Impact of STD and STI on Pregnancy

Shaian Vandenburg

Monroe College

This research paper dissects the problems and consequences of some Sexually Transmitted Diseases (STD) such as The Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), Gonorrhea, Chlamydia, Genital Herpes, Hepatitis B Virus and the Cytomegalovirus, and how it impacts all facets of pregnancy. Additionally, this paper will further discuss the Signs and Symptoms, Treatment, and preventative methods that can be used for these complications. Sexually Transmitted Diseases can complicate pregnancy and have serious effects on both the mother and the developing baby. Some of these problems may be seen at birth; others may not be discovered until months or years later.

HIV/AIDS

Human Immunodeficiency Virus (HIV) is a virus that causes Acquired Immunodeficiency Syndrome (AIDS). In the United States, the number of women with AIDS is on the rise (Johnstone, 1992). There have been many concerns of the effects that HIV/AIDS can have on pregnancy. In most cases, immune-compromised women reduces the CD Lymphocyte count below is normal threshold. Studies have proven that the outcome of Aids in pregnancy can be fatal. In the United States, the first 6 cases of Aids related pregnancies of Pneumocystis carinii pneumonia were fatal (Johnstone, 1992).

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Similarly, other studies have reported cases of pre-term labor, syphilis, and low birth weight. In the first controlled study of women who were infected with HIV/AIDS, results proved that there were correlations of pre-term labor, intrauterine growth retardation, and low birth weight. This infection can be transmitted to the baby through breastfeeding or at delivery. Other factors such as placental damage can also be related to an increased rate of transmission of the disease from the mother and the baby (Johnstone, 1992).

Other retroviruses, such as Moloney murine leukaemia virus126 or HTLV I in the human are also transmitted to the baby by breast feeding. HIV-1 occurs in breast milk and there is no doubt that infection has been transmitted to the baby postnatally.

Syphilis

This is a bacterial infection that is caused by sexual contact which usually starts off as a painless sore on common sites such as your genitals, rectum or mouth. It is caused by spiral shaped bacteria called Treponema pallidum. Syphilis is transmitted from the mother to the fetus if the disease is left untreated. This can often lead to death of the baby (WHO, 2017).

According to World Health Organization, the transmission of this disease from the mother to child resulted in approximately 143,000 early fatal deaths or stillbirths, 62,000 neonatal deaths and 44,000 babies were born either prematurely or with low birth weight (WHO, 2017).

Syphilis is treated with antibiotics. Benzathine penicillin is usually injected into the arm or buttocks of the infected patient, this form of treatment is known as the most effective treatment for this disease. However, like any other sexually transmitted disease, the best prevention from this disease is by abstaining or sexual contact with one partner who has been tested negatively for this disease.

Chlamydia

Chlamydia is a sexually transmitted disease that can be easily cured. This disease affects both men and women and can cause permanent damages to a woman’s reproductive system, making it difficult for her to get pregnant. This infection is caused by the bacterium Chlamydia trachomatis. Like gonorrhea, it is spread by unprotected vaginal or anal sex with an infected person. Chlamydia is easily spread because most men and women have no signs and are unaware of the disease. However, the signs in women are vaginal discharge, bleeding between periods or after sex, burning or pain when urinating, pain the abdominal or pelvic area and pain during sex. In rare cases, people with chlamydia have Arthritis or sore joints and inflammation of the eye (CDC, 2016). Men are rarely linked to health problems that are associated with chlamydia. Infections sometimes spread to the tube that carries sperm from the testicles, which causes pain and fever. Rarely, chlamydia can prevent a man from being able to have children (CDC, 2016).

This can have some effect on the baby if transmitted. Similarly, like Gonorrhea, Chlamydia can cause PID, which can cause Ectopic pregnancies. It can spread to newborn babies during delivery which can cause pneumonia and eye infections. In addition, pregnant women who are infected, have an increased risk of having a premature baby (CDC, 2016).

Generally, this disease is treated with antibiotics. It is usually advised to avoid sexual contact until the treatment has been completed. Some ways to prevent contracting Chlamydia are by protecting yourself with the use of condoms, and also by being in a monogamous relationship with someone who has been tested negatively for this disease.

Gonorrhea

Gonorrhea is a Sexually Transmitted Disease (STD) that is transferred from one person to another by unprotected vaginal, oral or anal sex. The infection is caused by the bacterium Neisseria gonorrhoeae (Keifer and Sarachik, 2016). This disease usually affects warm and moist areas of the body such as the eyes, throat, vagina, anus, urethra and the female reproductive tract. In females, these infections can appear like a common bacterial or yeast infection (Keifer, 2016).

Some of the symptoms are discharge from the vagina which can appear watery, creamy or slightly green, pain or burning sensation while urinating, the need to urinate more frequently, heavier periods or spotting, sore throat, pain while engaging in sexual intercourse, sharp pain in the lower abdomen and also fever.

According to the American Congress Obstetricians and Gynecologists (2016), miscarriage rates increases in women with this disease. Gonorrhea affects approximately 13,000 pregnant women each year in the United States (CDC). It poses a risk for an unborn child during pregnancy and also during delivery. Often times, women with this disease develop Pelvic Inflammatory Disease (PID),which can increase the chances of an ectopic pregnancy (Perkins, 2015). An ectopic pregnancy is a condition where the fetus implants in the fallopian tube instead of the uterus. Since this tube is too small to accommodate the fetus, tubal rupture and serious bleeding can result if the tube is not removed.

Babies that are delivered vaginally have a higher chance of contracting this disease from secretions in the vaginal tract. These symptoms can be very detrimental to the baby’s health. The signs are often discovered by skin infections, respiratory infections, blindness, meningitis, arthritis of the joints and lastly, systematic blood infections which can be life threatening to the baby. The best protection against this disease is abstinence, monogamy, and the proper use of condoms. Some lifestyle practices such as drugs and alcohol abuse can also increase the chances of contracting this disease (Sarachik, 2016).

Hepatitis B Virus

The term Hepatitis means inflammation of the liver that can be caused by many viruses or other infections. In addition to Hepatitis B, there are also Hepatitis A and C. However, Hepatitis B virus, Hepatitis B is a viral infection, that attacks the liver and can cause acute and chronic disease. This virus is transmitted through contact with the blood or other fluids of the body of an infected person. It is also spread by exposure to infected blood and various body fluids such as saliva, menstrual, vaginal and seminal fluids. Sexual Transmission of this virus particularly occurs in unvaccinated men who participate in sexual activities with partners with this disease

This virus can survive outside of the body for at least 7 days. During this time, it is still possible to cause an infection if it enters the body of someone who is unvaccinated. The incubation period of the Hepatitis B virus is approximately 75 days, but it can vary from 30 to 180 days. (Nettleman, 2016). Like any other disease, Hepatitis B, has many effects on the baby. Some of which includes, low birth weight and prematurity, neonatal jaundice and congenital anomalies or perinatal mortality. However, the effects of chronic Hepatitis B Virus infection on pregnancy outcomes have not been clearly defined (Nettleman, 2016).

Genital Herpes

Genital Herpes is caused by the Herpes Simplex virus (HSV). Having this disease during pregnancy can cause significant health risks resulting in neonatal diseases (Aga, 2009). This virus causes herpes by entering the body via mucous membranes or breaks in the skin. Like every other STD, Genital Herpes is spred by unprotected vaginal, anal and oral sex. There are two types of HSV, Herpes Simplex 1, which causes cold sores and Herpes Simplex 2, which causes Genital Herpes. Some signs and symptoms are fever & flu-like symptoms, nausea, muscle aches, painful urination, tingling or burning sensation in the area where blisters will appear. It is possible to get the infection in the mouth, tongue, lips and other parts of the body.

If a woman has contracted the genital herpes virus in the birth canal during delivery, herpes simplex virus can be spread to the infant causing neonatal herpes, which can sometimes be fatal. Neonatal herpes can complications that cause overwhelming infections to the central nervous system, mental retardation or even death. Babies are most at risk for neonatal herpes if the mother contracts genital herpes in the later stages of the pregnancy. Additionally, the virus can be spread to the baby in the first week of birth if he or she is kissed by someone with an active cold sore, also known as oral herpes. In rare conditions, herpes can be spread by touch, if someone touches an active sore and then immediately touches the baby. Therefore, it is advised that an infected person avoids contact with the baby.

Usually after birth, the baby is observed closely for approximately three weeks. Symptoms of neonatal herpes may include a skin rash, fever, crankiness, or lack or appetite. While these can be symptoms of other illnesses, it is advised that each symptom be observed carefully. Subsequently, The baby should be taken to his or her pediatrician and the parent should notify the doctor that he or she has the disease (ASHA, 2017).

There is no cure for Herpes. But, there are medications that can prevent or shorten the outbreaks of the disease. Treatment is generally given to pregnant women at the end of their pregnancy. Based on small studies, when acyclovir is taken in the last month of the pregnancy, it prevent the disease from reoccurring but it also poses as a risk to the unborn baby.

References   

CDC. (2016, May 19) Chlamydia- CDC fact sheet, Retrieved March 1, 2017, from Center for Disease Control and Prevention, https://www.cdc.gov/std/chlamydia.stdfactchalydia.htm.

Johnson, F, MD (1992). HIV and Pregnancy. Retrieved March 20, 2017 from International Journal of STD and Aids. http://journals.sagepub.com/doi/pdf/10.1177/09564624920030020.

Aga, I. (2009). Managing Genetal Herpes Infections and Pregnancies. Retrieved March 20, 2017, from Sage Journals. http://journals.sagepub.com/doi/full/10.2217/17455057.5.2.165

WHO. (2017, Januray). Hepatitis B (HBV.Hep B). Retrieved March 1, 2017, From World Health Organization. http://www.who.int/mediacentre/factsheets/fs400/en/.

WHO.(2017). Syphilis. Retrieved March 20,2017, from World Health Organization. http://www.who.int/mediacentre/news/releases/2016/antibiotics-sexual-infections/en/