Management of infection in pregnancy depends on a sound knowledge and understanding of the epidemiology of infection, for example:
- what is the background prevalence of the infection?
- what is the incidence of infection in pregnancy?
- what is the risk and timing of mother–child transmission?
- what are the risk factors for maternal and perinatal infection?
- what are the consequences, short and long term, of congenital/perinatal infection?
Knowledge about the timing of infection will influence the management, and the gestational age at infection may influence the risk of vertical transmission and implications for the fetus.
Prevention of infection can take the form of vaccination or avoidance, for example:
- seasonal vaccination against influenza
- vaccination against rubella
- avoidance of individuals with chickenpox
- avoidance of foods that may harbour Listeria, e.g. soft cheeses.
Detection (screening, signs and tests)
The National Screening Committee recommends antenatal screening of all women for:
- hepatitis B
Antenatal screening for rubella susceptibility stopped in England on 1 April 2016. The evidence has shown that screening for rubella susceptibility during pregnancy does not meet the UK National Screening Committee criteria for a screening programme.
Pregnant women may also present with signs and symptoms of infection, for example:
- chancres indicate syphilis infection
- genital ulcers, fever and muscle ache indicate herpes infection
- flu-like symptoms may indicate hepatitis infection.
Specific tests may also be used to confirm diagnosis, for example:
- polymerase chain reaction (PCR) to confirm herpes and Chlamydia infection
- blood test to confirm cytomegalovirus infection
- ultrasound of fetus to check for features associated with infection, e.g. hydrops fetalis.