Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Obstetrics and Gynecology Reports
Erschienen in: Current Obstetrics and Gynecology Reports 1/2022

25.11.2021 | Sexually Transmitted Disease (G Sel, Section Editor)

Sexually Transmitted Infections in Pregnancy, Screening and Treatment

verfasst von: Banuhan Şahin, Buğra Şahin, Gizem Cura Şahin

Erschienen in: Current Obstetrics and Gynecology Reports | Ausgabe 1/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Sexually transmitted diseases (STD) often complicate the pregnancy when conception occurs through unprotected intercourse. The importance and management of STDs in terms of pregnancy are examined in this review.

Recent Findings

During pregnancy, STDs must be investigated and treated aggressively because of the effects on both mother and fetus. With screening tests, an STD such as gonorrhea, chlamydia or syphilis can be determined in approximately 10% of all pregnant patients. In addition, when the spouse is not monogamous, a new STD can be contracted during pregnancy, and any STD in pregnancy has significant risks for the mother and infant. Syphilis, gonorrhea, trichomoniasis, chlamydia, hepatitis B, human immune deficiency virus (HIV), herpes simplex virus 1 and 2 (HSV-1–2) and human papillomavirus (HPV) are infections which affect pregnant women and potentially the fetus.

Summary

STDs are prevalent in pregnant women in many countries and are widely reported to be associated with increased risk of poor maternal and neonatal outcomes. Etiologic screening for syphilis, gonorrhea, trichomoniasis, chlamydia, hepatitis B, HIV, HSV-1–2 and HPV infection in all pregnant women combined with targeted treatment might be an effective intervention. However, the evidence base is insufficient to support the development of global recommendations. Adverse maternal-child health outcomes of potential interest are wide ranging and variably defined. Evidence from observational studies was limited, and trials of presumptive STD treatment have shown mixed results. Cost-effectiveness was influenced by STD prevalence and availability of testing infrastructure and high-accuracy/low-cost tests. Preliminary data suggested high patient acceptability. Preliminary data on harms, acceptability and feasibility and the availability of emerging test technologies suggest that etiologic STD screening deserves further evaluation as a potential tool to improve maternal and neonatal health outcomes worldwide.
Literatur
1.
WHO, Global Health Sector Strategy on sexually transmitted infections 2016–2021 towards ending STIs. 2016: Geneva.
2.
• Teasdale CA, Abrams EJ, Chiasson MA, Justman J, et al. Incidence of sexually transmitted infections during pregnancy. PLoS One. 2018; 13(5): p. e0197696. Findings from this study: screening tests showed, an STD such as gonorrhea, chlamydia or syphilis can be determined in approximately 10% of all pregnant patients.
3.
Bowen V, Su J, Torrone E, et al. Increase in incidence of congenital syphilis-United States, 2012–2014. MMWR Morb Mortal Wkly Rep. 2015;64:1241–5.CrossRef
4.
Nyatsanza F, Tipple C. Syphilis: presentations in general medicine. Clin Med (Lond). 2016;16:184–8.CrossRef
5.
Crino JP. Ultrasound and fetal diagnosis of perinatal infection. ClinObstetGynecol. 1999;42:71–80.
6.
Bowen V, Su J, Torrone E, Kidd S, et al. Increase in incidence of congenital syphilis - United States, 2012–2014. MMWR Morb Mortal Wkly Rep. 2015;64(44):1241–5.CrossRef
7.
Gomez GB, Kamb ML, Newman LM, et al. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ. 2013;91:217–26.CrossRef
8.
Nathan L, Bohman VR, Sanchez PJ, et al. In utero infection with Treponema pallidum in early pregnancy. PrenatDiagn. 1997;17:119–23.
9.
Satterwhite CL, Torrone E, Meites E, Dunne EF, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40:187–93.CrossRef
10.
CDC. Sexually transmitted disease surveillance 2013. Atlanta: US Department of Health and Human Services; 2014.
11.
Alger LS, Lovchik JC, Heel JR, Blackmon LR, et al. The association of Chlamydia trachomatis, Neisseria gonorrhoeae, and group B streptococci with preterm rupture of the membranes and pregnancy outcome. Am J Obstet Gynecol. 1988;159(2):397–404.CrossRef
12.
Workowski KA, Bolan GA. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03): 1–137.
13.
LeFevre ML. USPSTF: screening for chlamydia and gonorrhea. Ann Intern Med. 2014;161:902–10.CrossRef
14.
Costa MC, BornhausenDemarch E, Azulay DR, Perisse AR, et al. Sexually transmitted diseases during pregnancy: a synthesis of particularities. An Bras Dermatol. 2010;85:767–82.CrossRef
15.
Andrews WW, Goldenberg RL, Mercer B, Iams J, et al. The Preterm Prediction Study: association of second-trimester genitourinary Chlamydia infection with subsequent spontaneous preterm birth. Am J ObstetGynecolo. 2000;183:662–8.CrossRef
16.
LeFevre ML. USPSTF: screening for chlamydia and gonorrhea. Ann Intern Med. 2014;161:902–10.CrossRef
17.
Papp JR, Schachter J, Gaydos C, Van Der Pol B. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae. 2014. MMWR Recomm Rep. 2014; 63(No. RR-02): 1–19.
18.
Geisler WM, Wang C, Morrison SG, Black CM, et al. The natural history of untreated Chlamydia trachomatis infection in the interval between screening and returning for treatment. Sex Transm Dis. 2008;35:119–23.CrossRef
19.
Tosun S. Türkiye’de viral hepatit B Epidemiyolojisi Yayınların Metaanalizi, “Tabak F, Tosun S (eds). Viral Hepatit. Viral Hepatitle Savaşım Derneği Yayını, İstanbul MedikalYayıncılık, İstanbul, 2013: 25–8.
20.
Mıstık R. Türkiye’de viral hepatit epidemiyolojisi – Yayınların irdelenmesi, “Tabak F, Balık İ, Tekeli E (eds). Viral Hepatit. Viral Hepatitle Savaşım Derneği Yayını, İstanbul MedikalYayıncılık, İstanbul, 2007: 9–50.
21.
Sookoian S. Liver disease during pregnancy: acute viral hepatitis. Ann Hepatol. 2006;5:231.CrossRef
22.
Stevens CE, Toy PT, Tong MJ, et al. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-activeimmunization JAMA. 1985;253:1740.PubMed
23.
Centers for Disease Control and Prevention. HIV Surveillance Report. 2016; 28.
24.
• Gürlek B, Çolak S, Yılmaz B. Gebelikte Cinsel Yolla Bulaşan Hastalıkların Yönetimi. Journal of Human Rhythm. 2020;6(2):53–73. Findings from this study : AIDS test is repeated in the third trimester in places where the incidence of HIV or AIDS is ≥1/1000 pregnancies or to those at greater risk of HIV infection (those injecting drugs, working in prostitution, with a known or suspected HIV-positive partner, multiple sexual partners, the presence of another STD).
25.
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. 2012; 31: 1–235.
26.
Connor EM, Sperling RS, Gelber R, Kiselev P, et al. Reduction of maternalinfant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med. 1994;331:1173–80.CrossRef
27.
Centers for Disease Control and Prevention (CDC) Recommendations of the U.S. Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus. MMWR Recomm Rep. 1994; 43: 1–20.
28.
Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA2006;296:964–73.
29.
Anzivino E, Fioriti D, Mischitelli M, et al. Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Virol J. 2009;6:40.CrossRef
30.
Overall JC Jr. Herpes simplex virus infection of the fetus and newborn. Pediatr Ann. 1994;23:131–6.CrossRef
31.
Sauerbrei A, Wutzler P. Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 1: herpes simplex virus infections. Med MicrobiolImmunol2007;196:89–94.
32.
Kohl S. Neonatal herpes simplex virus infection ClinPerinatol. 1997;24:129–50.
33.
Rudnick CM, Hoekzema GS. Neonatal herpes simplex virus infections. Am Fam Physician. 2002;65:1138–42.PubMed
34.
Whitley R, Arvin A, Prober C, et al. Predictors of morbidity and mortality in neonates with herpes simplex virus infections. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. N Engl JMed 1991;324:450–4.
35.
Whitley R. Neonatal herpes simplex virus infection. CurrOpin Infect Dis. 2004;17:243–6.CrossRef
36.
Cusini M, Ghislanzoni M. The importance of diagnosing genital herpes. J AntimicrobChemother 2001;47Suppl T1:9–16.
37.
Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR RecommRep. 2010;59:1–110.
38.
Sheffield JS, Hollier LM, Hill JB, et al. Acyclovir prophylaxis to prevent herpes simplex virus recurrence at delivery: a systematic review. ObstetGynecol. 2003;102:1396–403.
39.
Brown ZA, Wald A, Morrow RA, et al. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA. 2003;289:203–9.CrossRef
40.
Sheffield JS, Hollie LM, Hill JB, Stuart GS, et al. Acyclovir prophylaxis to prevent herpes simplex virus recurrence at delivery: a systematic review. Obstet Gynecol. 2003;102:1396–403.PubMed
41.
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines MMWR. 2006;55:1–94.
42.
Garland SM, Steben M, Sings HL, James M, et al. Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine. J Infect Dis. 2009;199:805–14.CrossRef
43.
Silverberg MJ, Thorsen P, Lindeberg H, Grant LA, et al. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis. ObstetGynecolo. 2003;101(4):645–52.
44.
Clifford GM, Gallus S, Herrero R, Munoz N, et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet. 2005;366:991–8.CrossRef
45.
• Lochner HJ, Maraqa NF. Sexually transmitted infections in pregnant women: integrating screening. Pediatr Drugs. 2018;20:501–9. Findings from this study: increase in birth size can be observed, spreading to an extent that can even close the birth canal.
46.
47.
•• Şahin B, Şahin B. Gebelikte Perinatal Enfeksiyonlar. Jinekolojik & Obstetrik Aciller ve Gebelikte Covid 19' a Yaklaşım 2021;1:1387–401. Findings from this study: anogenital warts may proliferate during pregnancy and may have a tendency to bleed. When warts are removed in pregnancy, there may not be full healing during the pregnancy. Some lesions can be expected to regress spontaneously after the birth. Therefore, in suitable cases, treatment can be postponed until after the birth.
48.
•• Grant JS, Chico RM, Lee ACC, Low N, Medina-Marino A, Molina RL. Sexually transmitted infections in pregnancy: a narrative review of the global research gaps, challenges, and opportunities. Sex Transm Dis. 2020;47(12):779–89. Findings from this study: sexual partners must be clinically evaluated and there must be investigation of other STD agents.
Metadaten
Titel
Sexually Transmitted Infections in Pregnancy, Screening and Treatment
verfasst von
Banuhan Şahin
Buğra Şahin
Gizem Cura Şahin
Publikationsdatum
25.11.2021
Verlag
Springer US
Erschienen in
Current Obstetrics and Gynecology Reports / Ausgabe 1/2022
Elektronische ISSN: 2161-3303
DOI
https://doi.org/10.1007/s13669-021-00318-z

Weitere Artikel der Ausgabe 1/2022

Current Obstetrics and Gynecology Reports 1/2022 Zur Ausgabe

Family Planning (A Burke, Section Editor)

Alleviating Pain with IUD Placement: Recent Studies and Clinical Insight

Uterine Fibroids and Endometrial Lesions (T. Tulandi, Section Editor)

Classifications of Adenomyosis and Correlation of Phenotypes in Imaging and Histopathology to Clinical Outcomes: a Review

Sexually Transmitted Disease (G Sel, Section Editor)

HPV and Oral Cavity Diseases

Reproductive Endocrinology and Infertility (REI) (R Anchan, Section Editor)

Preimplantation Genetic Testing for Aneuploidy: Has the Controversy Settled? A Review

Sexually Transmitted Disease (G Sel, Section Editor)

Association of Human Papillomavirus and Chlamydia trachomatis Coinfection with Cervical Intraepithelial Lesions and Cervical Cancer

Family Planning (A Burke, Section Editor)

New Contraception Update — Annovera, Phexxi, Slynd, and Twirla

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Antikörper-Wirkstoff-Konjugat hält solide Tumoren in Schach

16.05.2024 Zielgerichtete Therapie Nachrichten

Trastuzumab deruxtecan scheint auch jenseits von Lungenkrebs gut gegen solide Tumoren mit HER2-Mutationen zu wirken. Dafür sprechen die Daten einer offenen Pan-Tumor-Studie.

Mammakarzinom: Senken Statine das krebsbedingte Sterberisiko?

15.05.2024 Mammakarzinom Nachrichten

Frauen mit lokalem oder metastasiertem Brustkrebs, die Statine einnehmen, haben eine niedrigere krebsspezifische Mortalität als Patientinnen, die dies nicht tun, legen neue Daten aus den USA nahe.

Neue S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Gestationsdiabetes: In der zweiten Schwangerschaft folgenreicher als in der ersten

13.05.2024 Gestationsdiabetes Nachrichten

Das Risiko, nach einem Gestationsdiabetes einen Typ-2-Diabetes zu entwickeln, hängt nicht nur von der Zahl, sondern auch von der Reihenfolge der betroffenen Schwangerschaften ab.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen
Bildnachweise