11. Syphilis
Detection of a syphilis infection
is important for you, your partner and your growing baby. Fortunately
this rare infection is also treatable. Screening tests for syphilis
during pregnancy have reduced the rate of syphilis in babies.
If you notice any open sore on your
genitals, have your healthcare provider check it. Syphilis can be
treated with penicillin and other safe medications.
12. Chlamydia
Chlamydia is a common sexually
transmitted disease; between 3 and 5 million people are infected every
year. Infection is caused by a germ that invades certain types of
healthy cells; it may be passed through sexual
activity, including oral sex. Between 20 and 40% of all sexually active
women have probably been exposed to chlamydia. In fact, over 200,000
pregnant women are infected every year.
Chlamydial infection may be linked to
ectopic pregnancy. In one study, 70% of the women studied who had an
ectopic pregnancy also had chlamydia.
Chlamydia is most likely to occur in
people who have more than one sexual partner. It may also occur in women
who have other sexually transmitted diseases.
Some healthcare providers believe
chlamydia occurs more commonly in women who take oral contraceptives.
Barrier methods of contraception, such as diaphragms and condoms used
with spermicides, may offer some protection from infection.
During pregnancy, a mother-to-be can pass
the infection to her baby as it comes through the birth canal. The baby
has a 20 to 50% chance of getting chlamydia if the mother has it. It may
cause an eye infection in baby, but that’s easily treated. A baby may
also get a chylamdial infection during birth and develop pneumonia,
which can be fatal.
Pelvic inflammatory disease (PID) can
result from an untreated chlamydia infection.
You may not have symptoms of chlamydia—75%
of those infected do not. Symptoms include burning or itching in the
genital area, discharge from the vagina, painful or frequent urination,
or pain in the pelvic area. Men may also have symptoms.
Chlamydia can be detected by a cell
culture. Rapid diagnostic tests done in the doctor’s office can provide a
result quickly, possibly even before you go home.
Chlamydia is usually treated with
tetracycline, but it shouldn’t be given to a pregnant woman. During
pregnancy, erythromycin may be the drug of choice, or Zithromax may be
prescribed for you and your partner.
After treatment, your healthcare
provider may want to do another culture to make sure the infection is
gone. The test may be repeated late in pregnancy to be sure you don’t
have the disease when you deliver.
13.Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is a
severe infection of the upper genital organs involving the uterus, the
Fallopian tubes and even the ovaries. There may be pelvic pain, or there
may be no symptoms at all.
Infection can result in scarring
and blockage of the tubes, making it difficult or impossible to get
pregnant or making you more susceptible to an ectopic pregnancy. Surgery
may be required to repair damage.
14. HIV and AIDS
HIV. HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome).
More than 1 million people in the United States are HIV-positive or
have AIDS. Nearly 56,000 new HIV infections occur every year—20% do not
even know they are infected.
About 2 out of every 1000 women who enter
pregnancy are HIV-positive, and the number of cases among women is
rising. It’s estimated that 6000 babies are born every year to mothers
infected with HIV. In fact, the CDC now recommends that all pregnant
women be offered HIV testing. Home testing kits are available; most are
very reliable.
After HIV enters a person’s bloodstream,
the body begins to produce antibodies to fight the disease. A blood test
can detect these antibodies. When detected, a person is considered
“HIV-positive” and can pass the virus to others. This is not the same as
having AIDS.
The virus weakens the immune system and
makes it difficult for the body to fight off disease. Gynecological
problems can be an early sign of an HIV infection, including ulcers in
the vagina, yeast infections that won’t go away and severe pelvic
inflammatory disease. If you have any of these problems, discuss them
with your healthcare provider. Early diagnosis and treatment are
crucial.
There may be a period of weeks or months
when tests don’t reveal the virus. In most cases, antibodies can be
detected 6 to 12 weeks after exposure. In some cases, it can take as
long as 18 months before antibodies are found.
Once a test is
positive, a person may be free of symptoms for some time. Studies
indicate taking over-the-counter multivitamins containing vitamins B, C
and E every day may delay the progression of HIV and delay the need to
start antiretroviral medications.
Two tests are used to determine if someone
has HIV—the ELISA test and the Western Blot test. The ELISA is a
screening test. If positive, it should be confirmed by the Western Blot
test. Both tests involve testing blood to measure antibodies to the
virus. The Western Blot test is believed to be more than 99% sensitive
and specific.
Before testing, a woman is advised she will be tested for HIV unless she declines—this is called opt-out testing.
For those at high risk of HIV, experts suggest testing before pregnancy
or as early in pregnancy as possible and testing again in the third
trimester. Rapid HIV testing during labor is recommended if a woman’s
HIV status is unknown.
With rapid HIV testing, results are
available within 30 minutes. This test has the same sensitivity and
specificity as the ELISA test. Positive results require confirmation
with Western Blot testing.
We know 90% of all cases of HIV in
children are related to pregnancy—mother to baby during pregnancy,
childbirth or breastfeeding. Research has shown an infected woman can
pass the virus to her baby as early as 8 weeks of pregnancy. A mother
can also pass HIV to her baby during its birth. Breastfeeding is not
recommended for women who are HIV-positive.
Research shows the chance of a woman
infected with HIV passing the virus to her baby can be nearly eliminated
with some medications. However, if an infection is not treated, there’s
a 25% chance a baby will be born with the virus. If a woman takes AZT
during pregnancy and has a Cesarean delivery, she reduces the risk of
passing the virus to about 2%! Studies have found no birth defects
linked to the use of AZT. Other HIV medications have also been proved
safe for use during pregnancy.
If you are HIV-positive, expect more blood
tests during pregnancy. These tests help your healthcare provider
assess how well you are doing.
AIDS.
A person is HIV-positive before developing AIDS. This process can take
10 or more years, due to the medications in use at this time.
The rate of AIDS among
women has grown to 20% of all reported cases. AIDS can leave a person
prone to, and unable to fight, various infections. If you are unsure
about your risk, seek counseling about testing for the AIDS virus.
Pregnancy may hide some AIDS symptoms, which makes the disease harder to
discover.
There is some positive news for
women who suffer from AIDS. We know if a woman is in the early course of
the illness, she can usually have an uneventful pregnancy, labor and
delivery.
