Sexually Transmitted Diseases (STD) In Pregnancy

Sexually transmitted diseases are infections that spread from one person to another during sexual contact (genital, anal, or oral). This may happen by way of saliva, semen, blood, vaginal mucus, or urine. An STD can be spread by germs including bacteria, viruses, or parasites. These infections can affect both you and your unborn infant.

STDs can cause:

  • Fetal death.

  • Stillbirth.

  • Premature labor.

  • Premature rupture of the membranes.

  • Miscarriage.

  • Infection of the baby's amniotic sac.

  • Infections that occur after birth (postpartum), in you and the baby.

  • Serious congenital deformities (birth defects).

  • Infections and illnesses in newborn infants.

  • Slowed growth of the fetus.

  • Maternal death.

STDs that are special problems in pregnancy include:

  • HIV (the AIDS virus).

  • Hepatitis.

  • Herpes virus.

  • Gonorrhea.

  • Chlamydia.

  • Syphilis.

  • Genital warts.

STDs that do not affect the fetus include:

  • Trichomonas.

  • Pubic lice.

  • Human papilloma virus (HPV).

You should take any medicine that has been prescribed for you, as directed. STDs that can be effectively and safely treated with antibiotics include:

  • Gonorrhea.

  • Chlamydia.

  • Syphilis.

If you have an outbreak of genital herpes virus infection at the time of your delivery, a C-section may be needed to prevent infection in your newborn baby. Anti-viral herpes medicines are often prescribed during the last 2 to 3 months of the pregnancy to prevent such an outbreak.

With certain STDs like syphilis, treatment of the newborn baby should be given even if the pregnant mother was treated during the pregnancy to protect the baby from the infection.

In mothers who are positive for HIV, taking zidovudine and other antiviral drugs during pregnancy greatly reduces HIV transmission to the newborn. There may also be an advantage to C-section, in reducing the risk the baby will develop the infection. Newborn babies of mothers with HIV are given antiviral medicine, as well.

SYMPTOMS

Some people may not have any symptoms but can still transmit the STD to others, during sexual contact. General symptoms of an STD may include:

  • Painful or bloody urination.

  • Pain in the abdomen, pelvis, vagina, anus, throat, or eyes.

  • Skin rash, itching, or irritation.

  • Growths, ulcers, blisters, or sores in the genital and anal areas.

  • Fever.

  • Abnormal vaginal discharge.

  • Pain or bleeding with sexual intercourse.

  • Yellow skin and eyes, seen with hepatitis (jaundice).

  • Swollen glands in the groin area.

DIAGNOSIS

  • A complete medical history, physical examination, and Pap test by your caregiver.

  • Blood tests.

  • Culture tests for infection.

  • Looking at vaginal discharge through a microscope.

  • A procedure in which a special solution is applied and the cervix is looked at with a lighted magnifying tube (colposcopy)may be used to help diagnose HPV.

  • A procedure that involves looking into the pelvis at the female organs with a lighted tube through a small incision(laparoscopy) can also be used for diagnosis.

TREATMENT

Treatment will depend on the type and location of the STD. Treatment may include:

  • Oral or injected antibiotics, vaginal creams, and suppositories may be used.

  • Special over-the-counter shampoo may be used to treat pubic lice.

  • Removing or treating warts (growths) with medicine, freezing, burning (electrocautery), or surgery.

  • Surgery for treatment of HPV of the cervix. This is not done until after delivery of the baby.

  • Supportive medicines for genital herpes, HIV, and hepatitis.

RISK FACTORS

  • Having multiple sex partners.

  • Having a sex partner who has other sex partners.

  • Taking illegal drugs or drinking too much alcohol, which can affect your judgment and put you in a vulnerable position.

  • Having unprotected sex (not using condoms).

  • Having open sores on your mouth or skin during sexual activity.

  • Engaging in oral and anal sex acts.

PREVENTION

  • Avoid excessive alcohol and do not take illegal drugs.

  • Do not have sex with anyone you do not know or who is at high risk for an STD.

  • When you and your partner are each other's only sexual contacts, having only one sex partner greatly reduces your risk of getting an STD.

  • Avoid risky sex acts that can break the skin; these increase your risk of getting an STD.

  • Use a latex condom or female condom during sexual intercourse.

  • Get the hepatitis vaccine. It is safe to take when pregnant.

  • The HPV vaccine has not been tested in pregnant women yet and should not be taken if you are pregnant.

HOME CARE INSTRUCTIONS

If you have an STD:

  • Take all medicines as instructed.

  • Do not have sexual intercourse until you and your partner are cured.

  • Do not douche.

  • Do not use tampons.

  • You may use anti-itch cream, with your caregiver's permission.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Go to your follow-up examinations to be sure that the STD is cured.

  • Inform any sex partners about your STD, so that they can be treated to prevent reinfection and any further spread of the STD.

SEEK MEDICAL CARE IF:

  • You have a fever.

  • You develop pelvic or abdominal pain.

  • You develop painful or bloody urination.

  • Your symptoms are not getting better after three days of treatment.

  • You have any of the symptoms mentioned above.

  • You think or know that you or your sex partner has an STD, even if there are no symptoms.