Sexually Transmitted Diseases and Pregnancy

What are sexually transmitted diseases?

Sexually transmitted diseases (STDs) are infections that are passed from one person to another by sexual contact, mainly sexual intercourse. They usually affect the male or female genital area; for example, the penis or vagina.

If you are pregnant and have an STD, your unborn child or newborn may get the infection and be harmed by it. Herpes, syphilis, gonorrhea, human papillomavirus (HPV), chlamydia, and trichomoniasis are common STDs that might be harmful to a baby. HIV infection, which causes AIDS, is another, very serious sexually transmitted disease. If you are infected with one STD, you may be infected with other STDs also.

How do they occur?

Bacteria and viruses cause STDs. They are usually passed between partners during sex. It is possible to have an infection without knowing it. You could infect your partner before you know you have an STD.

An unborn baby or newborn can get an STD in the following ways:

• The bacteria or viruses go into the placenta during the pregnancy and infect the baby before birth.
• After the amniotic sac breaks during labor, the bacteria or viruses move up the birth canal and infect the baby.
• During delivery the baby comes in contact with bacteria or viruses in the mother's genital area. For example, bacteria could spread to the baby from infected blisters in and near the birth canal (vagina).
• The baby gets the infection from an infected baby in the nursery or from an infected adult who handles the baby with unwashed or ungloved hands.

What are the symptoms?

Your symptoms depend on the cause of the infection. The most common symptoms are:

• painful bumps, blisters, or sores in the genital area that may stay and get worse or may come and go
• a rash in the genital area or on the palms of the hands and soles of the feet
• warty growths in the genital area
• itching in the genital area
• pain during sex
• painful joints
• pain in the pelvic area or abdomen
• sore throat
• a yellow or gray discharge from the vagina that may smell bad
• frequent or painful urination
• enlarged lymph nodes in the groin area.

Sometimes you may have no symptoms.

An infected newborn may have mild or very serious problems, depending on what is causing the infection and how far it has spread. Some of the symptoms a baby might have are:

• sores
• seizures
• tiredness
• no appetite
• vomiting, fever, and irritability
• jaundice (skin that looks too yellow)
• breathing problems
• rash
• swelling
• fever
• red eyes with pus.

Babies may also have an infection without any symptoms.

How are they diagnosed?

Your healthcare provider will ask if you or the child's father have had any symptoms of these diseases. At your first prenatal visit, you will be tested for viral and bacterial infections with:

• lab tests of a sample of cells from the genital area, cervix, or other areas that are commonly infected
• blood tests.

These tests may be repeated later during the pregnancy.

Your provider may use one or more of the following tests to check for infection in a newborn:

• lab tests of samples of the blood, urine, spinal fluid, or discharge from the eyes, nose, mouth, or vagina
• exam with a microscope of cells from areas that may be infected
• blood tests
• X-rays of the chest, bones, joints, or skull.

How are they treated?

If you have syphilis, gonorrhea, or chlamydia during pregnancy, you will be treated with antibiotics. Trichomoniasis may be treated with Flagyl or other medicines. The child's father or any of your sex partners should also get treatment.

If you have a herpes infection, you may be given medicine to treat the infection and to prevent it from returning. If you have a herpes sore or a positive test for herpes when you go into labor, you will probably have a cesarean section (C-section). This will help prevent infection of the baby during birth.

An HPV infection during pregnancy usually does not need to be treated until after delivery. However, you will regularly have tests to see if the infection is becoming more severe.

If you have an HIV infection, medicine will be given to you before the baby is born to help prevent the baby from having AIDS.

An infected baby must receive treatment because the infection could result in very serious problems or death. Treatment may include medicine and frequent checkups after the baby goes home. In some cases the baby may need to stay in the hospital for treatment.

How can I help prevent infection of my baby?

The best way to prevent infection is to practice safe sex. Have just 1 sexual partner who you know does not have an infection and is not sexually active with anyone else. If you are not sure of this, use latex or polyurethane condoms during foreplay and sexual intercourse to help prevent yourself from becoming infected.