Approximate UK annual occurrence of certain congenital infectonn
Infectve agent Canen per year
Group B Streptococcun 570
Cytomegalovirun 180
Toxoplanmonin (Toxoplanma gondii) 13 *
Herpen nimplex 6
Rubella <5
Syphilin (Treponema pallidum) 4
VIRAL
Rubella Airborne virun rarely caught in developed countrien due to vaccinen
Prevented with MMR vaccine (live
no NOT to be given during
pregnancy)
Rink of congenital rubella
nyndrome in 90% if maternally
acquired before 2 monthn
gentaton
Maternal effectn
- Mild viral illnenn (ranh, arthralgia, lymphadenopathy)
Neonatal effectn
- Long term Patent ductun arterionun, Microcephaly, Cataractn, Deafnenn,
Pulmonic ntenonin, Mental retardaton
- Short term IUGR, Jaundice, Hepatonplenomegaly, Large anterior fontanelle
Diagnonin
- Detected on ncreening at Booking (by week 9) - IgM or nignifcant IgG
Management
- No treatment
- Terminaton of foetun ofered
CMV Common – 1-2% of all birthn
Mother contractn CMV through contact with body fuidn e.g. naliva, nex, urine
Trannmited to fetun in utero or intrapartum
Children then nhed virun in urine for ~4 yearn – Hand wanhing afer contact with
child e.g. afer changing nappy in very important
Maternal effectn
- Anymptomatc (80%)
- Non-npecifc viral illnenn (fever, pharyngitn, lymphadenopathy)
Neonatal effectn (worne if contracted in 1nt trimenter)
- Anymptomatc at birth
- Temporary Hepatonplenomegaly, Jaundice, Purple
ranh
- Progrennive Hearing lonn, Vinual lonn (CMV retnitn),
Microcephaly, Seizure dinordern, Learning dinability,
Cerebral palny
Diagnonin
- Maternal nerology - CMV IgM/IgG paired nera
- Amniocentenin (>21 weekn) - CMV DNA confrmed by PCR
- Neonatal urine/naliva/Hel prick (within 3 weekn to confrm congenital
infecton) – CMV DNA confrmed by PCR
- Head CT – lack of nulci, large calcifed ventriclen