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Chapter 22 - Infectious Diseases in Pregnancy

Published online by Cambridge University Press:  26 January 2024

By
C. Tyler Smith ,
Christina Megli  and
Catherine A. Chappell
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Grace Lim
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Grace Lim
Affiliation:
University of Pittsburgh
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Summary

Infections cause direct maternal morbidity and remain a leading cause of maternal morbidity in the United States and globally. In this chapter, we will discuss the physiologic considerations of infectious diseases in pregnancy, alterations in pregnancy response to infections, changes in immune cell populations, and fetal immune response. Pregnancy is a state of relative immunosuppression order for the maternal “host” to not reject fetus and this immunosuppression has consequences in the setting of infectious illness. The pathophysiology, epidemiology, obstetric management, antibiotic therapy, and anesthetic management of the most frequent bacterial and viral infections in the obstetric patient including chorioamnionitis, sepsis, human immunodeficiency virus (HIV), group A streptococcus, and TORCH infections. Additionally, we will present the obstetric and anesthetic management of uncommon bacterial, viral, and parasitic infections. This chapter provides nuanced understanding of peripartum immunologic physiology, an overview of common obstetrical infections, and a quick resource for uncommon as well as tropical infections, such as tuberculosis and malaria as they relate to pregnancy for obstetrics anesthesia providers. Management pearls included in this chapter can improve maternal and fetal outcomes for pregnant patients with infections illnesses.

Keywords

infectionpregnancychorioamnionitissepsishuman immunodeficiency virus (HIV)group A streptococcusTORCHviralbacterialparasitic
Type
Chapter
Information
Obstetric Anesthesia and Uncommon Disorders , pp. 367 - 388
Publisher: Cambridge University Press
Print publication year: 2024

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