TORCH

Syphilis is most likely passed from a mother to her child if she is in the first or second stage of the disease, rather than the latent phase. If the mother is not treated, syphilis infects the baby more than 75 percent of the time.

Almost half of children infected before birth do not make it to term or die soon afterwards. The majority of children born with syphilis do not show any physical symptoms of the disease until weeks or months after birth. If left untreated, syphilis becomes a severe and chronic illness that affects the neurological and cardiovascular systems.

Symptoms of congenital syphilis differ between newborns and older infants because the disease progresses from its secondary stage to its final phase.

In newborns:

• Failure to thrive
• Irritability
• Watery nasal discharge (“sniffles”)
• Rash and lesions
  • Early rash: small blisters on palms and soles of feet
  • Late rash: copper-colored on palms, soles, and face
  • Rash around mouth, genitalia, anus
• Severe pneumonia

In older infants:

• Tooth abnormalities (notched and peg-shaped teeth)
• Bone pain and abnormalities in lower leg
• Neurological problems
• Blindness
• Deafness

Symptoms of congenital syphilis may resemble other skin conditions or medical problems. Always consult your child's physician for a diagnosis.

A simple blood test can determine if a mother or her child has syphilis.

For older infants, in which the disease has progressed, an eye exam, bone X-ray, or spinal tap can detect the presence of syphilis in the eyes, bones, or brain and central nervous system, respectively.

A single dose of antibiotics usually gets rid of congenital syphilis and prevents recurrent infections.

If the mother is treated early in the pregnancy, the infant is at minimal risk for infection.

If the baby is born with syphilis, he can be treated with antibiotics, as well, to get rid of the infection. Other effects of the baby’s syphilis may be treated separately.

By screening women early in their pregnancy, syphilis can be detected before it harms the mother or child.

Regular screenings during pregnancy can help ensure the baby's health.

A woman who gets varicella for the first time (chickenpox) during her pregnancy can pass it on to her unborn child, causing the syndrome.

Varicella is highly contagious — there is a 90 percent chance that an infected person will spread the disease to a household member who has not had chickenpox before.

For adults and children, varicella is spread through direct skin contact with the chickenpox rash or through the droplets in the air.

The risk of a mom passing the varicella virus onto her baby is extremely low. Only a primary varicella infection can cause the condition, and most adults and children have already had chickenpox or have been vaccinated against it.

Even if a mother does contract chickenpox while pregnant, there is only a 2 percent chance that the baby will develop congenital varicella syndrome.

Babies born with congenital varicella syndrome may have birth defects that affect the following parts of their bodies:

• Skin (mostly on arms and legs)
  • Thickened, overgrown scar tissue
  • Hardened, red, and inflamed skin
• Limbs
  • Limb atrophy: Limb deficiencies, malformations, and underdevelopment
• Autonomic nervous system: controls involuntary functions
• Brain
  • Ventriculomegaly: enlarged ventricles of the brain
  • Cortical atrophy: Degeneration of outer portion of brain
• Growth
  • Low birth weight
  • Microcephaly: abnormally small head
• Eyes
  • Cataracts: Clouding over the lens of the eye
  • Abnormally small eye(s)
  • Rapid, involuntary eye movement
  • Chorioretinitis: inflammation of the choroids layer behind the retina
• Psychomotor skills: Motor movements caused by mental process
• Learning disabilities
• Mental retardation

If you contract chickenpox during your pregnancy, fetal ultrasounds can monitor your baby to determine if varicella affects its development.

Varicella-zoster immune globin (VZIG) can be administered to newborns infected immediately after birth, in order to lessen the severity of the varicella disease.

For pregnant women who are exposed to the varicella virus and are at risk for developing chickenpox, VZIG can help prevent infection.

Pregnant women who contract varicella during pregnancy often have a more severe case of the disease than women who are not pregnant. Severe varicella may be treated with an antiviral medication given through an IV.

For babies born with congenital varicella syndrome, specific symptoms of the disease can be treated accordingly.

It is not a concern if the mother has already contracted chickenpox.

However, if you are pregnant and have not had chickenpox before, the following steps can help prevent congenital varicella syndrome:

• Avoid contact with anybody who has chickenpox.
• Susceptible people who are living with a pregnant woman should get the varicella vaccine.
• If you are already pregnant, DO NOT get the varicella vaccine, as it contains a live version of the virus. Get vaccinated at least a month before your pregnancy or after giving birth.

Complications can occur during pregnancy if a fetus is exposed to fifth disease. The disease affects the baby's ability to produce red blood cells and can lead to:

• Severe anemia
• Heart failure
• Fetal death

Fifth disease has not been cited as a cause for other birth defects.

Several factors influence the likelihood of congenital fifth disease, including:

• Whether the mother is immune. About half the adult population has been exposed to fifth disease and is therefore unaffected by contact with parvovirus B19.
• How early in the pregnancy the mother is infected. A baby is more likely to be affected by fifth disease if the mother contracts the virus during the first half of the pregnancy.
• Whether or not the mother is in contact with young children. Fifth disease is a childhood illness, so women who have frequent contact with children are likely to be exposed to the disease. Fortunately, these women are also the most likely to be immune to parvovirus B19.

Overall, fewer than 5 percent of pregnant women infected with parvovirus B19 transmit fifth disease to their baby.

Fifth disease is usually diagnosed based on a medical history and physical examination. The rash and progression of fifth disease is unique and can easily be diagnosed.

A blood test can determine if the mother:

• Is immune to fifth disease
• Has been recently infected

To determine if the baby has been infected with fifth disease, your physician can test for parvovirus B19 in amniotic fluid or fetal blood.

Since fifth disease is caused by a virus, medications cannot treat it. Your physician may closely monitor your baby’s development through fetal ultrasounds and blood tests.

In rare cases when the fetus has severe anemia, your doctor may suggest an intrauterine blood transfusion.

Frequent hand washing is the most common way to prevent the spread of viruses. Since fifth disease is contagious before the symptoms develop, avoiding people with the disease will not prevent infection.

At birth, infants born to an HIV-infected mother may test negative for the virus and have no symptoms. This does not mean that the infant does not have the virus. Blood tests will be done at various stages after birth up to and past 6 months of age to determine an infant's HIV status.

Symptoms may include the following:

• Failure to thrive: Delayed physical and developmental growth as evidenced by poor weight gain and bone growth
• Swollen abdomen (due to swelling of the liver and spleen)
• Swollen lymph nodes
• Intermittent diarrhea
• Pneumonia
• Oral thrush: A fungal infection in the mouth that is characterized by white patches on the cheeks and tongue. These lesions may be painful to the infant.

If your in infant is born to an HIV-infected mother, he may not test positive at birth and it may be necessary for him to undergo multiple blood tests at different intervals during his first 6 months of life.

As with many other conditions, early detection offers more options for treatment. Today, there are medical treatments that can slow down the rate at which HIV weakens the immune system, but, currently, there is no cure for the disease.

However, there are other treatments that can prevent or cure the conditions associated with HIV.

• Anti-retroviral drug therapy may be given to a pregnant woman, which has proven to greatly reduce the chance of an infant developing HIV.
• A cesarean section may be recommended to reduce infant transmission from the birth canal.
• If other feeding options are available, an infected mother should not breastfeed her infant.