STD’s and Vaginal Infections Flashcards
(46 cards)
Chlamydia (Chlamydia trachomatis)
(bacteria)
most common STD in US; most, prevalent in adolescents
What are CM?
Inflammation of cervix with mucopurulent discharge (dc).
May be asymptomatic
Untreated may lead to urethritis,
tubal occlusion, pelvic inflammatory disease (PID) and infertility.
Screening /Diagnosis of Chlamydia
- Screen 1st trimester or when enter healthcare.
- By culture or DNA, probe, or enzyme immunoassay. CDC
recommends nucleic acid amplification test (NAAT) or urinary,
vaginal or endocervical areas - Retest 3rd trimester/ if multiple sex partners or younger than 25
- Test for gonorrhea.
Treatment and management for Chylamidia
Antibiotics (bacterial).
Azithromycin 1 g oral single dose.
Doxycycline 100mg bid for 7 days
Erythromycin ophthalmic ointment NB’s conjunctival sac 1 hour of birth.
Pregnancy/Fetal/Neonatal Effects of Chlamydia
Pregnancy: Increased incidence of PROM, PTL, PID, ectopic pregnancy
Newborn may be asymptomatic.
Conjunctivitis
Scarring
Blindness
Respiratory problems may result in pneumonia.
Gonorrhea
Neisseria gonorrhea – an aerobic gram-negative diplococcus
Clinical Manifestations
Often asymptomatic
Complaint of mucoid or mucopurulent vagina/endocervical discharge,
dysuria and swollen, reddened labia
Pelvic, lower abdominal or rectal pain
Vulvovaginal inflammation progresses to yellow-green
vaginal discharge.
May ascend to involve pelvic structures = PID
Gonorrhea Screening/Diagnosis
Gram stain culture of endocervical, vaginal, rectum and possibly pharynx
Also, chlamydia culture and serologic test for syphilis
Screened at 1st prenatal visit. At risk clients screened again in 3rd trimester (36 weeks)
Gonorrhea Treatment/Management
Ceftriaxone (Rocephin)
125 mg IM single dose
Baby - Erythromycin ophthalmic ointment within 1 hour of birth.
Gonorrhea Pregnancy/Fetal/Neonatal Effects
Pregnancy: amnionitis, PTL and postpartum salpingitis.
Newborn: ophthalmia neonatorum (gonococcal conjunctivitis) If untreated, blindness
Because of the prevalence of
Chlamydia and Gonorrhea all states
have a law requiring preventive
treatment to newborns at birth.
Syphilis
Treponema pallidum (spirochete)
CM’s
-Primary stage: Ulcer - (chancre)
-condyloma – warts maybe present on vulva, perineum or
anus. (flatter than HPV genital warts)
-Secondary - maculopapular rash can be on hands & soles of feet
-This disease progresses to secondary and tertiary stages with varying characteristics.
Syphilis Screening/Diagnosis
Screened at first prenatal visit VDRL or RPR serology and again in 3rd trimester and at time of birth if they are high risk.
(If HIV or other STI always check to see that a RPR or VDRL was done too)
Syphilis Treatment/Management
Penicillin G 2.4 million units single dose. If allergic doxycycline or tetracycline – not to be used in pregnancy)
Treatment by 18th gestational week prevents congenital syphilis in neonate. However, treat at time of diagnosis.
Syphilis Pregnancy/Fetal/Neonatal Effects
Pregnancy: May result in spontaneous abortion or PTL. Transmitted across placenta after approximately 18 weeks gestation.
Newborn: Congenital anomalies and/or congenital syphilis
Congenital syphilis. (Test on cord blood).
Herpes Simplex Virus Type 2
(HSV)
CM’s
Lesions: Pain, red papules; pustular vesicles that break and form wet ulcers that later crust.
Low grade fever, chills, malaise & severe dysuria;
Dyspareunia (pain during intercourse
Herpes Simplex Virus Type 2
(HSV)
Screening/Diagnosis
Screening by history and examination for lesions.
New cases by culture from active lesions.
Multinucleated giant cells in microscopic examination of lesion
exudates.
Herpes Simplex Virus Type 2
(HSV)
Treatment and Management
-Acyclovir (Zovirax) oral 400mg PO tid 7-10 days
-Suppressive treatment with Acyclovir/ 36 weeks decreases viral shedding during delivery.
-Counseled cesarean birth may be indicated if active lesions present.
-MEDICATION IS NOT A CURE.
Herpes Simplex Virus Type 2
(HSV)
Pregnancy/Fetal/Neonatal Effects
Crosses placenta as well as acquired during direct contact
during birth
Human Papilloma Virus (HPV)
CM’s
Condyloma acuminata (genital warts) that spread, enlarge
during pregnancy.
(small soft papillary swellings) in the genital and anorectal regions
Human Papilloma Virus (HPV)
Screening/Diagnosis
Speculum exam,
Pap test (Papanicolaou),
history and SNS
Human Papilloma Virus (HPV)
Treatment/Management
Trichloroacetic acid
Laser treatment
Cryocautery
Human Papilloma Virus (HPV)
Pregnancy/Fetal/Neonatal Effects
Associated with cervical cancer later in life.
Bacterial Vaginosis
Gardnerella
CM’s
Vaginal discharge thin,
grayish with fish-like odor.
Intense pruritus
Bacterial Vaginosis
Gardnerella
Screening/Diagnosis
Wet-mount slide positive
for clue cells
Bacterial Vaginosis
Gardnerella
Treatment/Management
Topical metronidazole
(Flagyl)
Bacterial Vaginosis
Gardnerella
Pregnancy/Fetal/Neonatal Effects
Associated with PTL.
