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Pregnancy and sexually transmitted infections

What are sexually transmitted infections and how can they affect pregnancy?

A sexually transmitted infection (STI) or sexually transmitted disease (STD) is a bacterial or viral disease that can be contracted through oral, genital or anal sex with an infected partner. STIs can have serious consequences for your health and the health of your baby.
Some of these infections are not only transmitted through sexual intercourse. For example, you can get infected with a virus. This virus can exist outside the human body for at least a week. Hepatitis can be transmitted through contact with:

  • with a contaminated needle and other sharp instruments,
  • after contact with the blood or open wound of an infected person,
  • when using household items, such as a toothbrush or razor of a person with hepatitis.

Some infections enter the baby's body through the placenta, during childbirth, or when the membranes rupture. Infections pose a serious danger to newborns (and sometimes even threaten their lives). In the future, they can lead to irreversible consequences for the health and development of the baby. Moreover, STIs increase the risk of:

  • premature rupture of membranes,
  • occurrence,
  • frozen pregnancy.

The most common STIs include:

  • Chlamydia
  • Genital herpes
  • Gonorrhea
  • Hepatitis B
  • HIV AIDS
  • Syphilis
  • Trichomoniasis

How do I know if I have any STI?

It is important to identify and, if necessary, treat STIs during pregnancy. At the very first appointment, the doctor will give a referral for tests for many of these infections. Be sure to tell your doctor:

  • if you have had any infections in the past,
  • if you and your other half have more than one sexual partner,
  • if you or your partner have ever come into contact with a used needle, such as while using drugs or getting a tattoo.

The list includes repeat tests for syphilis, hepatitis and HIV. They are held in the second and third trimester. The results of these analyzes are entered into your exchange card, which you take with you to . The Ministry of Health of Russia recommends that all pregnant women be tested for HIV, HPV, syphilis and chlamydia. Even if at the moment your condition does not cause concern, you should keep in mind that some of the STIs can be present in the body for many years without symptoms. Therefore, you need to make sure that neither you nor your partner have been exposed to the virus in the past. Women with a high degree testing for gonorrhea and hepatitis C is also recommended. Tell your doctor right away if you were exposed to an STI during pregnancy or if you or your partner develop any unusual symptoms. In this case, you will be tested again. If the presence of one of the STIs is confirmed, you will probably want to know all about the risks and options for treating the disease.

How to avoid contracting an STI?

Reliable ways to avoid contracting STIs:

  • abstain completely from (vaginal, oral and anal),
  • to have sexual relations with only one partner, who definitely does not have infectious diseases who does not inject drugs and has no other sexual partners than you.

If you have a different situation, you need:
Do not have sexual intercourse with a partner who has ulcers or is showing symptoms of an STI. This also applies to a partner who, in your opinion, has not had sexual intercourse with anyone other than you. Do you suspect that your partner has other sexual partners or is injecting drugs? Use a latex condom during intercourse. This can reduce the risk of contracting most STIs.
Keep in mind that one untreated infectious disease increases the risk of contracting another, such as HIV, through contact with an infected person.
This is another reason not to delay testing, especially if you or your partner has symptoms.
With few exceptions, when one partner is treated for an infection, the other also needs to be treated. In addition, it is necessary to abstain from sex until the end of the course of treatment and total absence symptoms. Otherwise, you will continue to transmit the infection to each other.

Can STIs be treated during pregnancy?

Yes. The method of treatment depends on the type of STI. non-viral infections such as lamydia, gonorrhea, and syphilis can be treated. Some of the antibiotics are safe for pregnant women.
Viral infections such as herpes and do not respond to antibiotics. There is no cure for herpes, but your doctor may prescribe an antiviral medication that you will need to take in the last month of your pregnancy. Interferon preparations are also prescribed - viferon, genferon, immunoglobulins. This will reduce the likelihood of an exacerbation of the disease in the prenatal period. If you are HIV positive, you will need to take a number of antiretroviral drugs. This will help maintain the body and reduce the risk of infection in the child.

Today on the women's site "Beautiful and Successful" we will talk about sexually transmitted infections (STIs for short). This topic, already quite relevant, becomes especially important when we are talking about STIs during pregnancy. In today's article, you will find out which infections belong to this group, what future mothers should especially be afraid of and how to avoid infection.

How is an STI diagnosed during pregnancy?

Infection with STIs is most often associated with an early onset of sexual activity, frequent changes in sexual partners, and non-use of condoms.

As the name implies, the causative agents of these diseases are transmitted from person to person mainly through sexual contact. Non-sexual transmission of infection (through contaminated hands, household items) is extremely rare.

Hepatitis B, C and HIV viruses can be transmitted through blood, contaminated medical instruments, needles, personal hygiene items.

In the diagnosis of STIs during pregnancy, the most important step is to take material for laboratory tests.

  • For PCR method a scraping is taken from the urethra and cervical canal. Using this method, chlamydia, ureaplasma, mycoplasma, gardnerella, viruses, gonococcus are detected. During the study, the DNA of the infectious agent in the test material increases hundreds of times.
  • Research material ELISA method(determination of antibodies to infectious agents) - blood serum. Taking blood for STIs during pregnancy is carried out in the morning on an empty stomach. If you have IgA in the results of the analysis, this indicates the presence of an infection in the body, and IgG indicates a long-term illness. This method determines mycoplasmosis, ureaplasmosis, chlamydia, cytomegalovirus, herpes infection.
  • Gonorrhea is diagnosed by detecting gonococcus with bacterioscopic examination. During pregnancy, a preventive examination for gonorrhea is carried out three times (a smear for gn), then according to indications.

Women donate blood from a vein for STIs several times during pregnancy. For syphilis and hepatitis B, C, blood is taken 3 times during pregnancy, for HIV - 2 times.

What other tests should be taken if you are planning a pregnancy in the near future, we talked about in this.


Why are STDs dangerous during pregnancy?

On the site, the site will tell you about the most common STIs that are dangerous during pregnancy, which can lead to complications in a woman, fetus or newborn child.

  • Gonorrhea in women is sluggish, often as a mixed infection. If the infection occurred during pregnancy, then the disease proceeds rapidly - the woman suffers from pain when urinating, profuse corrosive whites. Gonococcal infection during pregnancy can cause septic abortion, premature rupture of membranes, and puerperal fever. Gonorrhea can be transmitted to a newborn during childbirth, affecting the eyes, vulva, and rectum.
  • Syphilis is a very insidious disease that can cause miscarriages and stillbirths. Syphilis is transmitted in utero from a sick woman to the fetus (congenital syphilis).
  • Genital herpes (HSV type II) is very dangerous when infected during pregnancy. May cause miscarriages and premature births. The child most often becomes infected with HSV during childbirth with rashes in the mother's genital tract. Therefore, the presence of an active process herpetic infection is one of the indications for delivery by caesarean section.
  • Trichomoniasis in pregnant women is a multifocal disease - the urethra is affected, often bladder, vulva, vagina and rectum, there is a high probability of developing trichomonas endometritis, as a result of which spontaneous miscarriage may occur.
  • Chlamydia during pregnancy can be manifested by spontaneous miscarriage, premature birth, polyhydramnios, endometritis, inflammation of the membranes of the fetus. Chlamydial infection also leads to postpartum complications, postpartum endometritis. Infection of a newborn can occur in two ways - in utero and during the passage of a newborn through a mother's birth canal infected with chlamydia. As a result, the baby may have chlamydial conjunctivitis and pneumonia.
  • Mycoplasmosis and ureaplasmosis. The most dangerous for humans are mycoplasma genitalium and ureaplasma urealyticum. Often, mycoplasmosis and ureaplasmosis are asymptomatic, and a woman may not even know that she is infected until she passes the test. Many doctors consider urogenital mycoplasmas to be opportunistic microflora and treat them with specific complaints of patients about infertility and miscarriage. However high level ureaplasma in pregnant women is a risk factor for the development of inflammation of the membranes and preterm birth. Therefore, it is not worth the risk and it is better to treat the disease.

If clinical manifestations or carriage are detected, the doctor treats the pregnant woman.

Treatment of STIs detected during pregnancy should be complex, staged, taking into account physiological indications.

In no case should you self-medicate and prescribe yourself drugs that you read about on the Internet or that helped your friend - you need to contact your gynecologist for help.

On preparatory stage For the treatment of STIs, Viferon and Genferon suppositories are used to increase immunity. Vaginal suppositories are locally prescribed.

Antibiotic therapy is usually started after 20 weeks of gestation, unless there is an indication for urgent treatment.

An important condition for the treatment of all types of STIs diagnosed during pregnancy is the simultaneous treatment of sexual partners, sexual rest or the use of condoms for the entire course of treatment.

To avoid complications of STIs during pregnancy, the expectant mother must take all the tests prescribed by the doctor on time, follow his instructions and, of course, treat your health and intimate life with care and responsibility.

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However, pregnancy can affect the choice of treatment. This section discusses the interaction of pregnancy and various infections.

Infections that are harmless at normal times can sometimes be dangerous to the fetus. If you have a high temperature, you need to see a doctor quickly: this main symptom infectious diseases.

People who decide to conceive a child are advised to undergo all examinations and, if necessary, to carry out treatment even before the onset of pregnancy.

Effect on the fetus various diseases depends on the ability of the bacteria or viruses that cause them to penetrate the unborn child, as well as on the presence of antibodies in the body of a pregnant woman, the time of infection and the possibility of treatment during this period.

The placenta acts as a kind of barrier that protects the unborn baby from the effects of many adverse factors, however, there are infections that can overcome the placental filter. This method of infection of the fetus is called transplacental.

Trichomoniasis is an insidious disease, the pathogens of which do not directly affect the fetus, but can cause severe cases, cause inflammation of the membranes.

With a penetrating method of transmission of infection, bacteria through the vagina enter the uterus, affecting fetal membrane, amniotic fluid and the fruit itself. The greatest risk of infection becomes after the rupture of the fetal bladder.

Infection of the child is also possible when he passes through the birth canal of the mother. In this sense, gonorrhea, chlamydia, hepatitis B, group B streptococci, chicken pox, the AIDS virus, genital herpes, condyloma, and fungal diseases, such as thrush, are very dangerous. To prevent an unfavorable outcome, doctors recommend giving birth by caesarean section.

In the postpartum period, infection of the child occurs through physical contact with the mother or during breastfeeding. Thus genital herpes, thrush, chicken pox are transmitted.

Inflammatory diseases that occur during pregnancy, caused by various bacteria, very often become the result of a violation of the normal microflora of the genitourinary tract. future mother.

Stress, reduced immunity, change hormonal background, which is often observed during pregnancy, can lead to an imbalance between normal and pathological microflora.

The result may be increased activity of opportunistic flora.

In severe cases, this can lead to abortion, infection of the fetus, or inflammation in the mother's genital tract in the postpartum period. So, for example, a banal thrush can not only deliver a lot to the expectant mother discomfort, but also to create in the vagina of a pregnant woman a favorable environment for the reproduction of pathogens.

When to sound the alarm?

Increased attention requires the threat of preterm birth and intrauterine infection fetus, which can be more or less dangerous, depending on the nature of the disease and the period of pregnancy. High temperature (starting from 38 °C) is the main symptom of any infection.

Urinary tract infections and pyelonephritis

Due to the peculiarities of the anatomical structure, women are more prone to infections than men. urinary tract: Since the urethra is very short, germs can easily enter the bladder. An additional factor risk is insufficient drinking, so you should drink at least 1.5 liters of water per day.

During pregnancy, the risk of urinary tract infections becomes even higher, especially due to the increase in progesterone, which prevents the bladder from emptying completely.

At the following signs a pregnant woman should immediately consult a doctor:

  • pain in the lower abdomen;
  • frequent urge to urinate, day and night;
  • burning sensation when urinating.

Only a urine test can detect bacteria; the most common is Escherichia coli. Treatment consists of taking a course of antibiotics. It prevents the occurrence of pyelonephritis (inflammation of the kidneys), which has similar symptoms, but with high temperature and back pain.

Chickenpox during pregnancy

Chickenpox (varicella) is caused by the varicella-zoster virus. The chickenpox vaccine was introduced in 1995. Now children are routinely vaccinated against the disease. In Russia, such a vaccination is not done. People who have been ill chicken pox or vaccinated are usually immune. If you are unsure, ask your doctor to find out with a blood test.

In childhood, the disease is usually tolerated easily. However, in adults - especially pregnant women - it can be serious.

Chickenpox protection. The disease at the beginning of pregnancy rarely causes birth defects. It is most dangerous for the baby if the mother gets chickenpox a week before the birth. This can cause a life-threatening infection in the newborn. Usually, an injection of varicella-zoster immunoglobulin reduces the risk of infection if treatment is started immediately after birth. The mother should also receive immunoglobulin to reduce the severity of the disease.

Cytomegalovirus during pregnancy

This is a common viral infection. In healthy adults, almost all of these infections go undiagnosed. Between 50 and 80% of adults in the United States are infected with cytomegalovirus by the age of 40. A woman can infect her baby before birth, at birth, or while breastfeeding. Women who contract cytomegalovirus for the first time during pregnancy can pass on a severe congenital infection to their baby.

Protection against cytomegalovirus. It is important to know how the virus is transmitted. The risk of infection is reduced by simple hygiene measures such as hand washing. If a pregnant woman is diagnosed with the virus, the presence of infection in the fetus is determined by amniocentesis. The doctor may order several ultrasounds to check if the fetus has developmental defects associated with infection. If the baby is infected, treating the mother with antibodies may help.

In a small percentage of children, symptoms of cytomegalovirus are detected at birth. It can be serious problems with the liver, convulsions, blindness, deafness, pneumonia. Some of these children die. Most survivors have significant neurological impairment.

Fifth disease (erythema infectiosum) during pregnancy

A contagious disease common among children school age. Caused by paravirus B19. Most noticeable sign infection in children is a bright red rash on the cheeks. The disease is often asymptomatic. Therefore, many adults do not know if they had it in childhood. If you get sick, you won't get sick again.

Almost half of women are susceptible to the B19 virus during pregnancy, so it is not uncommon for pregnant women to get the infection. Most of these women will give birth to healthy children. But in rare cases, the fetus can develop severe, even fatal, anemia. Anemia can cause heart defects and severe edema in the fetus. If such a complication develops, a blood transfusion through the umbilical cord is possible.

Protection against the fifth disease. There is currently no vaccine for this disease. Antiviral therapy is of no benefit to women who have an infection. If a pregnant woman may have been infected, blood tests can confirm infection or immunity to it. If an infection is present, additional ultrasounds may be done to see if the fetus has signs of anemia and birth defects hearts.

Rubella during pregnancy

Rubella is a viral infection sometimes confused with measles. But these diseases are caused by different viruses. Rubella is rare in the United States. Most children are vaccinated against it at an early age. However, small outbreaks still occur. So if you are not immune, you can get rubella during pregnancy.

Rubella protection. The disease is not severe, but can be dangerous if contacted during pregnancy. The infection can cause miscarriages, stillbirths, and birth defects. Most big risk for the fetus - in the first trimester, but in the second trimester there may be a danger.

Early in pregnancy, women are tested for rubella immunity. If you are pregnant and not immune, avoid all potentially harmful contact. Vaccination is not recommended during pregnancy. However, it can be done after childbirth to protect yourself for the future. If you want to be vaccinated against rubella, you must not become pregnant for six months after it. According to the Ministry of Health, rubella is more widespread in Russia than the B19 virus.

Herpes during pregnancy

Caused by the herpes virus. It comes in two forms: type 1 and type 2. Type 1 causes fevers around the mouth and nose, but can also affect the genital area. Type 2 causes painful blisters on the genitals that burst into ulcers. After the initial manifestation, the virus remains in the mother and can be transmitted to the child during pregnancy and childbirth, or through breast milk.

Herpes protection. Antiviral drugs can reduce the number of relapses and shorten their duration. If you have genital herpes, your baby may become infected during childbirth by passing through the birth canal. greatest danger for the infant represents the primary
infection of the mother with a herpes infection immediately before childbirth. Herpes recurrence during childbirth is much less dangerous.

After birth, a baby can contract herpes through contact with someone who has a fever on their lips. If there is a fever on the lips, do not kiss the child and wash your hands before handling it.

HIV and AIDS during pregnancy

Acquired immunodeficiency syndrome (AIDS) is a chronic life-threatening disease caused by HIV. Once infected, the virus may not show up for years. It is only when the virus becomes active and weakens the immune system that the disease called AIDS occurs.

Without treatment, women with HIV can pass the infection to their baby during pregnancy and childbirth or through breast milk.

Protection against HIV and AIDS. An HIV test is a common procedure during pregnancy. Sometimes a second analysis is done in the later stages of pregnancy. If you have reason to be afraid of HIV or AIDS, let your doctor know. There are tools that greatly reduce the risk of passing the infection to the child. Taking special medications before or during childbearing also improves health and prolongs the life of most infected women. If a child does get an infection, early treatment will slow the progression of the disease and increase the chances of survival.

Flu during pregnancy

A woman who has not been vaccinated against the flu can become ill during pregnancy. Even if vaccinated, it is still possible to contract a strain against which the immunization does not protect. If you think you have; flu, see a doctor immediately.

Flu protection. Doctors recommend that women in any trimester of pregnancy be treated for influenza with antiviral drugs. The benefits of antiviral therapy are believed to outweigh the potential risks of drug use. Antiviral therapy is especially effective if treatment is started no later than two days after the onset of: the first symptoms.

Listeriosis during pregnancy

Listeriosis is a disease caused by the bacteria Listeria monocitogeries. Infection in most cases occurs through food - shawarma, hot dogs, unpasteurized milk and soft cheeses. Majority healthy people Listeria does not make you sick, but flu-like symptoms may appear: fever, weakness, nausea, vomiting, diarrhea. During pregnancy, their manifestation is more likely. Protection against listeriosis. If you contract listeriosis during pregnancy, the infection can pass to the fetus through the placenta and lead to premature birth, miscarriage, stillbirth, or death shortly after birth.

Listeria infection during pregnancy should be avoided at all costs. Do not consume unpasteurized dairy products and meat dishes not subjected to heat treatment.

A friend advised me to give up unpasteurized dairy products, as they can make you sick. This is true?

Beware of listeriosis

Anyone who consumes raw milk or raw milk cheese can contract listeriosis, but the risk is especially high during pregnancy. Some foods may contain the bacillus Listeria monocytogenes, which causes listeriosis, which can be dangerous during pregnancy. The bacillus quickly enters the bloodstream and is transmitted to the baby through the placenta.

It is important to strictly observe the basic rules of hygiene:

  • regularly clean the refrigerator and the kitchen work surface;
  • maintain continuity of the cold chain when you buy groceries;
  • follow the rules for defrosting products;
  • throw away any food that seems stale to you;
  • do not let the products wind;
  • start cooking only with clean hands;
  • never eat raw or undercooked meat, boil eggs well, wash vegetables and herbs that you eat raw.

Toxoplasmosis during pregnancy

A pregnant woman with toxoplasmosis can pass the infection on to her baby, who can have serious complications.

To avoid infection:

  • Wear gloves when working with the ground, in the garden, and wash your hands thoroughly after work.
  • Wash all vegetables and fruits thoroughly.
  • If you have a cat, have someone else clean its toilet.

Protection against toxoplasmosis. Toxoplasmosis during pregnancy can lead to miscarriage, fetal growth disorders and premature birth. In most cases, development is normal, but blindness or impairment may occur.
vision, enlarged liver and spleen, jaundice, seizures and mental retardation.

If you suspect toxoplasmosis, your doctor may order a blood test. It is difficult to treat toxoplasmosis during pregnancy because it is not clear whether the medicines used are safe for the baby.

Vaginal infections during pregnancy

Not all microorganisms that have settled in the vagina are pathogenic. But there are infections that simply need to be treated, especially during pregnancy.

group b streptococcus during pregnancy

One in four adults is a carrier of a bacterium called group B streptococcus. In women, the microorganism can live in the intestines and vagina. Usually it does not harm the body. But a pregnant woman can pass it on to her baby during childbirth.

Babies, especially premature babies, cannot deal with bacteria the way adults can. If they get an infection, they can become seriously ill.

Protection against group B streptococcus. The use of antibiotics during childbirth in women who carry the bacteria prevents most infections in newborns. If tests show you have streptococcus, remind your doctor to give you antibiotics when you give birth.

If streptococcus affects a newborn, the disease can take two forms: early and late. In the early form, the baby becomes ill a few hours after birth. There may be infection of the brain fluid (meningitis), inflammation and infection of the lungs (pneumonia), a life-threatening condition called sepsis that causes fever, difficulty breathing, and shock. In the late form, the infection develops after a week or even several months and usually leads to meningitis.

Chlamydia during pregnancy

Despite the fact that from 2 to 8% of women of childbearing age are carriers of chlamydia, the disease of chlamydia is little studied. There is nothing strange here, since the infection is not dangerous for adults. For children, on the contrary, it represents serious threat. Chlamydia can cause premature birth and severe illness in a child.

If the maternal infection is not detected in time, about 50% of children become infected with chlamydia during childbirth. The consequences can be severe inflammation of the lungs and eyes, from which even the prevention of vision, carried out immediately after childbirth, does not save. Now you understand why it is important to detect and treat maternal chlamydia before delivery.

Infection occurs mainly through sexual contact. The disease proceeds in most cases imperceptibly, almost without symptoms. Therefore, in the interests of the safety of the child, at the slightest suspicion of the presence of the disease, a pregnant woman is tested for chlamydia. If the presence of pathogens is confirmed, treatment is necessarily undertaken. In this case, the partner must also take the course in order to prevent re-infection of the mother. For therapy, antibiotics approved for use by pregnant women are used. It is very important to take them strictly in accordance with the doctor's instructions, do not take breaks and do not stop taking them prematurely. Otherwise, insufficient dosage due to irregular intake can lead to the fact that not all bacteria die.

Bacterial vaginosis during pregnancy

In bacterial vaginosis, normal microorganisms, such as lactobacilli, are replaced by anaerobic bacteria. This leads to disruption of the natural environment of the vagina. Such changes are observed in every tenth pregnant woman. They are associated with an increased risk of miscarriage of up to 45%. Symptoms of an infection are mostly subtle, but can still be manifested in increased whitish-yellow discharge, itching and burning. An unpleasant smell, slightly reminiscent of the smell of fish, complements the picture of the disease. To confirm or dispel your suspicions, measuring the pH value helps.

It is very important to start therapy in a timely manner. If the infection is left untreated, it will travel to the uterus, where it can pose an increased risk to the baby's health. There is a risk of developing the infected amnion syndrome in the fetus.

If done in a timely manner necessary measures, the risk of miscarriage is reduced. In early pregnancy bacterial vaginosis treated with lactic acid preparations and vitamin C. later dates topical therapy with 2% clindamycin cream. Alternatively, metronidazole in the form of a vaginal gel or tablets can be used, but only for seven days. With this infection, it is not necessary to treat the partner at the same time.

Thrush, fungal infection, vaginal fungus during pregnancy

Yeast-like fungi in pregnant women are quite common. During childbirth, these fungi are found in the vagina in about 30% of all mothers.

In addition to itching, whitish curdled discharge with an unpleasant odor, which can cause burning and pain in the vaginal area. Unlike bacterial infections vaginal fungus does not pose much of a health risk during pregnancy.

The risk of miscarriage with this disease is low. However, if a woman suffers from a vaginal fungus at the time of childbirth, the child in 90% of cases in the first weeks of life develops fungal infection oral mucosa or diaper dermatitis. Therefore, in order to avoid unnecessary complications for the baby, it is advisable to treat fungal infection even before childbirth, using vaginal suppositories or antifungal creams.

Frequent complaints of pregnant women about the manifestations of candidiasis are caused by hormonal changes in the body, which results in a change in the microflora of the vagina. The action of hormones can cause a decrease in immunity and a decrease in the activity of leukocytes.

The most common manifestations of this disease in women include the appearance of vaginal discharge, usually having a curdled consistency, which is aggravated by urination. Often the process of urination is accompanied by painful sensations. Pain can also be felt during intercourse.

In order to obtain confirmation of the diagnosis, a microscopic examination of the vaginal smear of a pregnant woman is performed, bacteriological culture or PCR analysis.

In women suffering from candidiasis, the penetration of this fungus to the fetus is also possible. As a rule, the umbilical cord of the unborn baby, his skin, bronchopulmonary system and mucous membranes are affected. oral cavity. However, in more severe cases, other organs and systems of the child are also affected.

Infection of the baby can also occur when it passes through the birth canal of the mother. As a result. as a rule, the fungus affects the oral cavity of the newborn, which is manifested by the formation of a characteristic white plaque on the mucosa.

Of course, it is desirable to get rid of this disease even before conception.

Do not self-medicate using remedies that promise to get rid of candidiasis in 1-2 days: as a rule, such drugs relieve the symptoms of the disease, but not the pathogen itself!

Only your doctor will be able to choose an individual treatment regimen for thrush, while he will take into account all the individual characteristics of your body - the course of pregnancy, general state health, liver and kidney function, and a tendency to allergies.

In the first trimester of pregnancy, when the danger is great negative impact medical preparations per fetus, are often limited to only local treatment facilitating the condition of a woman. At a later date, the doctor selects antifungal drugs safe for expectant mothers, such as nystatin or pimafucin.

Since the causes of candidiasis include decreased immunity and hypovitaminosis, you will definitely be prescribed a multivitamin and immunomodulating agent.

It will help to cope with the disease and change lifestyle. So, diet will require special attention. Limit the consumption of sweets, flour products and spicy foods and be sure to include foods containing bifidobacteria in your menu. But you do not need an additional intake of lactobacilli - with candidiasis there is no shortage of them, and an excess of these microorganisms can contribute to the reproduction of a pathogenic fungus.

Prevention of the occurrence of thrush in pregnant women includes maintaining immunity, good nutrition and taking vitamin preparations, maintaining normal acidity vagina.

When choosing underwear for yourself, give preference to those products that are completely made of cotton, or at least have an insert from this material. Do not wear tights and tight-fitting trousers in hot weather or if you spend a lot of time in a warm room.

If you are exercising in the pool, remove your wet swimsuit as soon as possible after the end of your workout and thoroughly blot the genital area with a clean, dry towel after a shower: a humid environment is favorable for the development of pathogens.

During pregnancy, your mucous membranes become very sensitive, so apply all body care products - shower gels and creams - very carefully so as not to irritate the skin around the vagina.

Be careful with alternative treatments!

Topical therapy with natural remedies such as calendula extract, garlic, or tea tree oil is not recommended for thrush during pregnancy. These drugs destroy the natural microflora of the vagina and are ineffective in fighting a fungal infection. For prevention important role plays the right intimate hygiene: give up intimate cosmetics, always wash from front to back, use plenty of water, and avoid whirlpool baths in health clubs or saunas.

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1 Pregnancy and sexually transmitted infections Manual for pregnant women Kyzyl, 2013

2 Dear women! If you are pregnant or planning to become pregnant, there are simple steps steps you can take to protect your unborn child or newborn from infections that cause serious health problems. Our manual will allow you to accept it as a guide to be responsible for your life and for life, health and full development baby. We invite you to cooperate so that you maintain your health and the child is born healthy! The editor-in-chief of the collection is a freelance specialist in dermatovenereology of the Republic of Tyva Obukhov A.P. Photos from the site and from the presentation “Syphilis in China”, Kyzyl, RT, 2011, author candidate of medical sciences Obukhov A.P. 2

3 Sexually transmitted infections (STIs) in a pregnant woman can cause problems for her and her baby. A pregnant woman with an STI can infect her baby early in pregnancy, during pregnancy, and after the baby is born. She may have pregnancy complications: miscarriage, early birth, premature detachment placenta. Pregnant women should ask their doctors to get tested for STIs, as some doctors may not perform these tests. Questions and Answers: Can pregnant women be infected with STIs? Yes, women who are pregnant can be infected with the same STIs as women who are not pregnant. Pregnancy does not provide women or their babies with any protection against STIs. The consequences of an STI can be much more serious, even life-threatening for a woman and her baby, if a woman becomes infected with an STI during pregnancy. It is important that women are aware of the harmful effects of STIs and know how to protect themselves and their children from infection. How common are STIs among pregnant women in the Republic of Tyva? Syphilis and trichomoniasis, chlamydia are quite widespread in pregnant women of the Republic of Tyva. Others - HIV, genital herpes and bacterial vaginosis - are much less common in pregnant women. How do STIs affect a pregnant woman and her baby? STIs lead to the same consequences in pregnant women as they do in women who are not pregnant. STIs can cause cancer, chronic hepatitis, pelvic inflammatory disease, infertility, and other complications. Many of the STIs in women are asymptomatic; that is, no symptoms. A pregnant woman with an STI can infect her baby early in pregnancy, during pregnancy, and after the baby is born. Some STIs (like syphilis) cross the placenta and infect the baby while it is in the uterus. Other STIs (like gonorrhea, chlamydia, hepatitis B, and genital herpes) can be passed from mother to baby during childbirth as the baby passes through the birth canal. HIV can cross the placenta during pregnancy, infect the baby during the birth process, and unlike most other STIs, it can infect the baby through breastfeeding. A pregnant woman with an STI may also have an early onset birth period, placental abruption and postpartum infection. Harmful effects from STIs in infants may include stillbirth (a baby who is born dead), low birth weight, conjunctivitis, neonatal pneumonia, sepsis, neurological damage, blindness, deafness, acute hepatitis, meningitis, chronic illness liver and cirrhosis of the liver. Most of these diseases can be prevented if the pregnant woman gets up on time for prenatal 3

4 accounting in women's consultation, is tested for STIs at the beginning of pregnancy and closer to childbirth if necessary. Should pregnant women be tested for STIs? Yes, STIs affect women of various socioeconomic and educational levels, age, marital status, ethnicity and religion. Pregnant women should be screened for STIs at their first prenatal OB/GYN visit: Chlamydia Gonorrhea and Trichomoniasis Hepatitis B, HIV C Syphilis Pregnant women should ask their doctors to get tested for STIs, as some doctors may not perform these screenings. There are currently many STI tests available. Even if a woman has been tested for STIs in the past, she should be tested again when she becomes pregnant. Can STIs be treated during pregnancy? Chlamydia, gonorrhea, syphilis, trichomoniasis, and bacterial vaginosis can be treated with antibiotics during pregnancy. Antiviral treatment may be used for pregnant women with herpes and is mandatory for those with HIV. For women who have active genital herpes during labor, a C-section to protect the newborn from infection. Women who test negative for hepatitis B can be vaccinated against hepatitis B during pregnancy. How can pregnant women protect themselves from infection? Most the right way to avoid the transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term relationship monogamous relationships with a partner who has been tested for STIs and is not infected. Latex condoms, when used consistently and correctly, are very effective in preventing the transmission of HIV, the virus that causes AIDS. Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and trichomoniasis. Proper and consistent use of latex condoms can reduce the risk of genital herpes, syphilis, and chancre only when the infected area or site of potential exposure is protected by a condom. Proper and consistent use of latex condoms can reduce the risk for transmission of HPV and related diseases (such as venereal warts and cervical cancer). 4

5 Where can I get more information? GBUZ RT "Reskozhvendispanser" Kyzyl, Republic of Tyva, st. Shchetinkina-Kravchenko, house. 66. Room 7 (for syphilis), room 2 (female), room. 1 (male), cab. 10 (dispensary registration for syphilis and in the evening anonymous paid reception). Tel. registry: Internet address: What is syphilis? Syphilis is a sexually transmitted disease caused by the bacterium Spirochete pallidum. Syphilis leads to damage to the skin and internal organs and can cause death if left untreated. How common is syphilis? In 2011, 645 people were infected with syphilis in the Republic of Tyva, of which 63 were pregnant. In 2012, 614 people were infected with syphilis in the Republic of Tyva, 58 of them were pregnant. 70% of them had an early infectious stage (primary and secondary syphilis). 1 child was born with congenital syphilis. 97 newborns received preventive treatment By congenital syphilis. How do people get syphilis? Syphilis is transmitted from person to person by direct contact through the manifestations of syphilis. Usually manifestations of syphilis are present on the external genitalia, vagina, in the rectum. Manifestations can also be on the lips and in the mouth. Syphilis can be transmitted during vaginal, anal, or oral sexual (sexual) contact. Pregnant women with syphilis pass it on to their unborn children. How quickly do signs of infection appear after infection? The median time between syphilis infection and the onset of the first symptom is 21 days, but this time can range from 14 to 90 days. What are the signs of syphilis in adults? Stage of primary syphilis The appearance of a single wound (ulcer, erosion) marks the beginning of the first stage of syphilis, but there may be multiple wounds. The wound appears in the place where syphilis entered the body. The wound is usually firm, round, and painless. Because the wound is painless, it can easily go unnoticed. The wound lasts 3-6 weeks and heals whether the person is treated or not. If the infected person does not receive appropriate treatment, then the disease progresses and passes to the secondary stage. 5

6 Secondary syphilis Skin rash and/or sores in the mouth, vagina, or anus(damage to the mucous membrane) distinguishes the secondary stage of syphilis. This stage usually begins with a rash on one or more areas of the body. The rash associated with secondary syphilis may appear from the time the primary wound heals or several weeks after the wound has healed. The rash usually does not itch. This rash may appear as rough, red, or reddish-brown patches on the body, palms, and soles. However, this rash may look different on other parts of the body and may be similar to rashes caused by other diseases. Large, raised, gray or white lesions may form in warm, moist areas such as the mouth, genitals, or groin area. Sometimes the rash associated with secondary syphilis is so mild that it is barely noticeable. Other symptoms of secondary syphilis include fever, enlarged lymph glands, sore throat, hair loss on the head, eyebrows, eyelashes, headaches, weight loss, muscle and bone pain, and fatigue. Symptoms of secondary syphilis go away after treatment. Without appropriate treatment, the infection will progress to a latent period and advanced stages of the disease. Late and latent stages of syphilis The latent stage of syphilis begins when the main and secondary signs disappear. Sometimes, and often in the Republic of Tyva, syphilis initially proceeds without any manifestations, bypassing the primary and secondary stages, secretly. Especially often syphilis occurs in pregnant women. Without treatment, an infected person continues to have 6

7 syphilis in your body even though there are no signs or symptoms of the disease. This latent stage can last for years. Between 15 and 30% of people who have not been treated for syphilis have manifestations of late syphilis, which can appear 5 to 30 years after the infection begins. Signs of advanced syphilis include bone and muscle damage, paralysis, gradual blindness, and dementia. In the advanced stages of syphilis, the disease damages internal organs including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This damage can lead to death. How does syphilis affect a pregnant woman and her baby? A pregnant woman with syphilis can pass the disease on to her unborn child. Babies with syphilis can have many health problems. Syphilis in pregnant women leads to preterm labor and often to stillbirth. To protect the baby from syphilis, a pregnant woman should be regularly tested for syphilis during pregnancy (when registering at the antenatal clinic for a period of weeks, at 32 weeks of pregnancy and at birth). Urgent treatment should be obtained if blood tests for syphilis are positive. A child infected with syphilis may be born without symptoms of the disease. If not treated immediately, the child may develop serious problems within a few weeks. Untreated babies may have many health problems (cataracts, deafness) and may die. A pregnant woman who has previously received treatment for syphilis and who has a syphilis-positive precipitation microretraction (RPM, formerly called the Wassermann reaction) during pregnancy should receive prophylactic treatment for her baby. The earlier the better. 7

8 How is syphilis diagnosed? Micrograph of Treponema pallidum (pallid spirochete). A blood test for syphilis is the most common way to determine if someone has syphilis. Shortly after infection, the human body produces antibodies to syphilis that can be detected by an accurate, safe, and inexpensive blood test. In a venereal dispensary, syphilis can be diagnosed by examining material from syphilis wounds using a special microscope. If syphilis bacteria are present in the wound, they will show up on observation. Special Note: Because untreated syphilis in a pregnant woman can infect and kill her developing baby, every pregnant woman should receive prenatal care and should be tested for syphilis during pregnancy and delivery. What is the relationship between syphilis and human immunodeficiency virus (HIV-AIDS)? 8

9 Manifestations of syphilis in the mouth, on the genitals, in the vagina, in the rectum facilitate the transmission and transmission of HIV infection. A person with manifestations of syphilis is 2-5 times more likely to become infected with HIV. How is syphilis treated? No home remedies or over-the-counter medicines will cure syphilis, but syphilis can be easily treated with appropriate antibiotics prescribed by a venereologist. The treatment will kill the syphilis bacterium and prevent further damage. People who are being treated for syphilis should refrain from sexual contact with new partners until the syphilis sores are completely healed. People with syphilis should notify their sexual partners so that they can also be tested and treated. Who should be tested for syphilis? Husbands of pregnant women (it doesn't matter what kind of marriage it is - civil or legal), sexual partner (partners) are required to be examined 2 times! 1. when their wives are registered for antenatal care at the antenatal clinic (the gestational age of weeks or more if necessary) 2. at the gestational age of the wife of a week In the Republic of Tyva, such a rule is mandatory! Can syphilis recur, or "come back?" Individuals who have received treatment should be followed up to ensure that the treatment is successful. Having syphilis once does not protect a person from getting it again. Even after successful treatment, people can still be reinfected. Only laboratory tests can confirm if someone has syphilis. A pregnant woman who has previously received treatment for syphilis and who has a positive microprecipitation reaction (RMP, formerly called the Wasserman reaction) for syphilis during pregnancy should receive prophylactic treatment for her child. The earlier the better. Because manifestations of syphilis may be hidden in the vagina, rectum, under the foreskin, or in the mouth, it may not be obvious that a sexual partner has syphilis. If a person does not know that their sexual partner(s) have been tested and treated, they may be at risk of contracting syphilis again from an untreated sexual partner. How can syphilis be prevented? Proper and consistent use of latex condoms can reduce the risk of syphilis. Contact with a wound outside of the area covered by the latex condom can cause an infection. The surest way to avoid the transmission of sexually transmitted diseases, including syphilis, is to abstain from sexual contact or be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. I

10 Transmission of STIs, including syphilis, cannot be prevented by washing the genitals after intercourse, or by urinating or douching after intercourse. Any unusual manifestations, sores, or rash, especially in the groin area, should be a signal to refrain from having sex and an immediate visit to a venereologist or gynecologist. Avoiding alcohol and drug use can also help prevent the transmission of syphilis because these activities lead to risky sexual behavior. It is important that sexual partners talk to each other about their health, their HIV and syphilis status, and other STIs in a way that preventive measures could be accepted. What is chlamydia? Chlamydia is a common sexually transmitted disease caused by a bacterium. Chlamydia can infect men and women and can cause serious, often irreparable damage to a woman's genitals. How common is chlamydia? Chlamydia is a sexually transmitted infection that is most often talked about in Russia. In 2011, 553 cases of chlamydia were reported in the Republic of Tyva, in 2012 - 319 cases. More cases are not reported because most people with chlamydia have no symptoms and do not want to be tested. Chlamydia is most common among young people. How do people get chlamydia? People get chlamydia by having sex with someone who has the infection. "Having sex" means anal, vaginal, or oral sex. Chlamydia can be passed on even if the man is not ejaculating. People who have had chlamydia and have been treated can become infected again if they have sex with an infected person. Chlamydia can also be passed from an infected woman to her baby during pregnancy. Who is at risk of contracting chlamydia? Any sexy active person may be infected with chlamydia. This is a very common STI, especially among young people. It is believed that 1 in 15 is sexy active women aged years has chlamydia. What are the signs of chlamydia? Chlamydia is known as a "silent" infection because most infected people show no symptoms. If there are signs, they may appear a few weeks after intercourse. Even when there are no symptoms, chlamydia can damage a woman's genitals. In women, the bacteria first infect the cervix (the structure that connects the vagina or birth canal to the uterus) and/or the urethra (urethra). Some infected women have abnormal vaginal discharge or a burning sensation when urinating. Untreated infections can spread up to the uterus and 10

11 fallopian tubes (the tubes that carry fertilized eggs from the ovaries to the uterus), causing pelvic inflammatory disease. Pelvic inflammatory disease may be "silent" or may cause signs such as pelvic pain abdominal cavity. Chlamydia leads to infertility (not being able to become pregnant) and other complications. In Russia, 40% of infertility is caused by chlamydia. A serious complication of chlamydia is ectopic pregnancy. Some infected men have penile discharge or cutting and burning with boiling water when urinating. The testicles may enlarge and there is pain in one or both testicles (known as "orchitis" and "epididymitis"). Chlamydia can also infect the rectum in men and women, either through receptive anal sex or through spread from the vagina. While these infections often cause no symptoms, they can cause rectal pain, discharge, and/or bleeding (known as "proctitis"). How are chlamydia and HIV related? Untreated chlamydia can increase a person's chances of acquiring the HIV virus that causes AIDS. How does chlamydia affect a pregnant woman and her baby? In pregnant women, untreated chlamydia can spread to the newborn, causing an eye infection or pneumonia. Getting tested and treated for chlamydia during pregnancy is the best way to prevent these complications. All pregnant women should be tested for chlamydia at their first prenatal visit. Who should be tested for chlamydia? Any sexually active person can be infected with chlamydia. Anyone with sexual symptoms such as discharge, cramps, burning when urinating, unusual sores or rashes should avoid having sex until they are examined and treated by a doctor. In addition, anyone who has recently been diagnosed with an STI after oral, anal, or vaginal contact with a sexual partner should see a doctor for evaluation and treatment. How is chlamydia diagnosed? There are laboratory tests to diagnose chlamydia. Smears or scrapings are taken for verification cotton swab from the vagina, cervix, or urethra. How is chlamydia treated? Chlamydia can be easily diagnosed and treated with antibiotics. HIV-positive people with chlamydia should receive the same treatment as those who are HIV-negative. People with chlamydia should refrain from having sex until the course of antibiotics is completed to prevent spreading the infection to a partner. eleven

12 Chlamydial infection is widespread. Sexual partners who are not examined and appropriately treated, in high risk for reinfection. Having multiple chlamydial infections increases a woman's risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia should be retested one and a half and three months after treatment, whether or not they believe their sexual partners have been successfully treated. Babies infected with chlamydia can develop conjunctivitis and/or pneumonia. Chlamydial infection in infants is treated with antibiotics. What about treating partners? If a person has been diagnosed and is being treated for chlamydia, he or she should tell all partners who have had anal, vaginal, or oral sex in the past 2 months so that they can see a doctor and be treated. This will reduce the risk that sexual partners will develop serious complications and will also reduce the person's risk of being reinfected. A person with chlamydia should avoid having sex with all of his or her sexual partners until they have finished their chlamydia treatment. How can you protect yourself from chlamydia? Latex condoms prevent chlamydia infection in men by 70% with a single sexual intercourse, with their successive and correct application, in women by 50% with a single sexual intercourse. The surest way to avoid chlamydia is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be free. Where can I get more information? GBUZ RT "Reskozhvendispanser" Kyzyl, Republic of Tyva, st. Shchetinkina - Kravchenko, house. 66. Room 7 (for syphilis), room 2 (female), room. 1 (male), cab. 10 (dispensary registration for syphilis and in the evening anonymous paid reception). Tel. Registry Office: Internet address: Based on the materials of special literature, the collection was compiled by the Deputy Chief Physician of the State Budgetary Institution of Healthcare of the Republic of Tatarstan “Reskozhvendispanser”, the Chief Freelance Dermatovenereologist of the Republic of Tatarstan, Candidate of Medical Sciences Obukhov A.P. Photo on the front page from the site and from the presentation “Syphilis in China”, Kyzyl, RT, 2011. 12

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Sexually transmitted infections (STIs) are a group of infectious diseases resulting from ingenious, oral or anal sexual intercourse when the partner is a carrier of the infection. Such diseases are fraught with very serious consequences, both for the mother and for her unborn child. In addition, the presence of such infections can provoke other dangerous diseases with sexual transmission. One of them is HIV infection.

If you do not treat infections of the reproductive system in time, you may encounter such unpleasant phenomena as scars on the reproductive organs. When they affect the fallopian tubes, the risk of an ectopic pregnancy or a woman becoming infertile increases dramatically.

Identification and elimination of sexually transmitted infections STI during pregnancy, are of great importance for the expectant mother and her fetus, therefore, at the first prenatal examination, the gynecologist prescribes necessary tests, which can be used to determine the presence of such problems. Do not try to hide from the doctor the fact of sexually transmitted diseases in the past. You also need to tell the gynecologist if you or the father of the unborn baby had sexual relations with several sexual partners. Women who are at risk due to possible STIs are subject to additional diagnostics. It is carried out when the third trimester of pregnancy begins.

An examination can be carried out at an earlier date if symptoms of such diseases are detected. You can ask your doctor to test you for sexually transmitted infections such as gonorrhea, syphilis, chlamydia, and HIV. must be done because such diseases are not always accompanied by certain symptoms, as a result, a woman may not be aware that she is a carrier of the infection. If you notice any unusual symptoms, inform your doctor immediately so that he can order the necessary tests. If a woman is infected with sexually transmitted infections, then she should be aware of possible consequences for the development of the fetus and their health, as well as how to treat such diseases during pregnancy.

Ways to prevent STIs:

- most reliable method not to become a “victim” of STIs is to exclude any sexual contacts (we are also talking about anal and oral sex), or to have only one proven partner who does not enter into intimacy with other women (or men).

- do not have sexual relations with partners if you find any symptoms characteristic of STIs, this also applies to those people in whom you have full confidence in other areas human life. Use latex condoms, they will reduce the chance of contracting sexually transmitted infections.

both should be treated for STIs at the same time sexual partners, you should not have sex until complete recovery, if these conditions are not met, the treatment will not give the expected result.

- if you are at risk for having an STI, take the hepatitis B vaccine.