Sexually Transmitted Diseases and Pregnancy

What are sexually transmitted diseases?

Sexually transmitted diseases (STDs) are infections that are spread by sexual contact. STDs can be passed from one person to another by vaginal, oral, or anal sex. They usually affect the male or female genital area; for example, the penis or vagina.

Examples of STDs are:

• syphilis
• gonorrhea
• chlamydia
• herpes
• human papillomavirus (HPV), which causes genital warts and cervical cancer
• hepatitis B or C
• trichomoniasis
• HIV/AIDS

If you are pregnant and have an STD, your baby may get the infection and be hurt by it.

What is the cause?

Bacteria and viruses cause STDs. They are usually passed between partners during sex. You can also get some diseases by injecting illegal drugs.

You can have an infection without knowing it. This means 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 spread from you to the baby by passing through the placenta 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 another, infected baby in the nursery or from an infected adult who handles the baby with unwashed or ungloved hands.

What are the symptoms?

The symptoms depend on the type of 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 belly
• sore throat
• a yellow or gray discharge from the vagina that may smell bad
• frequent or painful urination
• swollen lymph nodes in the groin area
• fever

Sometimes there are 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 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 if you or the baby’s father have had any symptoms of these diseases. At your first prenatal visit, you will have tests for infection, including:

• tests of samples of cells from the genital area, cervix, or other areas that are commonly infected
• blood tests
• urine tests

It is routine to test for syphilis, gonorrhea, hepatitis and HIV. Some healthcare providers also routinely test for chlamydia and HPV as well.

You may have these tests again later in the pregnancy.

Your healthcare 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 metronidazole (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 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 cesarean section (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 the baby may need to stay in the hospital for treatment.

How can I help keep my baby from getting infected?

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 keep yourself from getting infected.