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STIs and pregnancy

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consequences during pregnancy because of STIs

consequences during pregnancy because of STIs

Published in Health & Medicine
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  • 1. STIs & Pregnancy
  • 2.  
  • 3. Adverse pregnancy outcomes
    • Spontaneous abortion,
    • Stillbirth,
    • Prematurity,
    • Low birth weight (LBW),
    • Postpartum endometritis, and
    • Various sequelae in surviving neonates
  • 4. Postpartum endometritis Various Sequelae in neonates 0 weeks 28 weeks 40 weeks Spontaneous Abortion Stillbirth Prematurity LBW
  • 5.  
  • 6. Estimated risk & timing of MTCT of HIV 30 – 45% 25 – 35% 15 – 30% Overall 5 – 10% 5 – 10% 5 – 10% 1 – 5% - - Through BF Early 2 months Late 2 months 10 – 20% 10 – 20% - During labor 5 – 10% 5 – 10% - During preg: Breastfeeding through 8-24months Breastfeeding through 6 months No breast feeding Timing
  • 7. WHO recommended drug treatment for STIs in pregnancy Source: World Health Organization Cefixime 400 mg orally as single dose, or ceftriaxone 125 mg by intramuscular injection. Gonorrhoea Erythromycin 500 mg orally qid for 7 days, or azithromycin 1 g orally single dose, or amoxycillin 500 mg orally tid for 7 days. Chlamydia Benzathine penicillin 2.4 million units by intramuscular injection. Three weekly doses recommended in latent syphilis of unknown duration. Syphilis Treatment in pregnancy STI
  • 8. WHO recommended drug treatment for STIs in pregnancy Primary infection only Aciclovir 200 mg orally five times a day for 7 days, or aciclovir 400 mg orally tid for 7 days. Recurrent infection Famciclovir 125 mg orally tid for 5 days, or valaciclovir 500 mg bid for 5 days. HSV-2 Preferable after the first trimester Metronidazole 200 mg or 250 mg orally tid for 7 days, or metronidazole gel 0.75%, one full applicator (5 g) intravaginally twice a day, or clindamycin 300 mg orally bid for 7 days. For trichomoniasis 2 g metronidazole stat recommended as first line treatment. Bacterial vaginosis and trichomoniasis Treatment in pregnancy STI
  • 9. WHO recommended drug treatment for STIs in pregnancy
    • Cautions:
    • Doxycycline, tetracycline, ciprofloxacin, norfloxancin, and ofloxacin should be avoided in pregnancy and when breast feeding.
    • Erythromycin estolate is contraindicated in pregnancy because of drug related hepatoxicity; only erythromycin base or erythromycin ethylsuccinate should be used.
    • Metronidazole should be avoided in the first trimester of pregnancy
    Source: World Health Organization