Viral Infections Quick-Reference (HIV · HBV · HCV · rubella · CMV · varicella · influenza · COVID)
Admission & discharge
Admission/discharge guidance checked 2026-10-18 against the linked sources. This is a clinical checklist for an individual decision, not an automatic discharge order.
General triage and discharge handover for a multi-virus index. HIV/HBV prophylaxis, antiviral courses and infection-specific testing require the separate specialist pathway; they are not replaced by this checklist.
When admission or continued hospital care is needed
- Respiratory compromise, severe dehydration, encephalopathy, acute liver failure concern, sepsis or obstetric/fetal deterioration requires urgent hospital assessment.
When clinic, day care or home care may be suitable
- A positive viral screen or uncomplicated infection does not by itself mandate admission. The actual virus, gestation, maternal condition and fetal/newborn risk determine care.
Before going home
- Maternal illness is stable, required antiviral/other treatment is accessible and relevant infection-control and fetal/neonatal plans are documented.
- Do not apply one discharge schedule or medicine list to all viruses in this index.
Discharge medicines and treatment changes
- Reconcile the disease-specific antiviral/other treatment with the responsible specialist, including breastfeeding and interaction considerations. Prevention of maternal-to-child transmission needs its own documented birth/newborn plan.
Tests, pending results and their reviewer
- Assign virology/serology, liver or other organ results and any fetal testing to a named reviewer; provide the actual review date.
Home care and counselling
- Explain infection-specific contact precautions, warning symptoms and how to access maternity/infectious-disease advice.
Follow-up: when and what to review
| When | Action / responsible service |
|---|---|
Before discharge | Book the relevant specialist and maternity follow-up, and communicate the newborn plan. |
At the infection-specific testing/scan interval | Review results and modify the birth/prevention plan when indicated. |
Return urgently
- Breathlessness, chest pain, confusion, jaundice, persistent vomiting, reduced movements or an unwell newborn requires urgent assessment.
Treatment
① Immediate stabilization — first minutes
③ First-line treatment & drug regimens
- Each row above contains the actionable core; detailed dosing pages queued for v1.1 verification cycle
Monitoring
- Viral-load schedules for HIV/HBV as per specialist programmes
Escalation
- ID physician involvement for all complex vertical-transmission scenarios
⑮ Complications & their management
Vertical transmission events
Paediatric ID referral; registry reporting per programme
Post-treatment care
- Postpartum vaccination catch-ups (live vaccines now allowed while breastfeeding)
Diagnosis & assessment
- Haemodynamic instability -> sepsis pathway
Initial assessment
See treatment table for testing and regimens.
Principles & follow-up
Special situations
| Infection | Pregnancy-critical actions |
|---|---|
HIV | ART regardless of CD4 (dolutegravir-based national programmes); mode by viral load; neonatal prophylaxis; avoid breastfeeding ONLY per national guidance context (India follows formula-replacement historically - verify current NACO) |
Hepatitis B | HBsAg screen; high viral load -> tenofovir T3; neonate HBIG + vaccine within 12-24 h; breastfeeding SAFE with immunisation |
Hepatitis C | DAA therapy POSTPARTUM (curative); breastfeeding OK unless cracked nipples bleeding |
Rubella | Non-immune: MMR POSTPARTUM only; exposure -> Ig within window; congenital-rubella counselling |
CMV | No routine treatment; hygiene counselling for seronegative mothers (toddlers!); congenital CMV specialist pathways |
Varicella | Non-immune exposure: VZIG within 96-144 h; chickenpox in mother around delivery = neonatal VZIG; acyclovir for severe maternal cases; live vaccine postpartum |
Influenza | Oseltamivir early for suspected flu ANY severity threshold lower in pregnancy; vaccination any trimester |
COVID-19 | Follow current MoHFW/national protocol; vaccination recommended; treat hypoxia aggressively (prone positioning safe) |
Sources (7)
2021-07 · updated 2025-12-22 (page review; guidance itself unchanged) · checked 2026-08-23 · verified-live
Open source ↗
CDC pages + wall chart: uncomplicated gonorrhoea cervix/urethra/rectum → ceftriaxone 500 mg IM single dose (<150 kg; 1 g if ≥150 kg); pharyngeal same; conjunctivitis 1 g IM; DGI 1 g IV/IM q24h; PID outpatient → ceftriaxone 500 mg IM ×1 + doxycycline 100 BD ×14 d + metronidazole 500 BD ×14 d; chlamyd…
· checked 2026-10-18 · verified-live
Open source ↗
Full primary recommendations read, focusing on critical-care-to-ward transfer: structured written handover, shared plan, monitoring, rehabilitation and receiving-team capability. Step-down is distinct from home discharge; no universal organ-support discharge cutoff is asserted.
19 November 2025 · checked 2026-10-18 · verified-live
Open source ↗
Scope: additional clinical-detail explanation for maternal-sepsis. Checked the assessment, management-decision and follow-up statements in that section against this source. This does not certify all pre-existing regimens, calculations or recommendations in the module. Additional admission/discharge …
· checked 2026-10-18 · verified-live
Open source ↗
Maternal/newborn transfer assessment, first void and effective feeding, handover, support/safeguarding, first midwife visit within 36 hours after transfer, postnatal danger symptoms. Full recommendations page read.
· checked 2026-10-18 · verified-live
Open source ↗
Normal-delivery discharge not less than 48 hours: full primary SOP PDF normal-delivery/discharge passages read. Corroborated by NHM CEmONC 2024 Part 1, chapter 8. This does not define a universal post-caesarean or complicated-case stay.
· checked 2026-10-18 · verified-live
Open source ↗
Official WHO summary read: at least 24-hour facility care after birth; additional contacts at 48–72 hours, 7–14 days and week 6; individual assessment/support. Summary facts only, not a claim that the full 242-page PDF was reviewed.
· checked 2026-10-18 · verified-live
Open source ↗
Full primary patient recovery page read: pain control, wounds, activity/VTE, urinary/bowel and infection warning signs, adult support and no driving/important decisions during the first 24 hours after general anaesthesia. Used as general recovery/handover principles, not operation-specific discharge…