Case Discussion : Infection

1. Case Discussion: Infection May 2014

2. 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?

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

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

5. 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?

6. Take Home Messages… • 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