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Respiratory Syncytial Virus And Pregnancy

Discussion in 'Gynaecology and Obstetrics' started by Egyptian Doctor, Oct 15, 2012.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Respiratory Syncytial Virus or RSV is one of the many cold-type upper respiratory infections that most of us acquire during the cold and flu season. For premature or medically-frail infants, the infection could become very serious, even fatal. RSV is a paramyxovirus and there are 2 types, A and B.

    RSV is transmitted by contact with respiratory secretions or contaminated surfaces. RSV can survive outside the body for many hours. Infection among health care workers can occur by touching eyes or nose with contaminated hands. RSV does not pose any special risk to the pregnant worker. Patients with RSV are on isolation and attention to environmental cleaning and hand washing is essential.

    Ribavirin is sometimes used as treatment for RSV infection. Direct contact with ribavirin is dangerous for the fetus of a pregnant woman. Ribavirin is usually administered in a head box as an aerosol. This head box recovers 99% of the drug.

    Health-care workers who are pregnant, or may become pregnant, are at risk of exposure during direct patient care when patients are receiving ribavirin through a head box, oxygen tent or mist mask. The at-risk worker may request alternative job responsibilities.

    recent epidemiologic studies have demonstrated protection against RSV in babies born to mothers with high levels of neutralizing RSV antibody.

    The contribution of IgG fusion or F protein antibody as a correlate with immunity from disease also has been described. With the availability of purified F protein vaccines such as the purified F protein vaccines, immunization of pregnant women with RSV surface glycoproteins to arm the newborn with high neutralizing antibody can be considered.

    Advantages of maternal immunization to augment naturally occurring maternal RSV antibody are that babies most at risk for infection are least responsive to vaccines, that pregnant women respond well immunologically to vaccines in general and that placental transfer of maternal IgG antibody occurs naturally during the third trimester.

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