Infection in pregnancy: possible essay topics.

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We have been working our way through infections and pregnancy in the MRCOG classes.

I fancy an infection topic in the essays in the near future.

Subjects like Malaria and TB have not featured in the essays, but have had recent TOG articles.

Others have featured in the exam as short essays as follows:


Chickenpox exposure in pregnancy



Gp B streptococcus



Hepatitis B



Herpes? 28 weeks. Ist. episode



HIV routine antenatal testing






Parvovirus exposure at 15 weeks



School canteen worker




There could be a general essay: “Discuss infection in relation to premature delivery”.

We discussed Group B Streptococcal infection and Hepatitis B on the 31st. July 2008.

GpB Strep would have to be:

    a general essay about how neonatal consequences could be minimised,

    what to write in a protocol,

    or a discussion of the infection in relation to pregnancy.

I can’t see it being a case e.g. of a carrier or someone with bacteruria in pregnancy or for prepregnancy counselling.

You simply need to know the College guideline.

The Hepatitis B question in March 2006 was along the lines of:

     “A 23-year-old pregnant woman from South East Asia has booking bloods reported as:

             Hepatitis B surface antigen positive,

             HBe antigen negative.

Describe the risks involved (7 marks) and how they might be minimised during and after the pregnancy (13 marks)”.

I think a Hepatitis B +ve woman in early pregnancy or at the pre-pregnancy counselling clinic is the likely format.

Paul Fogarty has written a short, sensible guide to the short essays in "Obstetrics, Gynaecology & Reproductive Medicine".

He also provided a mock essay question on Hepatitis B with a marking scheme.

It is worth having a look.

Basically, a woman is Hepatitis B +ve at booking.

You have to discuss things in 3 sections:

    the immediate management,  10 marks,

    the management of the rest of the pregnancy and puerperium,  8 marks,

    other aspects outwith the pregnancy.  2 marks.

It would be a good exercise to write an essay using his question.

Then have a look at his marking system.

Then have a look at what I thought the model essay should look like.


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