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Sexually Transmitted Diseases

Being pregnant doesn't protect you from acquiring a sexually transmitted disease (STD). If you become infected with an STD during pregnancy, or if you already have one when you become pregnant, you put your own health and your baby?s health at risk. Many STDs have few symptoms, so the Centers for Disease Control (CDC) suggests that all pregnant women -- young or old, married or not -- be tested for STDs during their first prenatal visits. Most of these diseases can be treated easily, before any harm can come to your baby. The most common include:

  • Genital herpes simplex infection

    At least one-fourth of all American women have genital herpes, a sexually transmitted disease caused by herpes simplex virus. Because this virus doesn't cause symptoms in everyone, many people don't even know that they're putting their partners at risk for the infection. The initial infection often causes only general symptoms, such as fever, swollen glands, and fatigue. Only a small percentage of people who have herpes ever develop the itchy, painful blisters in the genital area that make the virus easier to diagnose.

    If you know you have genital herpes, tell your provider at your first prenatal visit. If you don't have herpes but your partner does, tell your provider. Children born to mothers with active herpes infections at the time of labor run a small risk of contracting the disease themselves and may develop eye infections or sores on the skin or mouth. These infections aren't serious if treated with antiviral drugs immediately. However, herpes can morph into more life-threatening infections of your baby's brain or internal organs, so your provider will want to deliver your baby by cesarean if you have an active infection when you go into labor. If you have herpes and get frequent outbreaks, your doctor may suggest that you start taking an antiviral drug such as Acyclovir beginning at 36 weeks to prevent an outbreak at delivery.

    During pregnancy it's important to protect yourself against contracting herpes for the first time. Be sure that your partner is tested, and if your partner's test is positive, use a condom; avoid intercourse if he has symptoms. You should also avoid oral sex if your partner has cold sores in his mouth; cold sores may be caused by a herpes simplex virus. Your provider might suggest that you abstain from intercourse altogether during your 3rd trimester if your partner tests positive.
  • Chlamydia

    Chlamydia affects about 10 percent of all expectant mothers. You're at higher risk for having chlamydia if you're under 25 years old or have had multiple sex partners. Only about half of all women with chlamydia experience any symptoms, which usually include a burning sensation while urinating or a vaginal discharge. Unfortunately, whether you have symptoms or not, this infection can have devastating effects if it goes untreated. It can spread to your upper genital tract and cause pelvic inflammatory disease, ectopic pregnancy, or infertility. Your baby might become infected during delivery and contract pneumonia or eye infections as a result.

    The Centers for Disease Control recommends that all pregnant women be tested for chlamydia. This is easily done by taking urine or vaginal fluid samples. If your test is positive, your provider will prescribe a safe antibiotic. She'll suggest that your partner get tested too so you can avoid passing the parasite back and forth during pregnancy.
  • HIV

    About 160,000 women in the United States are now living with HIV, the virus that causes AIDS (acquired immune deficiency syndrome). This virus brings on symptoms that are mild at first or that can easily be mistaken for cold or flu symptoms; for this reason, many women don't realize that they're infected. The Centers for Disease Control is now recommending that all pregnant women be offered testing for HIV at the first prenatal visit.

    Whether or not you suspect that you're infected with HIV, it's wise to have the test for your baby's sake. Expectant mothers with the virus can now get treatment, which is usually a combination of medications, to prevent passing the infection to their unborn babies. New drugs make it possible to reduce the risk of passing HIV on to your baby to less than 2 percent; the risk jumps to 25 percent in mothers who are untreated. Women with advanced HIV may need cesarean deliveries to further protect their babies from contracting the virus.

    If you do not get tested in early pregnancy, your provider may ask you again during labor if you'd like to be tested using a rapid HIV test. If you test positive, your baby will have the benefit of medications to prevent transmission during delivery.

Originally published in You & Your Baby: Pregnancy.

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