Does the most common vaginal infection relate to infertility, or can it put an existing pregnancy at risk? Here's what you need to know.
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Nothing could be farther from the minds of most mothers-to-be than the possibility of having a sexually transmitted disease. But while there are no statistics on the number of prenatal STDs, it’s likely that pregnant women reflect the female population as a whole. According to the Centers for Disease Control and Prevention in Atlanta, this means one-fifth already have an STD, and one in 20 women will contract one in any given year.
Since some STDs can be extremely dangerous to your baby and treatments may need to be altered during pregnancy, it’s crucial to pay attention to diseases you’d rather ignore. What’s more, it’s your job to ask that you be tested, as screening for some STDs is not routine, and doctors tend to make judgments about whether their patients may have an STD based on socioeconomic status, perceived number of sexual partners and so on. Here’s what to do if you think you might be carrying something more than you bargained for.
Herpes is one of the few diseases you get for life, and many people who have it don’t know they do. Because women who already have the virus transmit their antibodies to the fetus, many of their babies aren’t infected. But if you contract herpes for the first time while pregnant, your baby could be in real trouble. “A pregnant woman could get herpes from a partner who doesn’t know he has it because he only sheds the virus a few times a year, and wind up with a desperately infected baby,” says Zane Brown, M.D., a professor of obstetrics and gynecology at the University of Washington in Seattle.
Brown says as many as half of the herpes-infected infants born to women who contracted the virus during pregnancy will die, and the rest may suffer severe problems, including brain or other organ damage. That’s why it’s critical for you and your partner to get tested as soon as you learn you’re pregnant. You’ll then need to practice safe sex throughout your pregnancy if you’re negative but he’s positive.
No matter when you were infected, the CDC recommends a Cesarean section if you have a herpes outbreak at the time of delivery to help prevent transmission to the baby. Herpes looks like blisters or ulcers near or inside the vagina or rectum, but you should be aware of any itching, tingling or tenderness, since there are often no visible signs. Acyclovir can be given anytime during pregnancy to women experiencing their first outbreak, but the CDC does not recommend routine treatment for pregnant women with recurrent herpes, as the drug could cause fetal abnormalities.
Human papillomavirus (HPV)
It’s not unusual to experience a first outbreak of HPV, or genital warts, during pregnancy, when your immune system is compromised, says Thomas Sedlacek, M.D., adjunct professor of obstetrics and gynecology at Allegheny University of Health Sciences in Philadelphia. While chemically “burning” off the warts is safe during pregnancy, many doctors won’t even treat them then because recurrences are so common and HPV usually poses very little threat to mother or baby.
Gonorrhea often has no symptoms, except for slight vaginal discharge, pelvic pain or burning with urination. But undetected or untreated with antibiotics, it can cause future infertility or ectopic pregnancy, and your baby may be born with an eye infection. Some evidence also links it to preterm labor. Fortunately, gonorrhea screening is generally performed in the first trimester.
Chlamydia is much like gonorrhea in that it often causes similar or no symptoms, but 60 percent to 70 percent of all infected mothers will transmit it to their babies, according to Trent MacKay, M.D., M.P.H., of the CDC’s division of STD prevention. Left untreated with antibiotics, it can cause sterility and ectopic pregnancy and, in newborns, pneumonia and eye infections.
Although syphilis is becoming increasingly rare, it’s one of the most devastating diseases a newborn can get, causing bone deformities, brain or eye damage, even death. Fortunately, nearly all women are screened for syphilis when they start prenatal care, and it’s curable with penicillin. You may or may not notice a painless sore near or inside the vagina or rectum that goes away on its own, although the infection remains.
Taking an HIV test right away is imperative if you have any risk factors, such as multiple sexual partners or have practiced needle sharing. While 25 percent of all HIV-positive moms pass the disease on to their babies, that number drops to 8 percent when infected mothers as well as their newborns receive the antiviral drug AZT. And according to a recent National Institutes of Health study, women who take AZT and have a Cesarean delivery before labor starts have less than a 2 percent risk of giving birth to an HIV-positive newborn. Breastfeeding is out of the question, since HIV is found in breast milk.
Whether it’s primarily an annoyance like HPV or a potentially deadly infection like herpes or HIV, early diagnosis and treatment are essential. Don’t let shyness put you or your baby at risk.