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.

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