Coupon Accepted Successfully!


Intrauterine Infections

T: Toxoplasmosis

O: Others (syphilis, hepatitis B, Varicella, Coxsackie B, HIV) etc)


R: Rubella


C: Cytomegalovirus


H: Herpes simplex

  1. Toxoplasmosis:
  • Caused by Toxoplasma gondii

Transmission ratg

  1. Ist trimester-15%
  2. 2nd trimester-60%
  3. Term 90%

Classical Triad Q

  1. Chorioretinitis
  2. Hydrocephalus
  3. Cerebral calcification - diffused

Other features: Q

  1. Anemia, Thrombocytopenic purpura Q
  3. Microcephaly Q
  4. Sensorineural hearing loss Q.


  1. Demonstration Of Parasite In The - CSF or in the tissue.
  2. Serological tests- the indirect fluorescent antibody (IFA test) or Sabin -Feldman dye test


  1. Pyrimethamine + sulfadiazine (Folinic acid)
  2. Spiramycin - Treatment of maternal infection
  3. In confirmed cases of fetal infection, or in cases where testing cannot be performed but acute maternal disease occurred in the die second trimester, pyrimethamine (plus folinic acid) sulfonamide alternating with spiramycin every 3 weeks beginning at 24 weeks gestation is recommended.
  1. Rubella: Virulence or infection depends on the gestational age at the time of transmission
    1. 12 wks -81%
    2. 13-16 wks -54%
    3. 7-22 wks -36%
    4. 23-30 wks -30%
    5. 31-36 wks -60%
    6. >36 wks -100%


  1. 1-10 wks - 100% cardiac defects and deafness
  2. 13-16 wks - 1/3 -deafness
  3. 20th wks - no defects


Diag: Antenatal: specific IgM in fetal blood obtained by percutaneous umbilical blood sampling

Post natal:

  1. Isolation of virus (Oropharynx, urine)
  2. Detection of rubella-specific IgM in cord or neonatal period
  3. Persistent rubella specific titer's over time


  1. No t/t available
  2. Conception should be avoided for 3 months following immunization
  3. Immunization during-pregnancy is not recommended
  1. Cytomegalovirus
    1. M/C IU infection Q
    2. Rate of IU Transmission 30-40%
    3. l0-18% of newborn infected -» significant disease


  1. Petechiae-79%
  2. HSM- 74%
  3. Jaundice
  4. Microcephaly
  5. IUGR
  6. Premature
  7. Chorioretinitis-20%
  8. Hearing loss-60-70%
  9. Periventricular celcificetor

Cottage cheese with ketch up appearance

Diag: Isolation of virus, Q from WBCs, urine, and saliva

  1. CMV Ag detection by ELISA in urine
  2. Hybridization technology in tissue and cells
  3. Intranuclear or Intracytoplasmic Inclusion bodies

TREATMENT: Ganciclovir / Foscarnet Q

    1. Type II is the cause of neonatal disease in 80% of cases : Vesicular Rash & Encephalitis
    2. Illness starts from 4-10 days after Birth
    3. Most common cause of neonatal disease is as a result of intrapartum transmission and is primarily associated with active shedding of virus from the cervix at the lime of delivery. In utero infection is uncommon.

Diag: Characteristics cells or histological changes in the scraping of tissues. Virus may be isolated from oropharynx, nasopharynx, conjunctivae, stool or urine.


Treatment: Acyclovir Q


Women with cervical HSV—> caesarian section Q

  1. Congenital Syphilis
    Manifestations of congenital syphilis can be classified as follows:
    1. Early manifestations (infectious stage): within first years of life:
      1. Bullous/maculopapular rash, vesicles, rhinitis and snuffles (earliest sign)
      2. Hepatosplenomegalyc. Lymphadenopathy
      3. Hematological: coomb's negative hemolytic anemia, thrombocytopenia
      4. Skeletal: osteochondritis/metaphysitis/pseudoparalysis
      5. Iugr/ failure to thrive
      6. Ocular: congenital glaucoma, chorioretinitis
      7. Cns: leptomeningitis, hydrocephalous
    2. Residual stigmata .
      1. Hutchison's teeth, mulberry molars
      2. Olympian brow
      3. Saddle nose
      4. Saber shins
    3. Late congenital syphilis (non-infectious) shows:
      1. Interstitial keratitis
      2. 8th nerve deafness
      3. Clutton's joints
      4. Asymptomatic neurosyphilis
      5. Recurrent arthropathy

Test Your Skills Now!
Take a Quiz now
Reviewer Name