Understanding STDs in Pregnancy -- Treatment

What Are the Treatments?

HIV

HIV, the virus that causes AIDS, is spread through sexual fluids, or through sharing needles with, or exposure to blood from, an infected person. A baby can contract it from the mother before or during birth, or through breast milk.

It's recommended that all pregnant women — not just those at risk — be screened for HIV. If you are HIV-positive, you can significantly reduce the potential for transmission to the baby by taking the right medicines. But to get treatment and prevent infection, you need to know that you are infected. If your doctor or midwife hasn't offered you HIV testing, ask for it.

Chlamydia

Chlamydia is caused by bacteria spread through sexual contact with an infected partner. In pregnant women, it's routinely tested for by checking the vaginal and cervical secretions and is easily treated with antibiotics such as erythromycin, amoxicillin or azithromycin. During pregnancy you should not use the antibiotic doxycycline because it can discolor your baby's teeth. Ointment is now routinely put in the eyes of newborns to prevent conjunctivitis, which can lead to blindness if not treated.

Genital Herpes

Genital herpes is caused by the herpes virus. It is transmitted through sexual contact with someone in whom the virus is active. There is no cure for genital herpes, but it can be managed. If tests show the virus to be active or you have a herpes genital lesion close to your delivery date, your doctor may recommend having a cesarean section instead of a vaginal birth. This will cut down the chance of the baby contracting the virus by contact with lesions in the birth canal. Acyclovir, valacyclovir and famciclovir are all considered safe to take in pregnancy and there are no studies that show an increase in birth defects among women that have taken these drugs. It appears that they are safe and may be prescribed if medically indicated by your doctor.

Genital Warts

The human papillomavirus that causes genital warts is spread during sexual contact with an infected partner. Many women discover that they have been infected by HPV when they have an abnormal Pap test. Other women may notice the warts. Although the virus never leaves the body, the warts can be treated with surgery or medications.

Several other, extremely rare, problems related to HPV and pregnancy:

• During pregnancy, warts may occasionally get larger. This is probably due to increasing levels of pregnancy estrogens. But they can be surgically removed — even in pregnancy — and preferably before labor to ensure a normal labor and delivery.
• If warts on the external female genitalia, such as the labia, grow very large, this may sometimes prevent the baby from passing through the birth canal. Occasionally, cesarean section is required.
• Warts located inside the vagina may make the vagina less elastic. This wart-infected tissue can fracture and hemorrhage during a vaginal delivery.