🌸 Infections in pregnancy can affect both mother and fetus, but the pattern of harm differs by organism.
This table separates maternal features from fetal / neonatal consequences to make revision easier.

🦠 Infections in Pregnancy – Maternal vs Fetal Effects

Infection	Maternal features	Fetal / neonatal effects	Key investigations	Management / prevention
Toxoplasmosis 🐱	Usually mild or asymptomatic. May cause a glandular-fever-like illness with lymphadenopathy.	Hydrocephalus, intracranial abnormalities, chorioretinitis, seizures, developmental delay.	Maternal serology; specialist fetal medicine review; amniotic fluid PCR in selected cases.	Specialist-led management. Prevention: avoid undercooked meat, contaminated soil, and high-risk cat-litter exposure.
Rubella 🎀	Fever, rash, lymphadenopathy, arthralgia; may also be mild or subclinical.	Congenital rubella syndrome: cataracts, congenital heart disease, sensorineural deafness, growth and neurodevelopmental problems.	Maternal serology and specialist assessment if infection or exposure suspected.	No specific antiviral treatment in pregnancy. Prevention by MMR vaccination before pregnancy.
Cytomegalovirus (CMV) 🧬	Often asymptomatic or causes a mild flu-like / mononucleosis-like illness.	Growth restriction, microcephaly, intracranial abnormalities, hepatosplenomegaly, petechiae, and sensorineural hearing loss.	Specialist maternal and fetal assessment, targeted ultrasound, virological testing where indicated.	Usually specialist-led. No simple routine antenatal treatment pathway in standard NICE guidance.
Herpes Simplex Virus (HSV) 💋	Primary or recurrent genital herpes; painful vesicles / ulcers, dysuria, systemic upset in primary infection.	Neonatal herpes: skin-eye-mouth disease, encephalitis, disseminated sepsis-like illness.	Clinical diagnosis ± PCR from lesions.	Maternal aciclovir; urgent obstetric review if active genital lesions or suspected primary infection near delivery.
HIV 🌍	May be asymptomatic or associated with chronic viral illness / immunosuppression if untreated.	Vertical transmission during pregnancy, labour/birth, or breastfeeding; untreated infant may develop immunosuppression and opportunistic infection.	Maternal HIV testing, viral load monitoring, specialist antenatal HIV care; neonatal testing after birth.	Antiretroviral therapy throughout pregnancy; neonatal prophylaxis; mode of birth guided by viral load and specialist advice.
Syphilis 🧪	May be asymptomatic, or cause chancre, rash, lymphadenopathy, or later systemic disease.	Miscarriage, stillbirth, hydrops, hepatosplenomegaly, rash, snuffles, bone disease, congenital syphilis.	Maternal serology as part of antenatal screening; neonatal assessment if maternal infection present.	Prompt maternal treatment, usually with penicillin, to reduce congenital infection risk.

🩺 Quick Pattern Recognition

Infection	Classic fetal / neonatal clue
Toxoplasmosis 🐱	Hydrocephalus + chorioretinitis + intracranial calcification pattern
Rubella 🎀	Cataracts + deafness + congenital heart disease
CMV 🧬	Hearing loss + microcephaly + periventricular / intracranial abnormalities
HSV 💋	Skin lesions + encephalitis / disseminated neonatal infection
HIV 🌍	Vertical transmission risk reduced dramatically by maternal ART
Syphilis 🧪	Snuffles + rash + periostitis / bone disease

💡 Revision pearl:
When learning congenital infection, ask two separate questions:
1. What happens to the mother?
2. What happens to the fetus or neonate?
That split makes the pattern much easier to remember.

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TORCH infections

🦠 Infections in Pregnancy – Maternal vs Fetal Effects

🩺 Quick Pattern Recognition

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