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TORCH INFECTION
T: Toxoplasmosis
O:Others(Varicella,Mumps,Coxsackie,
parvovirus, HIV, Encephalitis)
R: Rubella
C: Cytomegalo virus
H: Herpes
W TOXOPLASMOSIS : causative
organism Toxoplasma gondii an
intracellular parasite and CNS teratogen.
W t causes hepatosplenomegaly, retinitis,
brain cyst with consequent retardation &
epilepsy, high risk oI schizophrenia .
W Treatment : pyrimethamine,
sulphonamides.
W MUMPS increases rate oI pregnancy
loss.
W VARICELLA chicken pox): varicella
zoster virus. When mother is aIIected
beIore 20 weeks oI pregnancy causes:
microcephaly, eye deIects, limb deIects,
Ietal death, abortion
W Neonatal inIection, still birth iI in late
pregnancy
W HIV: high rate oI transmission to inIant20-
50) unless mother goes Ior
AZTZidovudine) in pregnancy, LSCS,
Bottle Ieeding & inIant AZT Ior 6 weeks
down to 3)
W RUBELLA: caused by rubella virus
W #ubella beIore 16 weeks oI pregnancy
crosses the placenta causing severe deIects.
W 8-10 weeks causes heart abnormalities,
mental retardation, deaIness & blindness.
W Preconception testing/ vaccination should be
given to all women, with avoidance oI
pregnancy Ior 2-3 months aIter vaccination.
W Prenatal rubella is a well known CNS
teratogen.
W RUBELLA: caused by rubella virus
W #ubella beIore 16 weeks oI pregnancy
crosses the placenta causing severe deIects.
W 8-10 weeks causes heart abnormalities,
mental retardation, deaIness & blindness.
W Preconception testing/ vaccination should be
given to all women, with avoidance oI
pregnancy Ior 2-3 months aIter vaccination.
W Prenatal rubella is a well known CNS
teratogen.
W CYTOMEGALO VIRUS: usually
acquired in childhood and is mild illness but
can cause hepatitis. I the mother contracts
it Irom a preschooler then 10 oI inIants
can be inIected with microcephaly,
deaIness, cirrhosis, anemia, pneumonia &
mental retardation
W HERPES SIMPLEX VIRUS TYPE-2
(HSV-2):
levated maternal antibodies to HSV-2
Iound in oII springs caused psychotic
disorders including schizophrenia.
W SYPHILIS caused by the bacterium, %7054302,
5,/:2
W Congenital syphilis is transmitted Irom mother to
Ietus through an inIected placenta during the
second trimester oI pregnancy or between 15 to
18 ) week oI intrauterine liIe.
W Features
arasmus, syphilitic rhinitis, Cry , hoarse, Ieeble
Hepatospleenomegaly ,Ascites
Cutaneous lesions especially over palms and soles
W Penicillin is the treatment.
W SYPHILIS caused by the bacterium, %7054302,
5,/:2
W Congenital syphilis is transmitted Irom mother to
Ietus through an inIected placenta during the
second trimester oI pregnancy or between 15 to
18 ) week oI intrauterine liIe.
W Features
arasmus, syphilitic rhinitis, Cry , hoarse, Ieeble
Hepatospleenomegaly ,Ascites
Cutaneous lesions especially over palms and soles
W Penicillin is the treatment.
W FIFTH DISEASE erythema inIectiosum:
parvovirus: mild rashes
W LST#A : is a bacterial inIection
Iound in cold cheese, cold deli meats,
raw seaIood.
W t can cause miscarriage or still birth
and such Ioods should be avoided.
W NFLUNZA : exposure during Iirst
trimester 7 Iold and in mid gestation 3
Iold risk oI schizophrenia
C0tSAt6ultlTY AT0PY
W Lat|n words conshared sangu|s
b|ood
W Def|n|t|on |t |s def|ned as marr|age
between c|ose re|at|ves
W Lg commun|t|es from North Afr|ca
m|dd|e east |arge parts of As|a In
Ind|a |t |s common among Mus||ms
south Ind|an Na|r fam|||es
BEDEE:TS CE CCDS~DGD:DECDS
R~RR:~GES
W K==|.n_ ||=, ..H.n ~n.l,.
W S~,.n_ ..H.n ~ .=ll und=d
~n.l, un..
W :n|..n_ .n=n |..n L,
=du.n_ H~n= n~l=~n=n
n HuL~nd Lund L, ~n.l,
.=.
D:S~D~DT~GES
W C|.n_ .l.
W D..ul, l...n_ .n ~unnu
n~.=d l.= =|~~= n ..d=
~n.l,.
PROPORTION AND GENES SHARED
BETWEEN CLOSE BLOOD RELATIVES.
e|at|on sh|p
W Identical twins
W Non Identical twins,
siblings, parents &
children
W Uncles , aunts, nephews,
nieces, grand parents,
half brothers, sisters
W First cousin, half uncles,
aunts, half nephews and
nieces
9roport|on of s|m||ar genes
W All 100
W 50
W 25
W 12.5
6FtFTlC ASPFCT 0F C0tSAt6ultlTY
W ChiIdren of unreIuted purents ure ut Iow
risk of inheriting fuuIty genes,
W ChiIdren born to consunguineous purents
ure ut higher risk for recessive genetic
diseuse,
W The risk uppIies onIy to immediute
offspring of reIuted individuuIs und not
to their grundchiIdren or other fumiIy
members,
W TotuI risk of huving u chiId with genetic
conditons when purents ure first cousins
is uround -%
ROLE OF NURSES
W Non judgemental attitude towards
consanguineous couples for good working
relations.
W provide premarital genetic counseling
W Refer couple for prenatal testing and
counseling for early detection of
genetically abnormal fetus.
W Implement public awareness programs
about negative aspects of such marriages
8LnA1AL nu18l1lCn Anu
lCCu ALLL8ClLS
W regnancy dleL should be
balanced(2300kcal) lL
should lnclude a loLs of
proLelns CPC Ca le
vlLamlns lollc acld should
be supplemenLed
F000 AllFR6Y
W Adverse lmmune response Lo a food proLeln
W lL ls dlfferenL from food lnLolerance Loxln
medlaLed reacLlons pharmacologlc reacLlons(
caffelne Lremors mlgralne flsh polsonlng)
W MosL common food allergles are
W Mllk egg peanuL Lree nuL seafood shellflsh
soy wheaL
W 1reaLmenL lnvolves avoldance dleLs
SlCnS Anu S?M1CMS Cl ALLL8C?
W Classlc lg L medlaLed food allergles are
classlfled as Lype l lmmedlaLe
hypersenslLlvly reacLlon
W leaLures angloedema (sofL Llssue
swelllng lnvolvlng eyellds face llps
Longue
W lLchlng of mouLh LhroaL eyes skln
nausea vomlLLlng cramps eLc
W Anaphylaxls shock deaLh
8LvLn1lCn Cl lCCu ALLL8C?
AA9% Amer|can assoc|at|on of 9ed|atry)
gu|de||nes
W uon'L eaL peanuLs durlng pregnancy
W Lxcluslve breasL feedlng
W Avold peanuLs whlle breasLfeedlng
W WalL Lo sLarL solld foods(afLer 6 monLhs)
W uelay lnLroduclng allergenlc foods
W lnLroduce new foods gradually and one aL a
Llme
W Clve chlld cooked food
8ole of prenaLal nuLrlLlon ln
prevenLlon of geneLlc dlseases
W uowns syndrome Zlnc
W MlLral valve prolapse Mv
magneslum
W Wllsons dlsease Zn Lo reduce Cu
W ClefL palaLe follc aclds
W Splna blflda follc acld mulLlvlLamlns
MA1LNAL AGL
W omen are born with all of the eggs
which they will use during their lifetime.
The eggs age as the individual grows
older & with it increases risk for
chromosomally abnormal pregnancy.
W Trisomy 13, 18, 21 are more common in
women with advanced maternal age.
W Studies have shown higher chance of
miscarriage in older mothers.
W ConLl
Materna| age%
years)
Down
syndrome
Any
1S24 1]1300 1]S00
2S29 1]1100 1]38S
3S 1]3S0 1]178
40 1]100 1]63
4S 1]2S 1]18
HATFRtAl 0Ru6 THFRAPY
E.=,H.n_ ,u =~, ~||l,,
n= .n n~ ..H, n~,
~= n nl, ,u Lu ~l
,u L~L,
Saida Haehese 1ohisoi
Lse ol dus ri jeiait laetatri
woei eures a thoouh
uidestaidri ol uirue riteaetroi
letweei othe,letus,dus.
Conti.
W Teratos reek word meaning monster.
W Teratogenicity is the ability oI a drug to cause Ietal
abnormalities when administered to pregnant lady.
W STAGES OF FETALDEVELOPMENT:
Pre embryonic 0-17)days post conception:
early abortion or no eIIect on Ietus
mbryonic 18-55days): high risk Ior
malIormation
Fetal period day 56- term) : risk is lower
Ior malIormation
#LCS CALSlNC ANOHAllFS
W AnLlconvulsanLs (phenyLoln
carbamazeplne ) hearL face
defecLs menLal reLardaLlon clefL llp
palaLe CnS and skeleLal
anomalles
W Alcohol feLal alcohol syndrome
W LlLhlum CPu
W ulazepam clefL palaLe
W 1etracyc||ne sta|ned teeth and depressed
ske|eta| growth
W Warfar|n menta| retardat|on IUG se|zure
nasa| hypop|as|a
W NSAID'S |nterfere w|th b|ood c|ott|ng
|ncreases r|sk for uncontro||ed b|eed|ng for
mother and ch||d
W Isotret|no|n etret|nate used to treat chron|c
acne psor|as|s causes chron|c ma|format|on
dur|ng organogenes|s
W Ch|oramphen|co| gray baby syndrome
hypotherm|a