Congenital Intrauterine Infections

by Deepika Deka

This book was conceived because a need was felt to upgrade knowledge, clarify doubts and proffer the advances in Perinatal Medicine on this subject. The main issues that confound the obstetrician and neonatologist are perinatal loss, infectious morbidity and congenital anomalies. Do infections cause recurrent abortions and stillbirths? Are IgG levels in mother a sign of acute maternal infection, and hence, are fetuses at risk? What are the risks to the fetus/neonate after maternal infection at different periods of gestation? How can the fetus be diagnosed as not infected in utero? Most confusing are the laboratory parameters. When in pregnancy should IgG/IgM or both be done? What is the interpretation of a positive or a negative test and how to manage a case with positive result? Is cesarean section required? What are the treatment options and prognosis and what to tell the couple? At present, the interpretation of laboratory results are quite perplexing, different laboratories give contrasting reports, indicating need for referral laboratories. Of utmost concern for a developing country is whether universal screening should be performed or not. What if the baby is born with Congenital Infection? Medicolegal issues add to the stress. What is the magnitude of the problem in developing countries? These countries have difficulty in collecting reliable and accurate data of perinatal infection, and are more willing to allocate budget in prevention of diseases than for treatment. Vaccines where available should be affordable and the Government should play an important role in enforcing immunization programs by intensive promotion or by legislation.

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