Handout_for_STI

STI/Other Infections

Chlamydia

• Presentation (Manifestations):

  • Often silent, difficult to diagnose. Symptoms are nonspecific.

• Screening/Testing:

  • Culture test.

• Treatment:

  • Oral medications such as azithromycin, doxycycline, or amoxicillin.

• Nursing Implications for Pregnancy:

  • Can cause conjunctivitis or pneumonia in the newborn if untreated.

  • Risks include PROM (premature rupture of membranes), PTL (preterm labor), and postpartum endometriosis.

  • May lead to OPTHALMIA NEONATORUM.

Gonorrhea

• Presentation (Manifestations):

  • Women are often asymptomatic; 1/3 remain undiagnosed.

  • Symptoms include purulent cervical discharge, menstrual irregularities, and pelvic pain (acute or chronic).

• Screening/Testing:

  • Culture test.

• Treatment:

  • IM Ceftriaxone, plus treatment for chlamydia as indicated.

• Nursing Implications for Pregnancy:

  • Risks include salpingitis during the 1st trimester, which may lead to miscarriage, PROM, preterm birth, chorioamnionitis, neonatal sepsis, intrauterine growth restriction, and maternal postpartum sepsis.

  • OPTHALMIA NEONATORUM can occur in neonatal gonococcal infections, potentially leading to blindness if untreated.

Syphilis

• Presentation (Manifestations):

  • Primary: Chancre appears 5-90 days after infection; it is painless.

  • Secondary: 6 weeks to 6 months; characterized by widespread maculopapular rash on palms and soles and generalized lymphadenopathy.

• Screening/Testing:

  • RPR or VDRL tests.

• Treatment:

  • IM penicillin G.

• Nursing Implications for Pregnancy:

  • Untreated maternal disease can lead to fetal or perinatal death in 40% of cases. Prompt treatment generally eliminates fetal infections, but delayed treatment can lead to significant fetal effects, including miscarriage or anomalies.

Human Papillomavirus (HPV)

• Presentation (Manifestations):

  • Lesions often occur in the posterior part of the introitus, vulva, vagina, and anus.

  • May cause profuse vaginal discharge, itching, dyspareunia, or postcoital bleeding.

• Screening/Testing:

  • History, evaluation of symptoms, Pap tests, and physical exam.

• Treatment:

  • No effective treatment to eradicate HPV; lesions may obstruct birth canal, necessitating cesarean delivery.

• Nursing Implications for Pregnancy:

  • HPV may be passed to the neonate during birth, but a cesarean is not mandatory unless lesions obstruct delivery.

Genital Herpes Simplex Virus

• Presentation (Manifestations):

  • Causes painful, recurrent genital ulcers; has two types: HSV-1 (oral) and HSV-2 (genital).

• Screening/Testing:

  • Culture test.

• Treatment:

  • Chronic and recurring; no cure exists.

• Nursing Implications for Pregnancy:

  • Congenital infections can be severe. If lesions are present during labor, a cesarean section is necessary to prevent transmission.

Hepatitis A, B, C

• Hepatitis A:

  • Symptoms include flu-like signs.

  • Screening/Testing:

  • No specific test mentioned for A; prevention through vaccination.

• Hepatitis B:

  • HBSAg; often silent or flu-like symptoms. Vaccine available, but no treatment.

• Hepatitis C:

  • Often asymptomatic with flu-like symptoms. Treatment includes interferon alfa or ribavirin.

• Nursing Implications for Pregnancy:

  • Pregnant women exposed to Hep A can receive immune globulin. Newborns require Hep B vaccine and HBIG. No reported breastfeeding transmission for Hep C.

HIV

• Presentation (Manifestations):

  • Presents with flu-like symptoms.

• Screening/Testing:

  • Blood test required.

• Treatment:

  • No cure available.

• Nursing Implications for Pregnancy:

  • Can be transmitted to fetus; ART and cesarean recommended to prevent vertical transmission.

Trichomonas

• Presentation (Manifestations):

  • Often asymptomatic, but may cause yellowish or green frothy, malodorous discharge, inflammation, dyspareunia, and dysuria.

• Screening/Testing:

  • Wet prep.

• Treatment:

  • Metronidazole or tinidazole orally in a single dose.

• Nursing Implications for Pregnancy:

  • Associated with preterm or low birth weight; can be transmitted to newborn during delivery.

Group B Streptococcus

• Presentation (Manifestations):

  • Often asymptomatic.

• Screening/Testing:

  • Rectovaginal culture test.

• Treatment:

  • IV Penicillin G or Ampicillin.

• Nursing Implications for Pregnancy:

  • Leading cause of neonatal morbidity and mortality.

TORCH Infections

• Overview:

  • Includes Toxoplasmosis, Other (hepatitis), Rubella, Cytomegalovirus, and HSV.

  • Typically present with flu-like symptoms in the mother, but have more serious effects on the fetus/neonate.

  • These organisms are capable of crossing the placenta.