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Maternity Chapter 7

Sexually Transmitted Infections

Reproductive tract infection encompasses both sexually transmitted infections and other common genital tract infections
how many sti infection every year? more than 19 million Americans are infected with STIs every year almost half of these are between the ages of 15 and 24
common sti infections: chlamydia, gonorrhea, human papillomavirus, herpes simplex virus type 2, syphilis, and HIV infection;
How to help patient with prevention of STI: include questions about a woman's sexual history, risky sexual behaviors, and drug-related risky behaviors as a part of her assessment Use openended questions
Chlamydia (Chlamydia trachomatis) it is the most commonly reported STI in American women. Can lead to: Pelvic inflammatory disease increased risk of ectopic pregnancy neonate developing conjunctivitis or pneumonia silver nitrate solution or antibiotic ointment does not stop transm
Screening for Chlamydia (asymptomatic condition) during 1st prenatal visit, then late in 3rd trimester if mother is under 25, or has new or multiple partners, or was previously positive. Sexually active adolescents under 25 should get tested every year
Treatment of Chlamydia doxycycline and azithromycin
Gonorrhea (asymptomatic) oldest communicable disease in the United States and second to chlamydia in reported cases. (asymptomatic)
salpingitis general term for infection of the uterus lining, fallopian tubes, or ovaries. >>Occurs in the 1st trimester of pregnancy with cervical gonorrhea Ophthalmia neonatorum can cause blindness in neonate
Treatment of gonorrhea cefixime or ceftriaxone
Syphilis caused by Treponema pallidum, a motile spirochete. Transmission is thought to be by entry in the subcutaneous tissue through microscopic abrasions that can occur during sexual intercourse. It has multiple stages
Primary Syphilis characterized by a primary lesion, the chancre, that appears 5 to 90 days after infection.
Secondary Syphilis occurs 6 weeks to 6 months later, characterized by a widespread, symmetric maculopapular rash on the palms and soles and generalized lymphadenopathy. The infected individual also may experience fever, headache, and malaise.
Screening for Syphilis may show false negative if in active phase retest 1-2 months later
Treatment of Syphilis Penicillin Although doxycycline, tetracycline, and erythromycin are alternative treatments for penicillin-allergic clients, both tetracycline and doxycycline are contraindicated in pregnancy, and erythromycin is unlikely to cure a fetal infection.
Jarisch-Herxheimer reaction Can occur when treated for syphilis acute febrile reaction often accompanied by headache, myalgias, and arthralgias that develop within the first 24 hours of treatment. Treated with analgesics and antipyretics.
Pelvic Inflammatory Disease(PID) infectious process that most commonly involves the uterine (fallopian) tubes (salpingitis), uterus (endometritis), and more rarely, the ovaries and peritoneal surfaces.
PID Screening screen in sexually active young women with the following: lower abdominal tenderness, bilateral adnexal tenderness, and cervical motion tenderness.
Human Papillomavirus >also known as condylomata acuminata, or genital warts, >is the most common viral STI seen in ambulatory health care settings. >20 millions >Lesions enlarge during pregnancy
Screening for HPV A woman with HPV lesions may complain of symptoms such as a profuse, irritating vaginal discharge, itching, dyspareunia, or postcoital bleeding.
Treatment of HPV warts may resolve on their own no treatment is the best bathing with oatmeal solution and drying with cool hair dryer can provide relief wear cotton underwear to keep the area dry maintain healthy lifestyle to boost immunity
Prevention of HPV Two vaccines are available: Cervarix and Gardisil Practice safe sex
Genital Herpes Simplex Virus HSV infection results in painful recurrent genital ulcers and is caused by two different antigen subtypes of herpes simplex virus: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). #2 transmitted sexually #1 transmitted nonsexually
Symptoms of HSV An initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria and may last 2 to 3 weeks. Cervicitis can occur
Screening for HSV history of headache, fever, or myalgia is suggestive. Local symptoms such as vulvar pain, dysuria, itching or burning at the site of infection, and painful genital lesions that heal spontaneously also are highly suggestive of HSV infections.
Treatment of HSV No known cure medications include acyclovir, valacyclovir, and famciclovir. Cleaning lesions twice a day with saline will help prevent secondary infection. using warm sitz baths with baking soda and keeping area dry
Hepatitis A fecal-oral route by ingestion of contaminated food also transmitted sexually
Hepatitis B virus (HBV) most threatening to the fetus and neonate
Management of Hepatitis increase rest periods, eat a high-protein, low-fat diet; and increase fluid intake. Give the vaccine
Hepatitis C readily transmitted through exposure to blood treatment: Interferon-alfa alone or with ribavirin for 6 to 12 months is the main therapy for chronic HCV-related liver disease
HIV 37,000 new infections every year!
Counseling for HIV testing has two parts explanation part result is given is 2nd part
Treatment of HIV
Created by: ekm



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