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Thursday, October 24, 2013

Sexual Transmitting Diseases (STD) and Pregnancy

Posted by Chantel Martiromo,  Article By Kyle J. Norton

Sexual Transmitting Disease (STD), also known as sexually transmitted infection is an illness which can only transmit through sexual intercourse as a result from the infectious partner or IV drug needles after its use by an infected person, through childbirth or breastfeeding, including vaginal intercourse, oral sex, and anal sex.

Types of Sexual Transmitting Diseases (STD)
There are at least 25 different STD have need identified, including
1. Genital Herpes
Genital herpes is a type of sexually transmitted disease affected both men and women. Features of genital herpes as a result of the affects of herpes simplex virus (HSV). It can be transmit through a small opening of the skin and mucous membranes during sexual activity. Symptoms of the disease includes pain, itching, discomfort and sores in your affected area. The biggest concern with disease during pregnancy is that you might transmit it to your baby during child birth, athough the rate of transmitting is very low but it can happen.

2. HIV/AIDS
It is an disease caused by the human immunodeficiency virus (HIV) which can severe damaging the immune system that can lead to infection and inflammation as a result of weakened immune system in fighting against foreign invasion. Symptoms include acute infection, fever, swollen lymph nodes,etc. Your baby may be infected by the virus as a result of sharing blood supply with you or you can transmit the disease during childbirth.

3. Genital warts
Genital wart has a cauliflower-like appearance and is one of most common sexual transmitting disease caused by the human papillomavirus (HPV) with symptoms of itching or discomfort in your genital area , bleeding with intercourse, etc. The main concern is that it can make the vagina less elastic and cause obstruction during delivery, if the wart is in the vagina.

4. Hepatitis B
Hepatitis B, C, a serious liver infectious disease caused by the hepatitis B, C virus (HBV). The infectious person can be a carrier as the virus is not active but sometime it can becomes chronic, leading to liver failure, liver cancer, or cirrhosis. Symptoms of hepatitis B, C include fatigue, loss of appetite,nausea, jaundice. etc. The disease can be transmitted to your baby. In severe case, Hepatitis B, C can threaten the live of your baby.

5. Chlamydia
It is one of common form of bacteria transmitting disease, according to the center for the diseases and control statistics, In 2009, 1,244,180 chlamydial infections were reported to CDC from 50 states and the District of Columbia. The disease can pass to your baby during childbirth. Symptoms of Chlamydia include abdominal pain, low back pain, nausea, fever, pain during intercourse, etc..

6. Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacteria Treponema pallidum. The disease is developed into your stages with no symptom in the first stage, rash in the palm, soles of the feet,, etc. in the second stage. In the latent (hidden) stage of syphilis, no symptoms, the disease is hidden but it can be transmitted through sexual activity. In the final stage, is also known as Tertiary Syphilis, the infectious person may experience symptoms of Heart, Eyes, Brain , Nervous system, etc. damages. According to the statistics, more than 6000 cases of syphilis are reported in the United States alone each year. It is a concern that you may transmit the disease to your baby during child birth.

7. Gonorrhea
Gonorrhea is a type of sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae and most likely to affect the urethra, rectum or throat and the cervix. Symptoms of Gonnorrhea include Increased vaginal discharge painful urination, vaginal bleeding after vaginal intercourse, abdominal and pelvic cramps and pain, etc. It is a concern that you may transmit the disease to your baby during child birth and result of blindness, joint infection, or a life-threatening blood infection in the baby.

8. Trichomoniasis
Trichomoniasis is the most common, curable sexually transmitted diseases. Symptoms of trichomoniasis include smelly vaginal discharge, genital itching, painful urination, etc. (With no symptoms in infectious men). Women with Trichomoniasis are a at higher risk of preterm birth, preterm premature rupture of the membranes (PPROM),having a low-birth-weight baby, etc.

Diagnosis
1. Screen Test
Screen test is an important tool used to detect to evaluate and detect a disease early in individuals without signs or symptoms. It is recommended that women who have a previous history of sexual transmitting diseases or are higher risk of getting them should be evaluated at least once during pregnancy to detect the risk of having them. Screen test includes, hepatitis B surface antigen (HBsAg) test, rapid plasma reagin (RPR) card test, tested for HIV infection, tested for Chlamydia trachomatis, tested for hepatitis C antibodies, etc.

2. Blood test
Blood test can be helpful in detecting certain types of sexual transmitting diseases, including HPV and latest stage of syphilis, etc.

3. Urinary test
It is always important to determine the presence of Chlamydia, Gonorrhea, HIV and other STD.

4. Etc.

Symptoms
Depending to the types of sexual transmitting diseases, please refer to above for more information.

Prevention
A. How to prevent
1. Practice safe sex
Always use condom during sexual activity, including anal sex, oral sex and vaginal sexual intercourse.
2. Limit sex partners
The risk of the diseases increase with numbers of sex partner.
3. Choose your partners with care
4. No alcohol and drug influence
Drunk and druged are always the excuse for not using a condom.
5. Microbicides
According to the article of Microbicide Research Aims to Prevent STDs Polysaccharides, protegrins, buffered gels and a variety of plant and animal extracts are among promising microbicide candidates.Network: Spring 1996, Vol. 16, No. 3, researcher concluded that the interest in microbicides has been fostered, in part, by the need for a female-controlled method that offers women protection against STDs. The best protection currently available is latex condoms, which men control. Yet, while microbicides have been discussed as a method that will benefit women, the development of these products may protect men from contracting STDs as well, Dr. Hitchcock suggests. And they may be more appealing than condoms to use.
6. Etc

Treatments
Conventional medicine
Types of medicine used, depending to the types of sexual transmitting disease, how far into the pregnancy she is and how far the disease has progressed.
Types of treatment in general
1. Antibiotics
For pregnant women infected by hepatitis B and gonorrhea, chlamydia, etc Antibodies are beneficial to the baby with injection at birth.
2. Anti viral medicine
Antiviral pills are beneficial for diseases caused by virus infection, such as herpes. Caesarean section may be necessary if the virus ia active at birth.
3. STD/ HIV/ AID
Antiretroviral drugs are the standard therapy for HIV infection and to prevent the disease to be transmitted to the baby.

Specific treatment
A. Genital Herpes
The medicine used is to reduce the symptoms, not cured. According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines, your doctor will provide you with corrected dose depending the diagnosis.
1. Adults Experiencing Their First Genital Herpes Outbreak, your doctor may prescribe one of the medicine below.
a. Acyclovir 400 mg orally three times a day for 7–10 days
b. Acyclovir 200 mg orally five times a day for 7–10 days
c. Famciclovir 250 mg orally three times a day for 7–10 days
d. Valacyclovir 1 g orally twice a day for 7–10 days
2. Recurrent Genital Herpes
a. Acyclovir 400 mg orally twice a day
b. Famiciclovir 250 mg orally twice a day
c. Valacyclovir 1.0 g orally once a day
d. Famciclovir 250 mg orally three times a day for 7–10 days
According to the study of Once-daily valacyclovir to reduce the risk of transmission of genital herpes, by Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, Douglas JM Jr, Paavonen J, Morrow RA, Beutner KR, Stratchounsky LS, Mertz G, Keene ON, Watson HA, Tait D, Vargas-Cortes M; Valacyclovir HSV Transmission Study Group., researchers found that Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples.

B. Hepatitis B, C
B.1 Hepatitis B
According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines. No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.

B.2. Hepatitis C
According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines. No treatment is available for pregnant women infected with hepatitis C virus (HCV). However, all women with HCV infection should receive appropriate counseling and supportive care as needed. No vaccine is available to prevent HCV transmission.

C. Genital warts
According to the recommedation of the Centers for Disease Control 2010 STD treatment guidelines
C.1. Patient-Applied
1. Podofilox 0.5% solution or gel
OR
2. Imiquimod 5% cream
OR
3. Sinecatechins 15% ointment
C.2. Provider–Administered:
1. Cryotherapy with liquid nitrogen or cryoprobe. Repeat applications every 1–2 weeks.
OR
2. Podophyllin resin 10%–25% in a compound tincture of benzoin.
OR
3. Trichloroacetic acid (TCA) or Bichloroacetic acid (BCA) 80%–90%
OR
4. Surgical removal

D. Trichomoniasis
According to the recommedation of the Centers for Disease Control 2010 STD treatment guidelines
D.1. Recommended Regimens
1. Metronidazole 2 g orally in a single dose
OR
2. Tinidazole 2 g orally in a single dose
D.2. Alternative Regimen
1. Metronidazole 500 mg orally twice a day for 7 days
2. Patients should be advised to avoid consuming alcohol during treatment with metronidazole or tinidazole. Abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole.

E. Syphilis
According to the recommendation of the Centers for Disease Control 2010 STD treatment guideline. the aim of the treatment is to kill the syphilis bacterium and prevent further damage,
1. In early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.
2. For patient has had syphilis for longer than a year, additional doses are needed to treat someone who has had syphilis for longer than a year.
3. People who are allergic to penicillin, other antibiotics are available to treat syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

F. Chlamydia
According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines. Chlamydia can be easily treated and cured with antibiotics.
1. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments.
2. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative.

G. Gonorrhea
According to the recommendation of the Centers for Disease Control 2010 STD treatment guideline. Recommended Regimens
1. Ceftriaxone 250 mg IM in a single dose
OR, IF NOT AN OPTION
2. Cefixime 400 mg orally in a single dose
OR
3. Single-dose injectible cephalosporin regimens
PLUS
Azithromycin 1g orally in a single dose
OR
4. Doxycycline 100 mg orally twice a day for 7 days

H. STD/HIVAID
Antiretroviral drugs are the standard therapy for HIV infection included Sustiva (efavirenz), Atripla (which contains Sustiva), Viread (tenofovir), and the combinations of Videx (didanosine, ddI) and Zerit (stavudine, d4T) or Zerit and Retrovir (zidovudine or AZT). Viramune (nevirapine).
There are some recommended guide for women who have infected by HIV virus, depending to the severity of the diseases. The aim of the treatment is to prevent the diseases to infect the newborn and to protect the health of the mother. HIV treatment should start as soon as possible, including in the first trimester (three months) of pregnancy. After giving birth, the mother should be re-evaluated and treatment may be needed to for health of the mother.

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