Infection In Pregnant Patients

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Notes 3 More General Terms 4 References

More Specific Terms

• HIV infection during pregnancy

Notes

• A woman in the 3rd trimester of pregnancy is immunosuppressed.
  

• defects in neutrophil chemotaxis
• defects in delayed-type T- cell mediated immunity
  

• Special considerations

• disseminated infection

• Herpes zoster
• coccidioidomycosis

• urinary tract infection are particularly common

• bacterial growth in urine is promoted by intermittent

• glycosuria
• aminoaciduria

• screen for asymptomatic bacteria monthly
• treat asymptomatic bacteria for 10-14 days
• asymptomatic urinary tract infections progress to pyelonephritis in 40% of pregnant women
• symptomatic urinary tract infections

• relapse or reinfect frequently
• treat aggressively with ampicillin or cephalosporin for 6 weeks
• pyelonephritis occurs in 1-2% of patients

• adequate to high fluid intake

• recurrent skin infections should prompt consideration of MRSA [2] - no evidence MRSA skin infection affects neonate

• Antibiotics generally contraindicated during pregnancy

• amantadine
• clarithromycin
• doxycycline
• flucytosine
• quinolones

• lomefloxacin
• ofloxacin
• ciprofloxacin

• tetracycline
• bismuth subsalicylate (2nd half of pregnancy)
  

• Antibiotics to be avoided if alternatives are available

• azole & triazole antifungal agents
• chloramphenicol at term
• metronidazole
• aminoglycosides
• antiparasitic agents
• antimalarial agents
• trimethoprim-sulfamethoxazole ( Bactrim)
• most antiviral agents
  

• Antibiotics generally regarded as safe during pregnancy

• beta-lactams
• cephalosporins
• erythromycin (except estolate)
• isoniazid
• amphotericin B
• mefloquine
• azithromycin

• safe in animal studies
• no studies in humans
  

• also see medications during pregnancy

More General Terms

• infection (infectious disease)
• pregnancy disorder; obstetric disorder

References

1. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
2. Laibl VR, Sheffield JS, Roberts S, McIntire DD, Trevino S, Wendel GD Jr. Clinical Presentation of Community-Acquired Methicillin- Resistant Staphylococcus aureus in Pregnancy. Obstet Gynecol. 2005 Sep;106(3):461-5. PMID: [1]
3. Prescriber's Letter 16(12): 2009 Antibiotic and Antifungal Use During Pregnancy and Breastfeeding Detail-Document#: [2] (subscription needed) [3]
4. National Guideline Clearinghouse Management of herpes in pregnancy. American College of Obstetricians and Gynecologists ngc-guideline: [4]

infection in pregnant patients