You may not know if you have one: STI’s and infections during pregnancy - News24

Karen Wilmot aka 'The Virtual Midwife' is a midwife, prenatal yoga teacher and founder of The Due Date Club, a private online community for pregnant women. 

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Testing for sexually transmitted infections (STIs), including HIV, is part of routine antenatal care and should be done at your first antenatal visit.

Testing won't harm your baby, but getting tested is essential as STIs often have no symptoms, so you may not know if you have one.

Early treatment and counselling are necessary because many STIs can affect your baby's health during pregnancy and after birth.

If left untreated, STIs can pass from the mother to her baby, causing congenital disabilities like blindness, deafness, and bone deformities and infections that may harm your baby's development.

Read: What is hyperemesis gravidarum?

Bacterial Vaginosis

Bacterial vaginosis (BV) is a common cause of vaginal discharge, and although it's not considered an STD, it has been linked to sexual activity.

The only symptom is foul-smelling, fishy vaginal discharge. BV during pregnancy has been associated with premature rupture of the membranes surrounding the baby in the uterus, preterm labour and infections.

There are no known direct effects of BV on the newborn, but if you have a bad-smelling discharge, you need to mention it at your doctor's appointment to receive the correct antibiotic treatment.

Chlamydia

Most chlamydial infections do not have symptoms. However, some women report abnormal vaginal discharge, bleeding after sex, or itching/burning with urination.

The antibiotics used to treat chlamydia are safe in pregnancy and are used in pregnant women for many other types of infections.

Left untreated chlamydial infection has been linked to preterm labour, premature rupture of membranes, and low birth weight. Your baby may become infected during delivery as the baby passes through the birth canal and can develop eye and lung infections.

Gonorrhoea

Gonorrhoea can cause problems in both you and your baby, but it can be treated with antibiotics and requires close follow-up to ensure the infection has been cured.

If left untreated gonococcal infection in pregnancy has been linked to miscarriages, premature birth and low birth weight, premature rupture of membranes, and chorioamnionitis.

Gonorrhoea can infect your baby during delivery as they pass through the birth canal, causing eye infections.

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Hepatitis B

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). A mother can transmit the infection to her baby during pregnancy, especially when mothers become infected close to the delivery time.

Pregnant women who are positive for HBV should receive HBV viral load testing and be treated with antiviral medications in the third trimester if their HBV viral load is high.

Their newborns should receive HBV vaccine and HBIG within 12 hours of birth to optimally prevent maternal-child HBV transmission.

Infected newborns have a high risk (up to 90%) of becoming chronic HBV carriers, leading to an increased risk of developing chronic liver disease or liver cancer later in life. Screening for HBV is vital to prevent mother-to-child transmission of HBV.

Hepatitis C

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV) and can be passed from an infected mother to her child during pregnancy.

Babies born to HCV-infected women have been shown to have an increased risk of being born prematurely and having a low birth weight.

Over 90 per cent of people infected with HCV can be cured with 8-12 weeks of oral therapy. However, there are currently no HCV treatments approved for use during pregnancy.

It is only safe to begin this treatment once the mother has given birth and completed breastfeeding. Newborns with HCV infection usually do not have symptoms, and most will clear the infection without medical help.

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Herpes Simplex Virus

Herpes Simplex Virus (HSV) infection can seriously affect newborns, primarily if the mother's first outbreak occurs during the third trimester.

Symptoms of herpes during pregnancy include itching, burning, painful, or tingling sensation in the genital area, vaginal discharge, painful urination and flu-like symptoms, including fever, headache, and muscle aches.

Lymph nodes in the groin may be tender and swollen. The hormonal, immune, and other physical changes during pregnancy contribute to a greater frequency of active herpes infections.

Acyclovir (Zovirax) and valacyclovir (Valtrex) are most commonly used for herpes outbreak suppression and treatment during pregnancy. These drugs help reduce how active the virus is. They also help speed up lesion healing and may decrease the chance of active lesions during labour.

Women with active genital herpes lesions or early symptoms will be recommended a Cesarean section to avoid transmission to the baby. Transmission can occur during pregnancy and after delivery.

Human Immunodeficiency Virus

Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS). HIV destroys specific blood cells crucial to helping the body fight diseases.

The most common ways HIV passes from mother to child are during pregnancy, childbirth, or breastfeeding. However, when HIV is diagnosed before or early during pregnancy and appropriate steps are taken, the risk of mother-to-child transmission can be less than 1%.

HIV symptoms during pregnancy include fever and chills, rash, fatigue, joint pain or muscle aches, swollen lymph nodes, ulcers in the mouth and recurrent yeast infections. HIV antibody testing during pregnancy, with patient consent, is a routine part of prenatal care.

Treatment with a combination of HIV medicines (called antiretroviral therapy or ART) can prevent the transmission of HIV to your baby and protect your health.

Human Papillomavirus

Human papillomaviruses (HPV) are viruses that most commonly involve the lower genital tract, including the cervix, vagina, and external genitalia.

Genital warts often appear as small cauliflower-like clusters which may burn or itch and frequently increase in number and size during pregnancy.

Genital warts can complicate a vaginal delivery, and a cesarean section may be recommended in cases where there are large genital warts that are blocking the birth canal.

There isn't a cure for HPV, but most women won't need any treatment during pregnancy. No drug is available to treat the virus itself. Instead, treatment focuses on managing any symptoms.

Also read: 'Young people have a voice': Fourteen-year-old HIV advocate to represent SA on the global stage

Syphilis

Syphilis is primarily a sexually-transmitted disease, but it may be transmitted to a baby by an infected mother during pregnancy.

Transmission of syphilis to a developing baby can lead to congenital syphilis, a severe multisystem infection. Syphilis has been linked to premature births and stillbirths and, in some cases, died shortly after birth.

Syphilis can be treated effectively with penicillin, and treatment should begin immediately following diagnosis. Their sex partner(s) should also receive treatment to prevent the mother from becoming re-infected and improve her partner's health.

Untreated infants that survive tend to develop problems in multiple organs, including the brain, eyes, ears, heart, skin, teeth, and bones.

Signs and symptoms of syphilis happen over time in stages. The stage you're in depends on whether or not you get treatment.

Treatment can prevent you from moving to the next stage, so getting treated as soon as you know you're infected is essential. The first sign of syphilis is a small, hard, painless sore called a chancre that usually develops in the genital or vaginal area.

You may have one or a few sores. They last for about 6 weeks, even if you get treatment.

Trichomoniasis

Vaginal infection due to the sexually-transmitted parasite Trichomonas vaginalis is widespread.

Symptoms include itching, irritation, unusual odour, discharge, and pain during urination or sex, although some women are asymptomatic. Trichomoniasis can be cured with medication prescribed by a doctor that is safe to take during pregnancy.

The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected.

If you are being treated for an STD other than HIV (or if your partner is undergoing treatment), counselling that encourages abstinence from sexual intercourse until the entire course of medication is crucial.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmitting or acquiring STDs and HIV.

Talk to your care provider about your options and ensure you are well informed to make an informed decision about your care.

Every test and investigation that is done in pregnancy gives information that tells your treatment plan. If you're at all concerned, it's always best to give your doctor a call.

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