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INFECTION IN
PREGNANCY
Presented by: Marie Charisma Ubia
WHAT IS A STI?
cream cheeze)
(extremely pruritic) ~ itchy
TREATMENT
Vaginal application of an over the counter
anti fungal cream such as miconazol
(moistat) for 7 ays or single dose of oral
fluconazole (Difluean)
If infection present in the vagina during
childbirth may cause candidal infection or
thrush in the newborn.
SEE PRACTITIONER
Will give prescription or recommend a specific over
the counter anti fungal cream or suppository thats
safe during pregnancy
Ypu can soothe the intching with an ice pack and
soaking for 10 minutes in a cool bath
Wont affect the baby.
Thrush Characterized by white patches on the sides
and roof of the mouth and sometimes on the tongue.
WOMAN TRICHOMONIASIS
TRICHOMONIASIS (AKA TRICH)
Fairly common STD caused by microscopic
parasite/single cell protozoan spread by
coites.
Trichimonas Vagiralis (T. Vagiralis)
highly contagious protozoan.
Signs and symptoms
Vaginal discharge (greenish-yellow and frothy
with small bubbles)
Consequences of Trichomoniasis
Preterm labour
Low birth weight infants (growth restriction)
Pre mature rapture of membranes
Post-cesarian infection
Bacterial Vaginosis(BV)
Local infection of the vagina
Gardnerella Vaginalis
Most common infection in pregnant women.
Mild infection and is easily treatable with
medication
Bacterial imbalance/not sexually tranmitted
S/SX
Asymptomatic 50%-70%.
Foul smelling vaginal discharge.
Discharge usually thin and dull gray or whit
Drug of choice
Metronidazol orally (Flagyul) (7days)
Tindazole (Tindamax) oral med (7days)
Clindamycin (Cleocin &Clindesse) (7days)
Topical med inserted into the vagina)
painless
Secondary Stage
Non itchy rash , commonly on their palms
and sores
Lesions in mouth and vagina
Painless but infectious wart like sores in the
genital area
Flu-like symptoms
Weight loss
Hair loss
Tertiary Syphilis
Serious
Lethal
Meningitis
Late
No symptoms(asymptomatic)
70% of women have mostly no signs and
symptoms
Pain on passing urine
Vaginal discharge containing puss
Mild lower abdomal pain
Pain during sex
Bleeding after sex or in between periods
Severe pelvic pain
TREATMENT
Drug of Choice
Complications
TREATMENT
Acyclouvir (IV)
(antiviral medication) for women(pregnant)
who get very sick during primary infection.
Valacyclovir (Valtrex)
Sitz Baths
Applying warm, moist tea bags to the area.
Applying warm, moist tea bags to the area.
DIAGNOSIS
Mostly asymptomatic
Cervix,
Vagina , Urethrn
Abnormal vaginal discharge
Pain/burning during urination
Spotting and pain during intercourse
Anal infection
Discharge
Itching/Pain
Treatment
Amoxicillin
Azithromycin
TREATMENT
Trichloroacetic acid
Bichloroacetic acid
Applied
to the lesions
Large lesions maybe removed by
Laser therapy
Cryocautery
Knife excision
Healing 4-6 weeks
Sitz bath and a lidocaine cream may soothe during
healing
EFFECTS ON PREGNANCY
HEPATITIS B
What is Hepatitis B?
Hepatitis means inflammation of the liver.
HepatitisB is a contagious liver disease that
results frominfection with the Hepatitis B
virus. When a personbecomes infected, the
Hepatitis B virus can stay in thepersons
body for the rest of his or her life and
causeserious liver problems.
What is HBIG?
HBIG is a medicine that gives a babys body a
boost or extra help to fight the virus as
soon as he or she is born. The HBIG shot is
only given to babies of mothers who have
Hepatitis B.
How many Hepatitis B shots does baby need?
After the first dose is given in the hospital,
the next dose is given at 1- 2 months of age.
The last dose is usually given by the time the
baby is one year old. We can ask doctor or
nurse when the baby needs to come back for
each shot. Prevent Hepatitis B. Get the baby
vaccinated.
HIV / AIDS
HIV is the virus that causes AIDS
The definition of AIDS relates to CD4+ T-cells
Count
Healthy adults usually have CD4+ T-cell counts of
1,000 or more
Aids and some HIV sufferers have less than 200
CD4+ T-cells
FURTHERMORE
dry cough
EFFECTS ON PREGNANCY
Spontaneous abortion
Stillbirth
Maternal mortality
Newborn mortality
Preterm delivery
Amnionitis (inflammation)
TREATMENT
MODES OF TRANSMISSION
blood
blood products
sexual fluids
People can be infected and NOT look sick or even
have AIDS but can still transmit HIV
Tuberculosis
INTRODUCTION
CONT..
CONT..
CAUSATIVE AGENTS:
PREDISPOSING FACTORS
CLINICAL FEATURES:
DIAGNOSTIC EVALUATION:
CONT..
EFFECT ON PREGNANCY
MOTHER:
Pregnant women with untreated TB are more likely to have preeclampsia, spontaneous abortion, preterm labour, difficult labour
and PPH.
Intrauterine fetal death.
Anemia
FETUS:
Under weight infant
Low apgar score
Perinatal death
IUGR
Preterm labour.
New born baby is at risk of postnatally acquired TB if mother has
still TB at the time of birth.
PREVENTION
CONT
CONT..
CONT
THERAPEUTIC MANAGEMENT
The principles of treatment for the pregnant woman
with TB are same as in the non pregnant patient.
The treatment of TB in pregnancy is important for two
reason.
For serious consequences of untreated TB and the risk of
its
spread to newborns.
Secondly the effect of the drugs used in its treatment on
the fetus.
1.Women with positive purified protein derivates (PPD)
and no evidence of active disease (asymptomatic),
Isoniazid prophylaxis 300mg/day is started after the
first trimester and continued for 6-9 months.
Pyridoxine (vit.B6) 50mg/day is added to prevent
peripheral neuropathy.
Daily doses-PO
Isoniazid
(pyridoxine)
Hepatitis, peripheral
neuropathy,
hypersensitivity.
Rifampicin
Nausea, vomiting,
hepatitis, orange
discoloration of urine
and secretion, febrile
reaction.
Ethambutal
Pyrazinamide
Hepatotoxicity, skin
rash, arthralgias,
hyperuricemias, G.I.
upset.
CONT..
3.Surgical management should be withheld, if
possible, but if deemed necessary should be
restricted for first half of pregnancy beyond 12
weeks.
OBSTETRICAL MANAGEMENT
During pregnancy
DURING LABOUR
CONT
Baby
should be given prophylactic isoniazid 1020mg/kg/day for 3 month when the mother is
suffering from the active disease.
If the mother is on effective chemotherapy for
at least 2 weeks, there is no need to isolate
the baby. BCG should be given to the baby as
early as possible.
CONT..
NURSING MANAGEMENT
CONT
CONT..
Complaining
CONT..
CONT..
CONT..
If the separation of mother and baby is not
practicable, the baby may be given
protective dose of isoniazide as
prophylactic:10-20 mg/kg/day for 3 months.
THANK YOU