Pregnancy: Sexually Transmitted Diseases

Sexually transmitted diseases, commonly called STDs, are infections that are spread by having sex with someone who has a STD. You can get a sexually transmitted disease from sexual activity that involves the mouth, anus, or vagina.

STDs are serious illnesses that require treatment, regardless of whether or not you are pregnant. But, when you are pregnant, you are not the only one at risk; many STDs can be especially harmful to you and your baby. Some STDs, like HIV/AIDS, cannot be cured and may be deadly.

Your health care provider will likely screen for some STDs at your first prenatal visit, but if you have sex with someone who might be infected, you will need to be screened at subsequent appointments and treated. If you suspect you have been exposed to a STD, be sure to tell your doctor immediately. Fast treatment is the best way to protect you and your baby.

• Herpes
• HIV/AIDS
• Genital warts (caused by human papilloma virus, or HPV)
• Hepatitis B
• Chlamydia
• Syphilis
• Gonorrhea
• Trichomoniasis

Sometimes, there are no symptoms of a STD. If symptoms are present, they may include:

• Bumps, sores, or warts near the mouth, anus, penis, or vagina
• Swelling or redness near the penis or vagina
• Skin rash with or without pain
• Painful urination
• Weight loss, loose stool, night sweats
• Aches, pains, fever, and chills
• Yellowing of the skin (jaundice)
• Discharge from the penis or vagina (vaginal discharge may have an odor)
• Bleeding from the vagina other than during a monthly period
• Painful sex
• Severe itching near the penis or vagina

STDs in pregnancy can harm you and your developing baby depending on the type of infection.

• HIV/AIDS: Thanks to the creation of powerful medications, transmission of HIV infection to your infant is almost completely preventable. But, when the disease is passed on, the results are catastrophic -- the baby may develop HIV infection.
• Herpes: Herpes infection in a pregnant woman is relatively safe until she gets ready to deliver. Active herpes lesions on the genitals are highly contagious and can infect the infant as he or she is being born. Also, the virus may begin multiplying and become infectious before any skin symptoms appear. Therefore, many women with herpes have a cesarean section to prevent the transmission of herpes to the newborn.
• Gonorrhea: Gonorrhea is a very common STD, usually diagnosed by performing a test on a swab of vaginal fluid. If contracted during pregnancy, the infection can cause vaginal discharge, burning while emptying the bladder, or abdominal pain. A pregnant woman with untreated gonorrhea has an increased risk of miscarriage or preterm delivery. A baby that is born while the mother has an active infection can develop blindness, joint infection, or a life threatening blood infection.
• HPV (Genital Warts): This is a very common STD. The genital warts often appear as small cauliflower-like clusters which may burn or itch. If you contract genital warts during pregnancy, treatment may be delayed until after you deliver. Sometimes the hormones from pregnancy can make them grow larger. If they grow large enough to block the birth canal, the baby may need to be delivered by a cesarean section.
• Chlamydia: Chlamydia may cause an increased risk of miscarriage and preterm delivery. Newborns who are exposed can get severe eye infections and pneumonia.
• Syphilis: Syphilis is most often diagnosed with a blood test, although a syphilitic skin lesion can also be tested. Syphilis is easily passed on to your unborn child. It is likely to cause a very serious infection to your baby that can be fatal. The infants are often premature. Untreated infants that survive tend to develop problems in multiple organs including the brain, eyes, ears, heart, skin, teeth, and bones.
• Hepatitis B: Hepatitis B is a liver infection caused by the hepatitis B virus. If a pregnant woman is infected with hepatitis B, she can transmit the infection to her baby through the placenta. Also, her newborn can become infected. In addition, women with hepatitis B are more likely to have a premature delivery. Luckily, early screening and the more widespread use of the hepatitis B vaccine can prevent infection.
• Trichomoniasis: Trichomoniasis is an infection that can cause yellow-green vaginal discharge and pain with sex or when emptying the bladder. It can increase the risk of having a preterm baby. Rarely, the new baby can get the infection during delivery and have a vaginal discharge after birth.

At your prenatal visit, your health care provider will screen for a number of STDs. But, if you think you have a STD, tell your provider. He or she can examine you and perform other tests to determine if you have a sexually transmitted disease. Be especially vigilant if you have a new sexual partner during pregnancy.

Treatment of a STD during pregnancy depends on how far the infection has progressed and how far along you are in your pregnancy. Many bacterial STDs like syphilis, gonorrhea, and chlamydia are treated with antibiotics given as a shot or taken by mouth. Below are common treatments for STDs in pregnant women and newsborns.

• HIV/AIDS: Although an incurable disease, you can prevent transmitting the virus to your baby by taking a multitude of medication.
• Herpes: Your doctor can prescribe antiviral pills to treat these lesions. Women with active herpes lesions at delivery will likely have a cesarean section to prevent transmitting the infection to the baby.
• Gonorrhea: Pregnant women with the infection can be treated with antibiotics. Because gonorrhea is often without symptoms, all newborn babies are given medications in their eyes at birth to prevent development of the gonorrhea eye infection.
• HPV (Genital Warts): If you contract genital warts during pregnancy, treatment may be delayed until after you deliver.
• Chlamydia: Mothers with chlamydia are treated with antibiotics. The drug used on all newborns to prevent a gonorrhea eye infection also prevents chlamydia from infecting the eye, but it can't prevent the pneumonia that may develop later.
• Syphilis: Your doctor will prescribe antibiotics during your pregnancy to decrease risk of transmitting the infection to your baby and stop the syphilis from progressing in you.
• Hepatitis B: If you have hepatitis B, your doctor will give your newborn an injection of antibodies to prevent him or her from becoming infected.
• Trichomoniasis: Pregnant women can be treated with medication to cure the infection.

If you are given an antibiotic to treat a STD, it's important that you take all of your medicine, even if the symptoms go away. Also never take someone else's medicine to treat your illness. By doing so, you may make it more difficult to treat the infection. Likewise, you should not share your medicine with others.

Here are some basic steps that you can take to protect yourself from contracting STDs:

• Consider that not having sex is the only sure way to prevent STDs.
• Use a latex condom every time you have sex, particularly if you have more than one sex partner. (If you use a lubricant, make sure it is water-based.)
• Limit your number of sexual partners. The more partners you have, the more likely you are to catch a STD.
• Practice monogamy. This means having sex with only one person. That person must also have sex with only you to reduce your risk.
• Choose your sex partners with care. Don't have sex with someone whom you suspect may have a STD or who has many sexual partners.
• Get checked for STDs. Don't risk giving the infection to someone else or your baby. Just because you've been screened for STDs early on in your pregnancy, does not mean that you can't contract one later during your pregnancy. If you engage in unprotected sex with more than one partner since your last STD screen, you need another set of screening tests. Also, you should be concerned if your partner may be having unprotected sex with other people.
• Don't use alcohol or drugs before you have sex. You may be less likely to practice safe sex if you are drunk or high. Plus, alcohol and drugs can harm your developing baby.
• Know the signs and symptoms of STDs. Look for them in yourself and your sex partners.
• Learn about STDs. The more you know about STDs, the better you can protect yourself.

• Stop having sex until you see a health care provider and are treated.
• Follow your health care provider's instructions for treatment.
• Use condoms whenever you have sex, especially with new partners.
• Don't resume having sex unless your health care provider says it's OK.
• Return to your health care provider to get rechecked.
• Be sure your sex partner or partners are also treated.

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