Yahoo Lifestyle Testing for STIs in pregnancy
As soon as I find out one of my patients is pregnant, there’s a stack of stuff to talk about and a whole heap of tests to order. I often watch the horrified faces of these poor mum-to-be as I mention that not only will we be finding out their blood type and making sure they’re immune to Rubella, we’ll also be checking them out for sexually transmitted infections (STIs), including syphilis.
Why test for STIs in pregnancy?
Many pregnant women are in monogamous relationships and consider themselves immune to nasties that are sexually transmitted. But there are a couple of reasons why this isn’t always right.
When you think about it, pregnancy and STIs have a lot in common: they usually result from unprotected sex! Seriously, though, many of these infections have few, if any, symptoms, so you might have been carrying them around for ages, even from before you met your partner.
Secondly, being pregnant means you have plenty of hormones circulating and dampening your immune system, making you more prone to infections.
Many STIs can pass through to bub, making him sick if left untreated. Wouldn’t you rather be safe than sorry? Here’s the list of what we test for:
HIV
Affects bub? YES
Treatable? YES (though it’s not curable)
We now have enough data to show that being pregnant doesn’t affect the virus itself, despite your immune system operating at half-mast. We also know that although it has happened, HIV rarely infects the baby while you’re pregnant. The main problem is during delivery or breastfeeding. For that reason we treat with all sorts of medications and avoid a vaginal delivery and breastfeeding.
Hepatitis B
Affects bub? YES
Treatable? Yes (under certain circumstances)
Across Australia, women have the biggest chance of catching hepatitis B in their 20s, an age when many are getting pregnant. It’s not only sexually transmitted, but is also carried in blood and other body fluids. This means you can even catch it from dodgy tattoo parlours and piercing establishments, where hygiene is poor. If you do have hepatitis B, you can give it to your baby during a vaginal birth, so you will likely be offered a caesarean.
Syphilis
Affects bub? YES
Treatable? YES (penicillin is still the best treatment)
Syphilis is quite rare in Australia these days, thank goodness. It’s no fun in pregnancy. Almost all babies whose mums have syphilis will catch it while in the uterus and up to 50 per cent of these pregnancies will end in premature delivery and death of the child. The surviving bubs have a high rate of congenital syphilis and early death.
Genital warts
Affects bub? NO
Treatable? YES (warts can be treated, but cervical changes are usually left until after the pregnancy, unless it’s cervical cancer)
Most specialists agree that unless genital warts (which are caused by the human papillomavirus)are massive, they won’t cause any problems during the delivery of the baby. They don’t infect the baby on the way out, even though his little face gets pretty up close and personal during labour. As for the pap test, there’s no special relationship between precancerous changes and pregnancy – but it’s a good opportunity to make sure you’re up to date with this important test.
Herpes
Affects bub? YES
Treatable? YES
In the case of herpes, we don’t routinely screen everyone because the blood test is notoriously inaccurate and only shows up antibodies that indicate you’ve had exposure to the virus at some time in your life. Instead, if there’s any sign of herpes during the pregnancy, we go and do swabs and treat as necessary. This will involve medication, especially if you have your first outbreak. We would also recommend a caesarean to avoid the baby coming into contact with the virus during the delivery.
Chlamydia
Affects bub? YES
Treatable? YES
Again, it’s only tested for if we think you’re at risk – for example, if you’re very young or we’ve picked up another STI. Chlamydia can cause premature delivery and nasty eye infections and pneumonia for the baby if he catches it during the delivery. It’s treated with antibiotics.
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