Understanding STDs in Pregnancy -- Basic Information
Chlamydia is the most common STD in the Western world. Untreated, it can cause preterm labor, preterm rupture of membranes, and postpartum endometritis (inflammation of the lining of the uterus). Babies who are infected during birth can suffer from pneumonia or conjunctivitis, which can lead to blindness if untreated. Some women have no symptoms while others may notice a vaginal discharge or lower abdominal pain or develop pelvic inflammatory disease. Some may not suspect that they have chlamydia, however, until their partner has symptoms such as trouble urinating and discharge from his penis.
Genital herpes can be passed from a mother to her baby during a vaginal delivery. Babies who come in contact with genital herpes can suffer damage to their eyes and central nervous systems. A herpes infection in a newborn can become life-threatening, affecting multiple organ systems rather than only the genitals.
The most dangerous situation occurs if a woman gets infected with herpes for the first time during pregnancy (primary infection), especially near delivery. A primary infection around the time of delivery puts baby at a very high risk of infection — as much as one chance in two. A woman who has been previously infected with the virus before pregnancy can have recurring infections, but the risk of her baby becoming infected in pregnancy and during delivery is very small because there is usually less virus present. Her existing antibodies will have crossed the placenta and help protect the fetus against infection.
Women who become infected for the first time often develop symptoms such as genital lesions, ulcerations, enlargement of lymph nodes, and pain. But women who have had genital herpes in the past don't necessarily exhibit symptoms every time the virus becomes active, even though they are contagious. For months or even years at a time, the virus may be inactive. When the virus becomes active, there may be symptoms such as itching and pain before the outbreak of blister-like sores on or around the genital area, or there may be no symptoms at all.
Genital warts or "condyloma" are caused by the human papillomavirus (HPV). This virus can lie latent, causing no symptoms, for months or years after infection. When an outbreak occurs, warts appear on or near the genitals or anus, or within the vagina. Pregnant women with HPV can have rapid growth of warts which can sometimes grow large. HPV transmission from mother to baby can occur but is rare. Babies who contract the virus can develop warts on their larynx (voice box) as infants or children — usually by age 5. But HPV is not considered a reason to do a cesarean section unless they are large enough to interfere with a vaginal delivery.