Pregnancy and Sexually Transmitted Diseases
One in four pregnant women has a sexually transmitted disease. Chances are she doesn’t know she’s infected - or that it can harm her baby. Find out how your former lifestyle can affect fertility here.
HUMAN PAPILLOMAVIRUS (HPV)
Stats: HPV is the most common STD in the U.S., with an estimated 75 percent of the reproductive-age population infected. Twenty million Americans have the genital form of HPV, with 6.2 million new cases diagnosed each year.
Symptoms: In some people, HPV can cause genital warts.
Testing: A Pap smear, which can detect changes in cervical cells, can indicate an HPV infection or the early stages of cervical cancer, particularly if the changes are dramatic. For minor Pap changes, a follow-up DNA test can confirm or rule out the presence of HPV. But testing for HPV in pregnancy if genital warts are not present is usually unnecessary because the virus is so prevalent and the risk of transmission is so low, says Thomas Cox, M.D., director of the Gynecology and Colposcopy Clinic at theUniversity of California at Santa Barbara. If you have warts that have not been diagnosed, however, you should see a doctor and be tested.
Risk to Mothers: A woman previously infected with HPV may get genital warts for the first time during pregnancy or find that her current warts grow significantly. Of the approximately 100 types of HPV, the ones that cause warts (strains 6 and 11) are the least worrisome. Strains 16, 18, 31, and 45 account for 80 percent of all cervical cancers.
Risk to Babies: The risk of HPV transmission during delivery is very low; less than 1 percent of affected women pass it to their babies. In these infants, there is a slight chance that they will later develop the virus in their larynx (voice box). If a woman has very large genital warts close to her due date, a c-section may be considered.
Treatment: Several treatments for genital warts that are often given to women who are not pregnant haven't been proven safe for use in pregnancy, says Dr. Cox. It's possible that your OB might freeze or laser the warts or put acid on them since these procedures are safe during pregnancy. Many healthy women appear to get rid of HPV over time or at least to suppress it to the point where it is no longer a threat to them, their partner, or their children.
Stats: Approximately 11,500 Americans get syphilis each year, though infection rates are significantly higher in some southern states and in African-Americans. In 1999 there were 420 reported cases of congenital syphilis in infants who acquired the disease from their mothers during pregnancy or delivery.
Symptoms: The primary stage of syphilis is characterized by a small, firm, round, painless sore (called a chancre) that appears from 10 to 90 days after infection at the place where the bacterium entered the body; the sore lasts one to five weeks. If not treated, the appearance of a non-itching rash on one or more parts of the body indicates the start of the second stage of syphilis. There may be rough, "copper penny" spots on the palms of the hands and bottoms of the feet. Most pregnant women with syphilis are asymptomatic, says Dr. McGregor.
Testing: In many states, a syphilis screen'a blood test'is the only routine prenatal STD test.
Risk to Mothers: Third-stage syphilis (called latency) begins to attack the internal organs, eventually leading to blindness, dementia, and lack of muscle coordination, among other complications.
Risk to Babies: Untreated early syphilis in pregnant women can result in perinatal death in up to 40 percent of cases, and, if syphilis is acquired in the four years preceding pregnancy, it may lead to infect in 80 percent of cases. If a mother-to-be doesn't receive treatment, or receives it too late in pregnancy, there's a 40 to 70 percent chance she'll deliver a syphilitic baby. Signs of an infection include sores, runny nose (sometimes bloody), jaundice, a small head, anemia, a swollen liver, slimy patches in the mouth, and inflammation of the bones in the arms and legs. A newborn may not show signs of infection until 3 to 8 weeks after birth.
Stats: The parasite which causes trichomoniasis is responsible for an estimated 7.4 million new cases in men and women each year.
Symptoms: The condition, often called "trich," can cause a foul-smelling or green vaginal discharge, vaginal itching, or redness within six months of infection. Other symptoms can include painful sexual intercourse, lower abdominal discomfort, and the urge to urinate.
Testing: A health care provider can diagnose trichomoniasis by examining vaginal discharge.
Risk to Mothers: Trichomoniasis can cause preterm labor.
Risk to Babies: Preterm labor can cause a baby to have a low birth weight. According to the CDC, mother-to-baby transmission of the parasite is rare, but symptoms in an infected infant include fever, as well as a vaginal discharge in girls.
Treatment: Antibiotics after the first trimester. (The medicine is not safe for use during the early months of pregnancy.)
The STD epidemic is an undeniable health threat to infants today. Unlike other epidemics, however, it is one that can be easily controlled. If pregnant women insist on being tested for these diseases, in most cases STDs can become what they should be'a nuisance, not a danger. Armed with the right information and a doctor's guidance, a woman with an STD can help keep herself -- and her baby