Sexual Health | Pregnancy and children | STIs in Pregnancy

STIs in Pregnancy
Session Overview
Description
This session describes the sexually transmitted and other genital infections that can affect pregnancy. It also explains the diagnosis and where it may differ between pregnant and non-pregnant patients, complications, treatment and management, considering the relevance of the trimester and risk to the foetus and mother.

Learning Objectives
By the end of this session you will be able to:

• Describe the antenatal screening programme for STIs in pregnancy
• Summarise the immunological and physiological changes in pregnancy that influence the response to STIs
• Describe special considerations for the management of STIs in pregnancy
• Describe the approach to the pregnant woman with symptoms
• List the STI and other genital infections that can affect pregnancy
• Discuss interpretation of results for specific infections and their implications for management
• Describe the complications to the mother and impact on the foetus of specific infections
   

Prerequisites
Before commencing this session you should complete the following:

• Session - Module 1/Female Anatomy and Physiology (260_0005)
• Session - Module 1/Female Genital Examination (260_0010)
• Session - Module 9/Antenatal Screening for Syphilis (260_0103)
• Session - Module 16/The Epidemiology of STIs and HIV in the UK and Internationally (260_0181)

Screening for infectious diseases has been a feature of antenatal care for many years. The Department of Health's 2003 'Screening for Infectious Diseases in Pregnancy: Standards to Support the UK Antenatal Screening Programme' consolidated this ongoing and varied practice into a national screening programme which includes susceptibility for:

• Hepatitis B
• HIV
• Syphilis

The screening programme previously included testing for rubella susceptibility. The decision was made to stop screening for this routinely from 1st April 2016 in view of the low likelihood of exposure to rubella following the successful MMR vaccination programme.

The screening programme has been extremely effective (Fig 1), with uptake of screening for all infections being persistently high (>95%).