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Your Pregnancy After 35 : Your Health and Medical History (part 7) - Sexually Transmitted Diseases

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25. Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) during pregnancy are serious because they can harm a developing fetus. STDs are contracted during sexual contact, including vaginal, oral or anal intercourse. If you have an STD, seek treatment as soon as possible!

Many pregnant women have an STD but don’t know they are infected. Ask for a test or treatment if you think you have an STD. Your healthcare provider routinely offers tests for hepatitis B, HIV and syphilis.

Sexually transmitted diseases are more common in women than in men. A woman is more susceptible because her reproductive organs are inside her body, a fertile environment for infections to grow. This also makes diagnosis in women more difficult than in men.

Some STDs are transmitted when the baby comes in contact with the virus during birth. Others are passed to the baby through the mother’s blood and infect the baby during pregnancy or birth. Left untreated, STDs can harm an unborn baby. Every year, thousands of babies are born early or suffer from infection because of undetected STDs passed to them by their mothers. Babies may suffer serious effects. In some cases, effects are not evident until years after birth.

The most common sexually transmitted diseases include monilial vulvovaginitis, trichomonal vaginitis, condyloma acuminatum (venereal warts; HPV), genital herpes simplex infection, chlamydia, gonorrhea, syphilis and HIV/AIDS.

Many sexually transmitted diseases can be diagnosed and treated during pregnancy. It’s important to be tested for an STD if you believe you might have been exposed. Discuss this important subject with your healthcare provider.

HIV and AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). About 1.2 million people in the United States are HIV-positive or have AIDS. Nearly 56,000 new HIV infections occur every year—20% of those infected don’t 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 all pregnant women be offered HIV testing. Home testing kits are available; most are very reliable.

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.

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 screening, results are available within 30 minutes.

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. A person is HIV-positive before developing AIDS. The process can take many years, due to medications in use at this time.

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. In most cases, antibodies can be detected 6 to 12 weeks after exposure. In some cases, it can take many months before antibodies can be found. 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.

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 birth. Breast-feeding 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 her baby 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’re HIV-positive, expect more blood tests during pregnancy. These tests help your healthcare provider assess how well you’re doing.

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’re 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.

26. Shingles

Shingles occurs when a type of herpes virus becomes active after having been dormant in nerve root ganglia. This can happen long after the primary infection has gone away. It occurs more often in people who are older, although it can occur in younger people as well.

Shingles occurs mainly in adults whose immune systems are compromised. During pregnancy, shingles can be a severe illness, with sharp pain and even breathing problems. The times of greatest concern for a pregnant woman are during the first half of pregnancy and around the time of delivery. Exposure during the first trimester, when major organs are developing in the fetus, can cause some birth defects. Fortunately, shingles rarely occurs during pregnancy.

Pain from shingles occurs in specific areas of nerve distribution. Treatment includes pain control with pain medications. If you think you have shingles, contact your healthcare provider, who can decide on treatment for you.

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