Summary
Samenvatting infectie en afweer: infecties in zwangerschap overzicht
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infectie en afweer: infecties in zwangerschap overzicht tabeloverzicht
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Probleem Epidemio Diagnose BeleidGBS (GI) Neonatale sepsis en 2/1000 early onset Screening op 35- AB: intrapartum
meningitis 1/10: kolonoisatie 37w: vaginale wisser Peniciline (ev
early onset 1e week ampicilline
(ernstiger) Mortaliteit = 6-15% Cefalozine
late onset Clindamycine
Transmissiekans = 50%
Maternale vaginale
kolonisatie
Bacteriële Anaërobe bacteriën 10-41% KO: frijze vaginale Behandelen bij
vaginoses fosfolipase: afscheiding met symptomen
prostaglandine visgeur, pH>4,5 Metronidazole
vroeggeboorte microscopie clue Clindamycine
cells Behandelen+ screenen
= AMSEL criteria vroeg in de zws bij hoog-
gramkleuring risico
kweek niet zinvol!!!
Chlamydia SOA 1-3% Azithromycine
trachomatis Ophthalmia neonatarum! Erythromycine of
Nasopharyngeale ampicilline
kolonisatie
Gonorrhoe Opthalmia neonatarum Laag in europa RESISTENTIE!!
Ceftriaxone +
azithromycine
Listeria GI: na orale besmetting Heldergroen Preventie: voedingsadvies
rauwe vis en kaas, vruchtwater AB:
Onderdiagnose! ongewassen groenten Verheven rode ampicilline/gentamicine
Meningitis vlekjes
APD en gramkleuring
Hemocultuur
Cultuur CSF
Syfilis Treponema pallidum 3/100 000 VDRL Benzathine Penicilline
SOA TPHA vroeg Partner testen en
1/3: fetal loss (treponemaal) behandelen
1/3 congenitale syfilis screening Soa screening
mucosa letsels, KO: ulcus,
palatumperforatie, papulosquameuze
Hepatosplenomegalie, rash, condyloma lata
huidletsels, petechiae
Herpes simplex: Congenitale herpes: 3/100 000 Geen veralgemeende Primo infectie op eind en
HSV-2 transplacentair screening zichtbare letsels sectio
Neonatale herpes: tijdens Gekend: inspectie, Acyclovir
baring kweek, PCR in 3e
- Laesis trim
- Encefalitis
- Gedissemineerde
infectie
Borstvoeding geen
probleem
HIV 70% perinataal besmet 30% global HIV testing (Ab + cART: viral load zo laag
+ risico andere (1/3 in utero) België: 0,3% immunoblot 24 ) aan mogelijk HAART
LET OP: borstvoeding Transmissie: 20-40% alle zwangere Viral load 36w > 50 copies/
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