STD in Pregnancy can have a very fatal consequences for both mother and her developing child. As a healthcare awareness organisation we bore the responsibility to create awareness about the preventive measures to be taken, treatment, to prevent being contracted etc from STDs during pregnancy.
A pregnant women has equal chances of being contracted with same STDs as women who are not pregnant. To ensure proper prenatal care is ensure that pregnant patients are regularly tested for STDs. These STD tests starts during the early stage of pregnancy and repeated thereafter.
The following are the recommendations for screening for STDs in Pregnant women, based on the type of STDs.
| Disease | CDC Recommendation |
|---|---|
| Chlamydia | First prenatal visit: Screen all pregnant women less than 25 yrs of age & older pregnant women at increased risk for infection.Third trimester: screen again if age is less than 25 years of age or at continued high risk.
Risk Factors:
NOTE: Pregnant women found to have chlamydia infection should have a test-of-cure three to four weeks after treatment and then be retested within three months. |
| Gonorrhea | First prenatal visit: Screen all pregnant women less than 25 yrs of age & older pregnant women at increased risk for gonorrhea at first prenatal visit.Third trimester: Scree again for women at continued high risk.
Risk factors:
|
| Syphilis | First prenatal visit: Screen all pregnant women.Early third trimester: Screen again women who are
|
| Bacterial Vaginosis (BV) | Evidence does not support routine screening for BV in asymptomatic pregnant women at high or low risk for preterm delivery. |
| Trichomoniasis | Evidence does not support routine screening for trichomoniasis in asymptomatic pregnant women. |
| Herpes (HSV) | Evidence does not support routine HSV-2 serologic testing among asymptomatic pregnant women. |
| HIV | First prenatal visit: Screen all pregnant women.Third trimester: Rescreen women at high risk for acquiring HIV infection. |
| Hepatitis B(HBV) | First prenatal visit: Screen all pregnant women.Third trimester: STD Testing for Pregnancy in this case is recommended for those who haven’t been tested prenatally, they are the one those who engage in behaviors that put them at high risk for infection, & those with signs or symptoms of hepatitis at the time of admission to the hospital for delivery.
Risk Factors:
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| Human Papillomavirus (HPV) | No screening recommended |
| Hepatitis C(HCV) | First prenatal visit: Screen all pregnant women at increased risk.Risk Factors:
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Following are the effects of STD on a Pregnant women
Chlamydia in Pregnancy : Being the most common STD in USA, its symptoms in Pregnant women include vaginal discharge, itching sensation, burning during urination. If left untreated among can result in premature rupture of membrane, preterm labor and low birth weight.
It can pass to the baby if it comes in contact with the birth canal affected by Chlamydia, if that happens a child can develop eye and lung infections and other symptoms of Chlamydia.
with gonococcal infection is left untreated it can lead to miscarriage, rupture of membrane, preterm labor and low birth weight and and chorioamnionitis.
It can pass to the infant, as the baby comes in contact with the birth canal affected by Gonorrhea, if that happens a child can develop eye infections and other symptoms of gonorrhea.
Pregnancy and Hepatitis B : It is caused due to the liver infection, caused by Hepatitis B virus. A mother can
transmit this disease to her baby and the risk of transmission depends on the stage at which mother has contracted the disease. There is a greater risk of passing this virus to the baby during the time of delivery.
Infected baby has a possibility of suffering from lifelong liver disease and this may result in the chronic liver disease. Approximately 25% of infants who develop chronic HBV infection will eventually die from chronic liver disease. Thus the life of mother and child by screening for Hepatitis B and providing treatment to help save infant being contracted by Hepatitis B.
Pregnancy and Hepatitis C :It is similar to Hepatitis B, thus Hepatitis C is caused due to the liver infection due to Hepatitis C virus. It can pass from Pregnant mother to her baby rarely but the chances of contraction increases in certain sub-groups. In some cases infants born with HCV contracted mother have been shown to have an increased risk for being small for gestational age, premature, and having a low birth weigh. In a new born baby, Hepatitis C do not have symptoms and majority get cured without any treatment.
Pregnancy and Syphilis : It is primarily a Sexually Transmitted Disease. It can passed on from Pregnant mother to child. Transmission of syphilis from mother to child can lead to multiple infections known as Congenital syphilis. Recently there has been steep increase in cases of Congenital syphilis.Syphilis can cause premature births, stillbirths, and, in some cases, death shortly after birth.
Infants suffering from Syphilis tend to develop multiple in multiple organs including brain, teeth, eyes, heart skin etc.
Pregnancy and HIV : Human Immunodeficiency virus (HIV) is the virus that causes weakening of immunity due to destruction of white blood cells that helps fighting the disease in the body. Pregnancy, labor, breast feeding are some of the very common way through which HIV passes from a mother to her child.However, when HIV is diagnosed before or during pregnancy & appropriate steps are taken, the risk of transmission of HIV can be lowered to less than 2%. Thus it is very essential, the HIV test during pregnancy as it provides more time to consult with her healthcare provider and decide on effective ways to protect her health and that of her unborn baby.
STD Treatment during Pregnancy
STDs such as chlamydia, gonorrhea, syphilis, and trichomoniasis, can be treated and cured using anti-biotics which are safer to take during pregnancy. Some viral STDs like genital herpes, hepatitis B, and HIV cannot be cured, but in some cases (like in early stages) they can be treated using anti viral medicines or preventive measures are required to be taken to reduce the risk of passing the infection to the baby.
STD Prevention during Pregnancy
Preventive counselling should be encouraged after knowing the sexual history of the patient. The most reliable way of preventing 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. Thus, counselling for abstaining sexual intercourse until the completion of the entire course of medication should be taken.
References
1. Institute of Medicine. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Eng TR, Butler WT, eds. Washington: National Academy Press. 1997.
2. Centers for Disease Control and Prevention. HIV Surveillance Report 2014; vol. 26.
3. Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States; 2012 Jul 31:1–235.