140 Obstetrics and Gynecology Board Review •••
❍ Which pregnancy complications are associated with chronic renal disease?
Hypertension, anemia, preeclampsia, preterm delivery, and fetal growth restriction.
❍ When should dialysis be initiated?
When serum creatinine levels are 5 to 7 mg/dL.
❍ Women who have received kidney transplants should achieve what goals before attempting pregnancy?
Good general health for 2 years after transplant, serum Cr <2.0 with none to minimal proteinuria, and absent or
easily controlled hypertension.
❍ What is the most common cause of acute renal failure in pregnancy?
Severe preeclampsia/eclampsia.
INFECTIONS
❍ How do you define vertical transmission of an infection?
Passage of infection from mother to fetus through the placenta, during labor and delivery, or postpartum via
breastfeeding.
❍ When does fetal immunity develop?
Between 9 and 15 weeks’ gestation.
❍ What is the incubation period of herpes?
2 to 12 days.
❍ What are the three stages of herpes simplex virus (HSV) infection?
Primary: Infection in a patient without preexisting antibodies to HSV 1 or 2
Recurrent: Reactivation with homologous antibodies present
Nonprimary first episode: Infection with one type of HSV in the presence of antibodies to the other type
❍ What is the incidence of new HSV infection among susceptible pregnant women?
Approximately 2%.
❍ What is the reason for most neonatal HSV infections?
Delivery through an infected birth canal, most often in asymptomatic mothers.
❍ What is the classification of neonatal HSV infection?
(1) Localized disease of the skin, eye, and mouth—the most common (45%). Not associated with neonatal
mortality
(2) CNS disease with or without skin, eye, and mouth disease (30%). 4% mortality
(3) Disseminated disease (25%). 30% mortality