You may not know if you have: STIs and infections during pregnancy

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Karen Wilmot aka The Virtual Midwife is a midwife, prenatal yoga teacher and founder of The Due Cluba private online community for pregnant women.


Testing for sexually transmitted infections (STIs), including HIV, is part of routine prenatal care and should be done at your first pregnancy visit.

Testing won’t harm your baby, but it’s important to get tested because STIs often have no symptoms, so you may not know if you have one.

Early treatment and counseling are necessary as many STDs can affect your baby’s health during pregnancy and after birth.

Left untreated, STIs can be passed from mother to baby, causing birth defects such as blindness, deafness, and bone deformities and infections that can affect your baby’s development.

Read: What is hyperemesis gravidarum?

Bacterial Vaginosis

Bacterial vaginosis (BV) is a common cause of vaginal discharge, and while not considered an STD, it has been linked to sexual activity.

The only symptom is a foul-smelling, fishy vaginal discharge. BV during pregnancy has been linked to premature rupture of the membranes surrounding the baby in the womb, preterm labor and infections.

There are no known direct effects of BV on the newborn, but if you have foul-smelling discharge, you need to mention it at your doctor’s appointment to get the right antibiotic treatment.

chlamydia

Most chlamydia infections have no symptoms. However, some women report abnormal vaginal discharge, bleeding after sex, or itching/burning when urinating.

The antibiotics used to treat chlamydia are safe in pregnancy and are used in pregnant women for many other types of infections.

Untreated chlamydial infection has been linked to preterm labor, premature rupture of membranes and low birth weight. Your baby can become infected during delivery, when the baby passes through the birth canal, and develop eye and lung infections.

gonorrhea

Gonorrhea can cause problems for both you and your baby, but it can be treated with antibiotics and requires close follow-up to ensure the infection has been cured.

Untreated gonococcal infection in pregnancy has been associated with miscarriage, preterm birth and low birth weight, premature rupture of membranes and chorioamnionitis.

Gonorrhea can infect your baby during labor as it passes through the birth canal and cause eye infections.

Must read: Can using different birth control methods affect your future fertility?

Hepatitis B

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). A mother can transmit the infection to her baby during pregnancy, especially if the mothers become infected just before delivery.

Pregnant women who are HBV positive should have an HBV viral load test and be treated with antiviral drugs in the third trimester if their HBV viral load is high.

Your newborns should receive HBV vaccination and HBIG within 12 hours of birth for optimal prevention of mother-to-child HBV transmission.

Infected newborns are at high risk (up to 90%) of becoming chronic HBV carriers, resulting in an increased risk of developing chronic liver disease or liver cancer later in life. Screening for HBV is essential to prevent mother-to-child transmission of HBV.

Hepatitis C

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV) and can be passed from an infected mother to her child during pregnancy.

Babies born to HCV-infected women have been shown to be at increased risk of preterm birth and low birth weight.

Over 90 percent of people infected with HCV can be cured with 8 to 12 weeks of oral therapy. However, there are currently no HCV treatments approved for use during pregnancy.

It is only safe to start this treatment when the mother has given birth and breastfeeding is complete. Newborns with HCV infection usually have no symptoms, and most will clear the infection without medical help.

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Herpes simplex virus

Herpes simplex virus (HSV) infection can seriously affect newborns, especially if the mother’s first outbreak occurs during the third trimester.

Symptoms of herpes during pregnancy include itching, burning, pain or tingling in the genital area, vaginal discharge, painful urination, and flu-like symptoms, including fever, headache, and muscle aches.

Lymph nodes in the groin may be tender and swollen. The hormonal, immunological, and other physical changes during pregnancy contribute to a greater frequency of active herpes infections.

Aciclovir (Zovirax) and valacyclovir (Valtrex) are most commonly used to suppress and treat flare-ups of herpes during pregnancy. These drugs help reduce the activity of the virus. They also help speed lesion healing and may reduce the chance of active lesions during labor.

For women with active genital herpes lesions or early symptoms, caesarean section is recommended to avoid transmission to the baby. Transmission can occur during pregnancy and after birth.

human immunodeficiencyy virus

Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). HIV destroys certain blood cells that help the body fight disease.

The most common ways that HIV is transmitted from mother to child are during pregnancy, childbirth or breastfeeding. However, if HIV is diagnosed before or early in pregnancy and appropriate measures are taken, the risk of mother-to-child transmission can be less than 1%.

Symptoms of HIV during pregnancy include fever and chills, skin rash, tiredness, joint or muscle pain, swollen lymph nodes, mouth ulcers, and recurring yeast infections. HIV antibody testing during pregnancy is a routine part of prenatal care, with the consent of the patient.

Treatment with a combination of HIV medicines (called antiretroviral therapy or ART) can prevent passing HIV to your baby and protect your health.

Human papillomavirus

Human papillomavirus (HPV) is a virus that most commonly affects the lower genital tract, including the cervix, vagina, and external genitalia.

Genital warts often appear as small cauliflower-like clusters that can burn or itch and often increase in number and size during pregnancy.

Genital warts can make vaginal delivery difficult, and a cesarean section may be recommended in cases where large genital warts are blocking the birth canal.

There is no cure for HPV, but most women do not need treatment during pregnancy. There is no drug available to treat the virus itself. Instead, treatment focuses on treating all symptoms.

Also read: “Young people have a voice”: 14-year-old HIV advocate to represent SA on the global stage

syphilis

Syphilis is primarily a sexually transmitted disease, but it can be passed from an infected mother to a baby during pregnancy.

Transmission of syphilis to a developing baby can lead to congenital syphilis, a serious multisystem infection. Syphilis has been associated with premature birth and stillbirth, and in some cases died shortly after birth.

Syphilis can be effectively treated with penicillin, and treatment should begin immediately after diagnosis. Her sexual partners should also be treated to prevent re-infection of the mother and improve her partner’s health.

Untreated infants who survive tend to develop problems in multiple organs, including the brain, eyes, ears, heart, skin, teeth, and bones.

Signs and symptoms of syphilis appear in stages over time. The stage you are in depends on whether you are receiving treatment or not.

Treatment can prevent you from progressing to the next phase, so it’s important to get treatment as soon as you know you’re infected. The first sign of syphilis is a small, hard, painless sore called a chancre, which usually develops in the genital or vaginal area.

You can have one or more wounds. They last about 6 weeks even with treatment.

trichomoniasis

Vaginal infections caused by the sexually transmitted parasite Trichomonas vaginalis are common.

Symptoms include itching, irritation, an unusual odor, discharge, and painful urination or sex, although some women are asymptomatic. Trichomoniasis can be cured with medications that are prescribed by a doctor and are safe to take during pregnancy.

The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex, or to have a long-term, mutually monogamous relationship with a partner who is known not to be infected.

If you are being treated for an STD other than HIV (or if your partner is being treated), counseling that encourages abstinence from sexual intercourse throughout the course of medication is crucial.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmitting or contracting sexually transmitted diseases and HIV.

Talk to your care provider about your options and make sure you are well informed to make an informed decision about your care.

Every test and exam done during pregnancy provides information that will guide your treatment plan. If you’re at all concerned, it’s always best to call your doctor.

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