Syphilis if untreated can lead to.. - ANSWER infection may cross placenta to fetus and re-
sult in spontaneous abortion, stillborn infant, premature labor and birth, or congenital syphi-
lis. Major signs of congenital syphilis are enlarged liver and spleen, skin lesions, rashes, ostei-
tis, pneumonia, and hepatitis.
Treatment for syphilis - ANSWER Benzathine penicillin G is primary treatment to cure dis-
ease in both woman and fetus. Women who are allergic are desensitized and then treated.
Gonorrhea infection - ANSWER Not transmitted via placenta; vertical transmission from
mother to newborn during birth may cause ophthalmia neonatorum. Endocervicitis and
weakness of fetal membranes increase risk for premature rupture of membranes and pre-
term labor. Chlamydia infection is likely to accompany gonorrhea infection.
Treatment for gonorrhea - ANSWER Cephalosporins such as ceftriaxone (pregnancy cate-
gory B) are recommended for gonorrhea during pregnancy. Because 20%-50% of women
with gonorrhea also have chlamydial infection, azithromycin or amoxicillin (pregnancy cate-
gory B) is recommended to accompany gonorrhea treatment. Partner also should be treated
to prevent reinfection. Infants are treated with an ophthalmic antibiotic such as ceftriaxone
at birth to prevent ophthalmia neonatorum. Tetracycline should not be used in a pregnant
woman for chlamydial infection that often accompanies gonorrhea
Chlamydia - ANSWER often accompanies gonorrhea. Fetus may be infected during birth
and suffer neonatal conjunctivitis or pneumonitis. Conjunctivitis is prevented by erythromy-
cin ophthalmic ointment. Chlamydia may be responsible for premature rupture of mem-
branes, premature labor, and chorioamnionitis.
Treatment for chlamydia - ANSWER Education is particularly important because infection
is usually asymptomatic. Both partners should be treated to prevent recurrent infection. As
1
, with all STDs, use of condoms decreases risk for infection. Azithromycin or amoxicillin is rec-
ommended treatment during pregnancy. Tetracycline should not be used during pregnancy.
Trichomoniasis - ANSWER Common cause of vaginitis in 10%-50% of pregnant women.
Associated with premature rupture of membranes and postpartum endometritis.
Treatment for Trichomoniasis - ANSWER Metronidazole (Flagyl), pregnancy category B,
may be given to pregnant woman as 2-g single oral dose. Should withhold breastfeeding dur-
ing treatment and 12-24 hr after last dose. Consistent association between fetal abnormali-
ties or injury and metronidazole use has not been upheld
Condyloma Acuminatum - ANSWER also called venereal or genital warts, transmission
may occur during vaginal birth and is associated with development of epithelial tumors of
mucous membranes of larynx in children. Pregnancy can cause proliferation of lesions, which
are associated with cervical dysplasia and cancer
Treatment for Condyloma Acuminatum - ANSWER Common choices for nonpregnant
therapy (podophyllin, podofilox, imiquimod) are not recommended during pregnancy. Exci-
sion of maternal lesions by cryotherapy or cautery may be done.
Oral candidiasis (thrush) - ANSWER may develop in newborns if maternal vaginal infec-
tion is present at birth. It is treated with application of nystatin (Mycostatin) over surfaces of
oral cavity four times a day for several days. Characteristic "cottage cheese" vaginal dis-
charge with vulvar pruritus, burning, and dyspareunia. Vulva may be red, tender, and edem-
atous.
Oral candidiasis (thrush) treatment - ANSWER C. albicans is part of the normal vaginal
flora but may become pathogenic if the yeast becomes excessive. Candidiasis (sometimes
called Monilial vaginitis) is a persistent problem for many women during pregnancy. Exam-
ples of maternal treatment choices include topical nystatin, miconazole, clotrimazole, buto-
conazole terconazole, and tioconazole.
2
sult in spontaneous abortion, stillborn infant, premature labor and birth, or congenital syphi-
lis. Major signs of congenital syphilis are enlarged liver and spleen, skin lesions, rashes, ostei-
tis, pneumonia, and hepatitis.
Treatment for syphilis - ANSWER Benzathine penicillin G is primary treatment to cure dis-
ease in both woman and fetus. Women who are allergic are desensitized and then treated.
Gonorrhea infection - ANSWER Not transmitted via placenta; vertical transmission from
mother to newborn during birth may cause ophthalmia neonatorum. Endocervicitis and
weakness of fetal membranes increase risk for premature rupture of membranes and pre-
term labor. Chlamydia infection is likely to accompany gonorrhea infection.
Treatment for gonorrhea - ANSWER Cephalosporins such as ceftriaxone (pregnancy cate-
gory B) are recommended for gonorrhea during pregnancy. Because 20%-50% of women
with gonorrhea also have chlamydial infection, azithromycin or amoxicillin (pregnancy cate-
gory B) is recommended to accompany gonorrhea treatment. Partner also should be treated
to prevent reinfection. Infants are treated with an ophthalmic antibiotic such as ceftriaxone
at birth to prevent ophthalmia neonatorum. Tetracycline should not be used in a pregnant
woman for chlamydial infection that often accompanies gonorrhea
Chlamydia - ANSWER often accompanies gonorrhea. Fetus may be infected during birth
and suffer neonatal conjunctivitis or pneumonitis. Conjunctivitis is prevented by erythromy-
cin ophthalmic ointment. Chlamydia may be responsible for premature rupture of mem-
branes, premature labor, and chorioamnionitis.
Treatment for chlamydia - ANSWER Education is particularly important because infection
is usually asymptomatic. Both partners should be treated to prevent recurrent infection. As
1
, with all STDs, use of condoms decreases risk for infection. Azithromycin or amoxicillin is rec-
ommended treatment during pregnancy. Tetracycline should not be used during pregnancy.
Trichomoniasis - ANSWER Common cause of vaginitis in 10%-50% of pregnant women.
Associated with premature rupture of membranes and postpartum endometritis.
Treatment for Trichomoniasis - ANSWER Metronidazole (Flagyl), pregnancy category B,
may be given to pregnant woman as 2-g single oral dose. Should withhold breastfeeding dur-
ing treatment and 12-24 hr after last dose. Consistent association between fetal abnormali-
ties or injury and metronidazole use has not been upheld
Condyloma Acuminatum - ANSWER also called venereal or genital warts, transmission
may occur during vaginal birth and is associated with development of epithelial tumors of
mucous membranes of larynx in children. Pregnancy can cause proliferation of lesions, which
are associated with cervical dysplasia and cancer
Treatment for Condyloma Acuminatum - ANSWER Common choices for nonpregnant
therapy (podophyllin, podofilox, imiquimod) are not recommended during pregnancy. Exci-
sion of maternal lesions by cryotherapy or cautery may be done.
Oral candidiasis (thrush) - ANSWER may develop in newborns if maternal vaginal infec-
tion is present at birth. It is treated with application of nystatin (Mycostatin) over surfaces of
oral cavity four times a day for several days. Characteristic "cottage cheese" vaginal dis-
charge with vulvar pruritus, burning, and dyspareunia. Vulva may be red, tender, and edem-
atous.
Oral candidiasis (thrush) treatment - ANSWER C. albicans is part of the normal vaginal
flora but may become pathogenic if the yeast becomes excessive. Candidiasis (sometimes
called Monilial vaginitis) is a persistent problem for many women during pregnancy. Exam-
ples of maternal treatment choices include topical nystatin, miconazole, clotrimazole, buto-
conazole terconazole, and tioconazole.
2
