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STIs and pregnancy
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STIs and pregnancy

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consequences during pregnancy because of STIs

consequences during pregnancy because of STIs

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    STIs and pregnancy STIs and pregnancy Presentation Transcript

    • STIs & Pregnancy
    •  
    • Adverse pregnancy outcomes
      • Spontaneous abortion,
      • Stillbirth,
      • Prematurity,
      • Low birth weight (LBW),
      • Postpartum endometritis, and
      • Various sequelae in surviving neonates
    • Postpartum endometritis Various Sequelae in neonates 0 weeks 28 weeks 40 weeks Spontaneous Abortion Stillbirth Prematurity LBW
    •  
    • 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
    • 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
    • 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
    • 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