Sexually Transmitted Disease During Pregnancy

Sexually transmitted disease can complicate pregnancy and will have serious consequences for both a woman and baby.

Bacterial vaginosis (BV)

  • It is a polymicrobial clinical syndrome resulting from a change in the vaginal community of bacteria, a common cause of vaginal discharge in women of childbearing age.
  • It has been linked to sexual activity although often not considered an STD .
  • Women may have no symptoms or may have complained of a foul-smelling(fishy) and greenish vaginal discharge.
  • This bacteria during pregnancy has been associated with serious pregnancy complications, including premature rupture of the membranes surrounding the baby in the uterus, preterm labor, premature birth, chorioamnionitis, as well as endometritis. Otherwise, there are no known direct effects of bacterial vaginosis on the newborn.

Chlamydia

  • Is the most common sexually-transmitted bacterium.
  • Although the majority of chlamydial infections (including those in pregnant women) do not have symptoms, infected women may have abnormal vaginal discharge, bleeding after sex, or itching/burning with urination.
  • Untreated chlamydial infection has been linked to problems during pregnancy, including preterm labor, premature rupture of membranes, and low birth weight.
  • The newborn may also become infected during delivery as the baby passes through the birth canal. Exposed newborns can develop eye and lung infections.

Hepatitis B virus

  • It is a liver infection caused by the hepatitis B virus (HBV).
  • A mother can transmit the infection to her baby during pregnancy.
  • While the risk of an infected mother passing HBV to her baby varies, depending on when she becomes infected, the greatest risk happens when mothers become infected close to the time of delivery. Infected newborns also have a high risk (up to 90%) of becoming chronic HBV carriers themselves.
  • Infants who have a lifelong infection with HBV are at an increased risk for developing chronic liver disease or liver cancer later in life. Approximately 25% of infants who develop chronic HBV infection will eventually die from chronic liver disease.

Hepatitis C virus

  • It is a liver infection caused by the hepatitis C virus (HCV), and can be passed from an infected mother to her child during pregnancy.
  • An infected mother will transmit the infection to her baby 10% of the time, but the chances are higher in certain subgroups, such as women who are also infected with HIV.
  • In some studies, infants born to HCV-infected women have been shown to have an increased risk for being small for gestational age, premature, and having a low birth weight.
  • Newborn infants with HCV infection usually do not have symptoms, and a majority will clear the infection without any medical help.

Herpes simplex virus (HSV)

  • Has two distinct virus types that can infect the human genital tract, HSV-1 and HSV-2.
  • Infections of the newborn can be of either type, but most are caused by HSV-2.
  • The symptoms of genital herpes are similar in pregnant and in nonpregnant women.
  • Although transmission may occur during pregnancy and after delivery, the risk of transmission to the neonate from an infected mother is high among women who acquire genital herpes near the time of delivery and low among women with recurrent herpes or who acquire the infection during the first half of pregnancy.
  • HSV infection can have very serious effects on newborns, especially if the mother’s first outbreak occurred during the third trimester.
  • Cesarean section is recommended for all women in labor with active genital herpes lesions or early symptoms, such as vulvar pain and itching.

Human Immunodeficiency Virus (HIV)

  • It is the virus that causes acquired immunodeficiency syndrome, or AIDS.
  • HIV destroys specific blood cells that are crucial to helping the body fight diseases.
  • The most common ways that HIV passed from mother to child are during pregnancy, labor, and delivery, or through breastfeeding.
  • When HIV is diagnosed before or during pregnancy and appropriate steps are taken, the risk of mother-to-child transmission can be lowered to less than 2%.A mother who knows early in her pregnancy that she is HIV-positive has more time to consult with you—her healthcare provider—and decide on effective ways to protect her health and that of her unborn baby.

Human Papillomavirus (HPV)

  • Most commonly involve the lower genital tract, including the cervix, vagina, and external genitalia.
  • Genital warts frequently increase in number and size during pregnancy.
  • Genital warts often appear as small cauliflower-like clusters which may burn or itch.
  • If a woman has genital warts during pregnancy, you may elect to delay treatment until after delivery.
  • When large or spread out, genital warts can complicate a vaginal delivery. In cases where there are large genital warts that are blocking the birth canal, a cesarean section may be recommended.
  • Infection of the mother may be linked to the development of laryngeal papillomatosis in the newborn—a rare, noncancerous growth in the larynx .

Syphilis

  • It may be transmitted to a baby by an infected mother during pregnancy.
  • Transmission of syphilis to a developing baby can lead to a serious multisystem infection, known as congenital syphilis.
  • Syphilis has been linked to premature births, stillbirths, and, in some cases, death shortly after birth.
  • Untreated infants that survive tend to develop problems in multiple organs, including the brain, eyes, ears, heart, skin, teeth, and bones.

Trichomoniasis

  • Vaginal infection due to the sexually-transmitted parasite Trichomonas vaginalisis very common.
  • Although most people report no symptoms, others complain of itching, irritation, unusual odor, discharge, and pain during urination or sex.
  • Infection in pregnancy has been linked to premature rupture of membranes, preterm birth, and low birth weight infants.
  • Rarely, the female newborn can acquire the infection when passing through the birth canal during delivery and have vaginal discharge after birth.
  • Screening and prompt treatment are recommended at least annually for all HIV-infected women, based on the high prevalence of T. vaginalis infection, the increased risk of pelvic inflammatory disease (PID) associated with this infection, and the ability of treatment to reduce genital tract viral load and vaginal HIV shedding.
  • This includes HIV-infected women who are pregnant, as T. vaginalis infection is a risk factor for vertical transmission of HIV.

Treatment

STDs, such as chlamydia, gonorrhea, syphilis, and trichomoniasis can all be treated and cured with antibiotics that are safe to take during pregnancy. Viral STDs, including genital herpes, hepatitis B, and HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to the baby.

Prevention

The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected. For those who are being treated for an STD other than HIV (or whose partners are undergoing treatment), counseling that encourages abstinence from sexual intercourse until completion of the entire course of medication is crucial. Latex male condoms, when used consistently and correctly, can reduce the risk of transmitting or acquiring STDs and HIV.

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