Sexually Transmitted Infections During Pregnancy

surgery has led to a reduction in febrile morbidity rates (Qvistad et al. 1983; Crowley et al. 2001). If screening is not practical, many clinics and practitioners routinely treat all women receiving surgical abortion for chlamydia presumptively and, in high prevalence areas, would treat for gonorrhea as well. Intrauterine infection may be the result of hematogenous or ascending infection. For example, congenital syphilis Treponema pallidum is hematogenously spread in the mother’s blood and invades the placenta and fetal tissues. Such infection produces characteristic histologic changes in the placenta. Ascending infection from the cervix and vagina may occur through intact or compromised fetal membranes and can cause chorioamnionitis and amniotic fluid infection. HIV and hepatitis B, in contrast, are hematogenously disseminated in the mother but do not pass the placental barrier. Vertical transmission occurs in these cases at parturition, through exposure to blood and secretions. Fetal loss, prematurity, and preterm rupture of membranes, low birth weight, and a variety of perinatal complications occur more frequently in pregnant women with reproductive tract infections, including STIs and bacterial vaginosis. Intrauterine or perinatally transmitted STIs can have severely debilitating effects on pregnant women, their partners, and their fetuses, and are among the top causes of disability-adjusted life years lost in developing countries. All pregnant women and their sex partners should be asked about STIs, counseled about the possibility of perinatal infections, and ensured access to treatment, if needed. Sexually transmitted infections (STIs) in pregnancy may result in adverse pregnancy outcomes, fetal infection, neonatal infection, and a broad range of social consequences. Adverse pregnancy outcomes include ectopic pregnancy, miscarriage, and stillbirth, congenital and perinatal infections, and maternal puerperal infections. Infection before pregnancy can lead to ectopic pregnancy and infertility, and infection during pregnancy can cause miscarriage, chorioamnionitis, preterm delivery, small-for-dates infants, and congenital infection. The susceptibility to infection is increased during pregnancy, and the clinical manifestations of some STIs are altered during pregnancy. STIs present at delivery can cause maternal puerperal infection and neonatal infections.