Sexually Transmitted Diseases and Pregnancy

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KEY POINTS

• Sexually transmitted diseases (STDs) are infections such as chlamydia, gonorrhea, herpes, crab lice, syphilis, HPV and genital warts, trichomonas, HIV/AIDS, and hepatitis that pass from one person to another during sexual contact.
• Some STDs can be cured with antibiotic medicine, especially when they are diagnosed and treated early. There is no cure for STDs caused by a virus, like herpes, HIV, HPV, and genital warts.
• If you have an STD, you may need to take medicine before the baby is born. Your healthcare provider may recommend a C-section to help keep the baby from getting infected during birth.
• You can help prevent STDs if you use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex. Some STDs can be prevented by a vaccine.

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What are sexually transmitted diseases?

Sexually transmitted diseases (STDs) are infections that pass from one person to another during sex. They may also be called sexually transmitted infections, or STIs. Some of the more common STDs are chlamydia, gonorrhea, herpes, crab lice, syphilis, HPV and genital warts, trichomonas, HIV (the virus that causes AIDS), and hepatitis A, B, and C. Some of these diseases are more dangerous than others. Some can make you very sick or cause death.

You can have one of these diseases and not know it because you don't have any symptoms and don't feel sick. You can then spread the disease to sexual partners. Or you may know that you have an STD but are too embarrassed to talk about it with your sexual partner. Sexual partners can get the disease if you don’t practice safe sex every time.

STDs can make it hard for you to get pregnant. They can also increase the risk that you will have a tubal pregnancy, which can be very dangerous. Some infections may increase the risk for early labor and premature birth. STDs can spread to your baby and cause the baby to have birth defects or die.

What is the cause?

Bacteria, viruses, and parasites cause STDs. They are usually passed between partners during sex. This includes vaginal intercourse, anal intercourse, oral sex, skin-to-skin contact in the genital area, kissing, and the use of sex toys, such as vibrators. Hepatitis B and HIV can also spread through IV drug use.

Your baby can get an STD in the following ways:

• The bacteria or viruses can spread from you to the baby by passing through the placenta before birth. The placenta is the tissue inside the uterus attached to the baby by the umbilical cord. It carries oxygen and food from your blood to the baby’s blood.
• After the bag of waters breaks during labor, the baby can come in contact with bacteria or viruses in and near the birth canal.
• Your baby can get the infection from another infected baby in the nursery or from an infected adult who handles your baby with unwashed or ungloved hands.

What are the symptoms?

The symptoms depend on the type of STD. Some STDs may not cause symptoms until years after you are infected. Others may start within a few days. Symptoms may include:

• Burning or pain when urinating
• Unusual discharge from the vagina or penis
• Itching, burning, or pain around the vagina, penis, or rectum
• Rashes, sores, blisters, or painless growths around the vagina or rectum
• Pain with sex
• Sore throat
• Vaginal bleeding between menstrual periods

Some of the symptoms your baby might have are:

• Sores or rash
• Seizures
• Tiredness
• No appetite
• Vomiting, fever, and irritability
• Jaundice (skin that looks too yellow)
• Breathing problems
• Swelling of infected areas
• Fever
• Red eyes with pus

Babies may also have an infection without any symptoms.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. At your first prenatal visit, you will have tests for infection, such as blood or urine tests. You may have these tests again later in the pregnancy.

To check for infection, your baby may have:

• Blood tests
• Tests on urine, spinal fluid, or fluid samples from the eyes, nose, mouth, or vagina
• X-rays

How are they treated?

Some STDs can be cured with antibiotic medicine, especially when they are diagnosed and treated early. There is no cure for STDs caused by a virus, like herpes, HIV, HPV, and genital warts. However, treatment of these infections can lessen or avoid complications.

If you have a herpes infection, you may be given medicine to treat the infection and to prevent it from coming back. If you have a herpes sore or a positive test for herpes when you go into labor, your healthcare provider may recommend a C-section. This can help keep the baby from getting infected during birth.

An HPV infection during pregnancy usually does not need to be treated until after your baby is born. However, you will regularly have tests to see if the infection is getting worse.

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

An infected baby must be treated because these infections could cause very serious problems or death. Treatment may include medicine and frequent checkups after the baby goes home. In some cases your baby may need to stay in the hospital for treatment.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider.

Tell everyone with whom you have had sex in the last 3 months about your infection. Or you can ask the clinic staff to tell them. They will not use your name. Your sexual contacts need to be treated even if they don’t have any symptoms.

Don’t have sex until both you and your partner have finished all of the medicine and your healthcare provider says it's OK. Then always use condoms every time you have sex.

Ask your healthcare provider:

• How and when you will get your test results
• What other STDs or STIs you should be tested for
• How long it will take to recover
• If there are activities you should avoid and when you can return to normal activities
• When it is safe to start having sex again
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help keep from getting infected?

• Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
• Have just 1 sexual partner who is not sexually active with anyone else.
• If you had sex without a condom and are worried that you may be infected, see your healthcare provider even if you don’t have symptoms.
• Have regular prenatal visits while you are pregnant. At each visit your healthcare provider will check to make sure that you and the baby are healthy. Regular visits can help you and your provider prevent possible problems.