Viral infections in pregancy and Tr of foetus or neonate -How useful is diagnosis viral disease in preg to minimize ill effects on neonate??

How useful is diagnosis of maternal infection of viral diseases in pregancy? Can we save the foetus from viral damage?  Are antiviral agents are capable and effective to protect the foetus from viral, threat??Is the congenitally infected squeal affected foetus can be treated in utero if viral/ parasitic infection of mother is detected in time??

Amongst the intrauterine infections  there are  very few  treatable entities  . Congenitally   infected babies   are A)  either stillborn  but the B) those treated in time have low risk  of sequelae but this is not applicable to all viral infections for which no drugs are available (Rubella, HSV).. Point 1:-Toxoplasmosis can be treated  both    antenatally and postnatal . Drugs   used include   pyremethamine and sulphadiazine  folinic acid is given  concurrently . But not all foetus , where mother are affected with acute Toxoplasmosis will respond to such drugs and some will  escape.  Infants   with Toxo induced neurological  manifestations have  significant long  term squelae. Point 2 Herpes simplex    infection can be treated  postnatally    using acyclovir. Prognosis   is better   for disease   localized  to skin  mucus membranes  and eyes whereas   patients   with encephalitis  and disseminated disease have   higher rates of sequelae. Point 3 There   is no   specific   treatment for  congenital  rubella syndrome   and affected  infants have   uniformly poor   prognosis. Point 4  No   antiviral therapy    has been  found to be effective  against congenital  CMV   infections   of CNS   though Gancyclovir  has been   tried  for hepatic  pulmonary and ophthalmic disease. Infants   with early  neurological   manifestations  like microcephaly have  significant   sequelae.

 DISORDERS MIMICKING CONGENITAL   INFECTIONS

 The diagnosis of  intrauterine infection is difficult to establish  in an older child and the  diagnosis   is based on clinical  examination and neuro imaging. There are some   other conditions  which   can mimic   congenital  infections   . These include   Aicardi syndrome  incontinentia pigmenti  tuberous sclerosis  Cockayne syndrome  etc.

An interesting condition described by  Baraister   . ( also called pseudo TORCH  syndrome )  includes  microcephaly   intracranial calcification cerebral  atrophy  and mental   retardation ). Similar   case has been recently   reported   from India. These   entities should be kept   in mind while  interpreting the  results  of clinical  evaluation    and neuroimaging   in the absence  of definite   serological   evidence  for the diagnosis.