Sexually Transmitted

Infections and
Pregnancy
Candidiasis
Other Names
Candidiasis
Yeast Infection
Thrush
1. A Woman with Candidiasis

Candidiasis is a vaginal infection

spread by the fungus candida.
It results in a thick vaginal discharge
that resembles cream cheese and is
extremely pruritic.
The vagina appears red and irritated.
Occurs more frequently during
pregnancy which causes the vaginal
pH to be less acidic.
Cont, Woman with Candidiasis
Also occurs in women being
treated with an antibiotic for
another infection, in women with
gestational diabetes and in
women with HIV infection.
It is diagnosed by microscopic
analysis of the vaginal discharge
mounted on a wet slide
Problems with C. albicans in
hospitals
 Cincinnati Children’s
Hospital Medical
Center
 Patients were getting
oral, genital,
epdiermal, and throat
infections
 Doctors noticed biofilm
in those locations
 Diaper rash in infants
 Some fatalities
Cause

Fungal infection
Normally women have
yeast in their genital region
It becomes a problem
when the yeast grows to
profusely
Is it common?
About 70% of women
will experience a yeast
infection during their life
40% of these women
will have more than one
infection
Symptoms
Itching
Burning
Soreness
Irritation of
Vulva
Symptoms
Under a Microscope
Diagnosis

➢Microscopic
Examination
Microscopic
❖ Swab the infection
❖ Place it on slide
❖ Add a drop of
Potassium
Hydroxide
❖ The solution
dissolves the cells
but leaves the
Candida
Treatment
Over the
counter
vaginal
creams
Oral
Medication
It can go
away on its
own
Prognosis
Candidiasis is
TREATABLE!!!
One should
abstain from
sexual activity
until the
infection is
cured
Preventing Candidiasis
Keeping the area cool,
dry, and clean
Dry off after shower or
swimming
Change out of wet clothes
Wearing cotton underwear
to allow for better air
circulation
 Cont,Woman with Candidiasis
Treatment
 is vaginal application of an over the counter
antifungal cream or oral meds

Miconazole (monistat) for 7 days

Fluconazole (Diflucan) a single dose
Risk Factors
Diabetes
BirthControl Pills
Steroids
Antibiotics
A woman with
trichomoniasis
 2. A woman with trichomoniasis

Trichomoniasis is an infection caused

by a single-cell protozoan spread by
coitus.
A woman may notices a yellow-gray,
frothy, odorous vaginal discharge.
It is diagnosed by examination of
vaginal secretions on a wet slide that
has been treated with potassium
hydroxide (KOH) or by a vaginal
culture.
Cont. A woman with
trichomoniasis
Important to be identified
because they may be
associated with preterm labor,
PROM and pos CS infection.
The drug of choice is a single-
dose oral metronidazole
(Flagyl)
A woman with
Bacterial vaginosis
.
3. A woman with Bacterial vaginosis

Bacterial Vaginosis is a local

infection of ther vagina by
the invasion of, most
commonly, Gardnerella
Vaginalis organisms
The discharge is gray and has
a fishy odor.
3. cont, a woman with
vaginosis
Pruritus may be intense
The treatment is oral
metronidazole (Flagyl) or
Clindamycin for 7 days
If left untreated may cause AF
infections and preterm Labor
as well as PROM.
A woman with
Chlamydia
 4. A woman
Chlamydia with
is one Chlamydia
of the most common
types of vaginal infectionsseen in both
pregnant and nonpregnant women.
The infection is caused by the gram-
negative intracellular parasite.
It causes a heavy, gray-white vaginal
discharge
Screening is by a vaginal culture during
a woman’s first prenatal visit.
 cont. A woman with
Chlamydia
Ifa woman has multiple sexual partners,
screening may be repeated again in the
third trimester.
Therapy for the nonpregnant women is
usually with doxycycline (vibramycin) a
tetracycline but contraindicated during
pregnancy because of possible long
bone deformities.
cont. A woman with
Chlamydia
 Azithromycin (Zithromax) or
Amoxicillin (Amoxil) is used instead
 The woman partner shoul also be
treated to prevent her from being
reinfected
 If left unterated they are associated
with PROM, preterm labor, and
endometritis in the postpartum
period
5. A woman with Syphillis
Syphillis is a systemic
disease caused by the
spirochete Treponema
Pallidum.
The first stage results in a
painless ulcer (chanre) on
the vulva or vagina.
 Early in the pregnancy (before week 18), the
Cont. appears
placenta a woman with syphylis
to provide some protection
against the disease, but after this time, however,
the spirochete crosses the placenta freely and
may be responsible for spontaneous
miscariage, preterm labor, stillbirth or ongenital
anomalies.
 All pregnant women are screened at first
prenatal visit by a VDRL, ART, or FTA-ABS
antibody reaction test.
 Cont.syphilis
 Those with multiple sexual partners are screened
again at about 36 weeks of pregnancy.
 The drug of choice is one injection of Benzathine
Penicillin G during pregnancy, after therapy the
woman may experience a sudden episode of
hypotension, fever, tachycardia and muscle aches
(Jarisch-Herxheimer reaction) this due to the sudden
destruction of spirochetes.
A woman with Herpes
Genital Herpes
 6. A woman with Herpes
Simplex
 Genital Virus isType
herpes infection II by
caused infection
the herpes
simplex virus (HSV) type 2
 The first time the woman contracts a herpes infection,
painful, small, pinpoint vesicle on an erythematous
base develop on her vulva or in the vagina,
accompanied by a low grade fever 3 to 7 days after
exposure, although the symptom fade in a few days
the virus remains in local nerve ganglions, becoming
activated again anytime she has a break in the skin or
also possibly by stress.
Cont. Herpes
 Can be transmitted across the p[lacenta to cause
congenital infection and can also be transmitted to
the newborn after birth
 Those with active lesion are scheduled for CS birth
and if no lesion a vaginal birth is preferable.
 The drug of choice is oral acyclovir (Zovirax) or
valacyclovir (Valtrex)
 Patient can reduce the pain by taking sitz bath or
applying warm, moist tea bags to tha area.
 7. A woman with Gonorrhea

Gonorrhea is an STI caused by the gram-

negative coccus Neisseria Gonorrhoeae.
A yellow-green vaginal discharge may
be present or the woman may be
assymptomatic
It is associated with spontaneous
miscarriage, preterm birth and
endometritis in the postpartum period.
7.A woman with Gonorrhea
Cont. A woman with Gonorrhea
Also the major cause of PID and
infertility.
Diagnosis is made by culture of
the organism from the vagina,
rectum, or urethra.
 Cont gonorrhea
Traditionallybeen treated with
amoxicillin and the current
recommended therapy is oral
cefixime (Suprax) or intramuscular
ceftriaxone (rocephin)
Sexual partner should also be
treated to prevent reinfection
A woman with Human
Papillomavirus Infection
 8. A woman with Human
Papillomavirus Infection
 Human papillomavirus (HPV) causes fibrous
tissue overgrowth on the external vulva
 At first lesion appear as discrete papillary
structures; they then spread, enlarge and
coalesce to form large, cauliflower-like lesion
and tend to increase in size during
pregnancy because of the high vascular
flow in the pelvic area
 Cont.HPV
 Therapy for such lesion is aimed at dissolving
the lesion.
 Podophyllum (Podofin) is the drug of choice for
nonpregnant
 Trichloroacetic acid (TCA) or bichloroacetic
acid (BCA) are applied to the lesion weekly
during pregnancy.
 Large lesion may be removed by Laser Thrap,
cryocautery or knife excision.
Human immunodeficiency
virus (HIV)
 9. A woman with HIV Infection
 Human immunodeficiency virus (HIV) is the
organism responsible for Acquired
Immunodeficiency Syndrome (AIDS) and the
most serious of the STIs because it can be
fatal to both mother and child.
 The virus is contracted through coitus, by
exposure to infected blood, by vertical
transmission across the placenta to the fetus
at birth, or by breastmilk to the newborn
The disorder is caused by retrovirus that
infects and disables the T lymphocytes
CONtitHIV
(without the body cannot fight
infection)
Risk Factors:
Multiple sexual partners of the
individual or sexual partner
Bisexual partners
Intravenous drug use by the individual
or sexual partner
Blood transfusions (rare