Managing Sexually Transmitted Infections in Pregnant Women

Nadi K Gupta; Christine A Bowman

Disclosures

Women's Health. 2012;8(3):313-321. 

In This Article

Abstract and Introduction

Abstract

Sexually transmitted infections (STIs) constitute a major public health problem in the UK and may result in very costly complications. Many STIs pose the risk of a number of adverse pregnancy outcomes including miscarriage, still birth, preterm delivery, low birth weight and ophthalmia neonatorum. National guidelines for the management of STIs are produced and regularly revised by the British Association of Sexual Heath and HIV. This review outlines the latest recommended treatment options during pregnancy for the commonly encountered STIs.

Introduction

Sexually transmitted infections (STIs) constitute a major public health problem, not only in the UK but worldwide. A 2003 House of Commons Health Select Committee inquiry into sexual health described a sexual health crisis in the UK that amounted to a public health emergency.[1]

The number of newly diagnosed STIs in England remained high at 418,598 cases between 2008 and 2010.[101] Many STIs pose the risk of a number of adverse pregnancy outcomes including miscarriage, still birth, preterm delivery, low birth weight and ophthalmia neonatorum. Effective management is imperative as STIs can be detrimental to both the mother and baby and can result in very costly complications.

Drugs selected for treatment should not be contraindicated in pregnant women, should have a high efficacy and be well tolerated.

The common STIs that are known to have significant implications in pregnancy are Chlamydia trachomatis, Neisseria gonorrhoeae, human papilloma virus (HPV), herpes simplex virus (HSV), Trichomonas vaginalis and syphilis. This review outlines the treatment options during pregnancy for the commonly encountered STIs. NICE has produced guidance for the routine antenatal care of healthy pregnant women, which includes specific recommendations for STI screening.[102] National guidelines for the management of STIs are produced and regularly revised by the British Association of Sexual Heath and HIV (BASHH).[103] Readers are encouraged to review both NICE and BASHH guidelines for more comprehensive information.

It is beyond the remit of this article to discuss the management of HIV and hepatitis B during pregnancy.

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