagnosis of congenital toxoplasmosis in the newborn infant should be considered in the presence of positive maternal serology and/or suggestive clinical findings often associated with abnormalities of ophthalmological examination, cerebrospinal fluid analysis and cranial CT scan.
Management of congenital toxoplasmosis should be carried out in conjunction with a colleague experienced in this area. The treatment of choice for congenital toxoplasmosis in the neonate is the combination of pyrimethamine, sulphadiazine and folinic acid administered for one year. These children need to be followed carefully for evidence of myelosuppression secondary to medication, appearance or progression of retinal disease, development of ventricular obstruction and developmental delay. Multidisciplinary follow-up care, appropriate to the deficit and with attention to auditory function, is required. Breastfeeding by an infected mother provides no risk to her infant. These infected children are not contagious.
Hepatitis : Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [1]
Hepatitis, Viral, Human : Viral hepatitis in man.u [1]
Hepatitis A : Hepatitis caused by HEPATOVIRUS. It can be transmitted through fecal contamination of food or water. [1]
Hepatitis B : Hepatitis caused by hepatitis B virus. It may be transmitted by transfusion of contaminated blood or blood products. [1]
Hepatitis C : A form of hepatitis, similar to type B post-transfusion hepatitis, but caused by a virus which is serologically distinct from the agents of hepatitis A, B, and E, and which may persist in the blood of chronic asymptomatic carriers. Hepatitis C is parenterally transmitted and associated with transfusions and drug abuse. [1]
Hepatitis D : Hepatitis caused by the HEPATITIS DELTA VIRUS in association with hepatitis B. It is endemic in some European countries and is seen in drug users, hemophiliacs, and polytransfused persons. [1]
Hepatitis E : An acute form of hepatitis caused by a virus serologically distinct from the agents of hepatitis A, B, and C. Hepatitis E is associated with fecally-contaminated water, is enterically transmitted, and is commonly found in tropical or subtropical countries
Chlaymydial infection:
Chlamydial infection is caused by the bacteria Chlamydia trachomatis . Chlamydia is the leading sexually transmitted disease (STD) in the United States today, with an estimated 4 million new cases occurring each year. A pregnant woman may pass the infection to her newborn during delivery. Pelvic inflammatory disease (PID), a serious complication of chlamydial infection, has emerged as a major cause of infertility of women of childbearing age.
Chlamydia is spread during sexual intercourse via the exchange of bodily fluids through mucous membranes in the anus, mouth, and genital areas.
Symptoms and Signs
Men and women with chlamydial infections may experience abnormal genital discharge or pain during urination. These early symptoms may be absent or very mild, but if they occur, they will do so within 1 to 3 weeks of exposure. However, half of infected women and 25 % of infected men may have no symptoms whatsoever. As a result, the disease is often not diagnosed until complications develop. In addition to pelvic inflammatory disease , chlamydia can cause an inflamed rectum and conjunctivitis . The bacteria have also been found in the throat as a result of oral sexual contact with an infected partner.
Diagnosis and Treatment
Chlamydia is easily confused with gonorrhoea because the symptoms of both diseases are similar, and because they often occur together. Until recently, the only way to diagnose chlamydia was to take a sample of secretions from a patient’s genital area and culture the organism in special tissue culture in the laboratory. While still the most definitive test, it is expensive and technically difficult. Results can take up to 3 days. More recently, however, several rapid tests that use sophisticated techniques and a dye to detect bacterial proteins have been developed and are a readily available test for chlamydial infection.
Chlamydia
Chlamydia is curable with certain antibiotics like tetracycline, erthyromicin, and azithromycin (but not penicillin, as is the case for other STDs). It is very important that a person with chlamydial infection take all of the prescribed medication, even after symptoms disappear.
HIV & Pregnancy
Most babies born to HIV-infected women escape the virus, but 1 in 4 do become infected before or during birth or through breastfeeding, although no one is certain when viral transmission occurs. Transmission may also be linked to the mother’s health during the pregnancy or birth--there are more viruses during the earliest stages of AIDS than later, for example. Currently, physicians may prescribe drug Retrovir (AZT) for infected pregnant women to reduce rates of transmission; effectiveness of this therapy increases the earlier HIV is diagnosed during the course of infection or before or after pregnancy.
Genital Herpes & Pregnancy
A pregnant woman who develops a first episode of genital herpes can pass the virus to her foetus and may be at higher risk for premature delivery . Newborns rarely become infected with herpes ( neonatal herpes ); however, half of those who become infected either die or suffer neurological damage. With early detection and therapy, many serious complications can be lessened. The new-born's chances of infection depend on whether the mother is having a recurrent or a first outbreak. If the mother is having her first outbreak at the time of a vaginal birth, the baby's risk of infection is approximately one in three. If the outbreak is a recurrence, the baby's risk is very low. Because of the danger of infection to the baby, however, the physician will perform a caesarean section if herpes lesions are detected in or near the birth canal during labour. Some physicians also perform a viral culture at the time of delivery to detect shedding in women known to have had genital herpes outbreaks in the past. A baby born with herpes can develop encephalitis (inflammation of the brain), severe rashes, and eye problems. Acyclovir can greatly improve the outcome for babies with neonatal herpes, particularly if they receive immediate treatment.
Syphilis & Pregnancy
Pregnant, infected women untreated for syphilis often pass the bacteria to their unborn children, resulting in stillbirth (1 in 4) or in an infected infant (40-70%). The effects of syphilis on infants include skin sores, rashes, fever, jaundice, anaemia , and various deformities, along with weakened or hoarse crying sounds and swollen liver and spleen. Testing and treatment early in pregnancy is the best way to prevent syphilis in infants and should be a routine part of prenatal care.
2006-08-06 07:42:58
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answer #1
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answered by oph_chad 5
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Rubella ("German measles"), Toxoplasma, Cytomegalovirus (CMV), Herpes, Syphilis, hepatitis B, coxsackie virus, Epstein-Barr virus, varicella-zoster virus, and human parvovirus to name a few, can all cause birth defects if the mother has these during pregnancy.
2006-08-06 05:32:11
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answer #4
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answered by petlover 5
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