Infections in Pregnancy :
• Most common - CMV
• Most teratogenic - Rubella
• M/C Time for rubella transmission to fetus - 1st trimester
(maxmimum - 1to 4 weeks),
absent transmission - beyond
20 weeks.
• In Rubella - M/C single defect which occurs is – Sensorineural hearing loss
• Heart defects seen in Rubella - PDA and Pulmonary artery stenosis
• After rubella vaccine, pregnancy is contraindicated for 1 month.
• CMV Transmission can occur in any trimester.
• Most severe infection of CMV occurs if transmission occurs in 2nd trimester.
• CMV transmission can occur during vaginal delivery and breastfeeding also.
• Primary infection – leads to 40% transmission
• Recurrent infection – leads to 0.2%-2% transmission.
• CMV never Leads to Heart Defects in Fetus
• M/C time for toxoplasma infection - 3rd trimester
• Maxmimum/most severely fetus is affected if fetal infection occurs in 1st trimester
• Triad of toxoplasma - intracerebral calcification, chorioretinitis andhydrocephalus
• Treatment of Toxoplasma - Spiramycin (prevents fetal transmission but it cannot treat fetal infection if it is present.)
• Spiramycin + pyrimethamine and sufonamide combination is given to treat fetal infection and prevent further transmission.