May 2014 Case Discussion: Infection

Consider Heidi… Heidi presents to confirm second pregnancy She is working four days per week with a young son in child care Heidi is concerned about the fact that he is often sick and she is worried about contracting infections from him. What are the issues for Heidi? Would you consider extra screening and interventions at this point?

Heidi Represents… Heidi is 15 weeks pregnant Her son came home from child care feeling unwell and has bright red rash on che eks Heidi presents to GP with her son who is diagnosed with parvovirus based on his clinical presentation What are the implications for Heidi?

Heidi is concerned… Heidi is aware that contracting parvovirus in pregnancy can be dangerous. She is worried. She is asking what to do now?

Heidi is concerned… After discussion and negotiation with Heidi, you have performed parvovirus serology Heidi is IgM + and IgG negative What do you tell Heidi? What do you do now?

At booking, important to consider extra risk of exposure to infection Ensure immunisation schedule is up-to-date – preconception if possible Refer to Immunisation Handbook re current guidelines for immunisation in preconception and in pregnancy Despite high immunity in the adult population, contracting Parvovirus remains a risk in pregnant women This infection can be sub clinical in 30 – 40% of cases Parvovirus can cause early pregnancy loss, chronic maternal anaemia, severe foetal anaemia and foetal hydrops Take Home Messages…