Article Text
Abstract
Context Maternal-fetal (MF) herpetic infection is a public health problem, with an evolving persistent or latent and early or late consequences for infants. MF herpes infections can be transmitted from mother to child during: prenatal, intranatal and postnatal period.
Aim to present a clinical case of MF herpetic infection, 2 infants, twins who had antenatal and postnatal risk factors for MF herpes infection.
Methods Anamnesis: two infants from the fourth pregnancy, childbirth third (III task stagnant), kind of woman, by age 2 months, duplex, born at 40 weeks, birth weight 1600g, born naturally, from a mother who has not screened for TORCH infections before and during pregnancy. Emergency hospitalised in serious condition with: cough, stuffy nose, loss of appetite, abdominal cramping. Objective: serious state, drowsiness, pale, mottled skin with patterns, perioral cyanosis, anterior fontanelle 5,0cmx 5,4 cm, not pulsating. Semi productive cough, chest indrawing, tachypnea-50 breaths/minute. Auscultation- rough breathing, rales not charged. Weakened heart sounds, systolic murmur at the apex and Botchin point. Slightly bloated abdomen, enlarged liver in size. Paraclinically: 3200g body mass, ALT 351.4 IU/L, AST 185.9 IU/L, haemoglobin 90.0 g/L, lymphocytes 74 × 109/l, BSR- 12 mm/h.. Electrocardiogram: sinus rhythm, tachycardia. Chest X-ray: bilateral bronchopneumonia medial basal (S2, S3, S5/S4, S10) CTI-0.52. USG: ultrasonographic signs of hepatosplenomegaly. Ventricolomegaly, increased pulsing of brain vein. ECO doopler heart: moderate valvular stenosis of the pulmonary artery, pulmonary failure I, persistent foramen ovale- 3.8 mm. Insignificant hypertrophied of right ventricle. Pump function in normal limits. Failure of tricupspide and pulmonare valve I.
Results Infants had the following antenatal risk factors- stagnant pregnancy,intrauterine growth restriction and postnatal- nutritional index on percentile<3%, hight level of ALT/AST, ventriculomegaly, cardiac and pulmonary disease.
Conclusions Assessing antenatal, intranatal and postnatal risk factors allows suspects maternal fetal infection with subsequent investigation, early diagnosis and possible therapeutic interventions;
- infection
- risk factors
- infants