Sexual Transmitted Diseases

Subject: Midwifery I (Theory)

Overview

Sexually transmitted illnesses are diseases that are spread primarily through sexual contact. The disease can also be spread in other ways. These are Trichomoniasis, Candidiasis, Gonorrhea, Syphilis, and Acquired Immune Deficiency Syndrome (AIDS). Trichomoniasis is caused by trichomonas vaginitis, an anaerobic bacterium that is particularly harmful to the vaginal epithelium. Candidiasis is a fungal infection caused by Candida Albicans. Neisseria gonorrhea is a gram-negative diplococcus that prefers columnar epithelial tissues. Syphilis is caused by treponema pallidum and can occur before, during, or after pregnancy. Symptoms may be suppressed throughout pregnancy. The incubation period is 6 weeks.

Sexually transmitted illnesses are diseases that are mostly spread through sexual contact. Other means of transmission of the disease exist. They are as follows:

  • Trichomoniasis
  • Candidiasis
  • Gonorrhea
  • Syphilis
  • Acquired Immuno Deficiency Syndrome (AIDS)

Trichomoniasis

Trichomoniasis is caused by trichomonas vaginitis, an anaerobic bacterium that is extremely harmful to the vaginal epithelium. Sexual intercourse is the most common mechanism of transmission. Male and females are both affected.

Clinical Features

  • Increase vaginal discharge, which may be normal to copious, greenish in color, and bubbly in nature.
  • Green, frothy discharge and a friable erythematous cervix are typical symptoms.
  • Micturition frequency and urethritis may also be present.
  • A swab investigation reveals the presence of protozoa.

Management

  • Both husband and wife should be treated concurrently.
  • After 12 weeks of pregnancy, take 400 mg metronidazole three times a day for five days.
  • Maintaining and improving personal/vaginal hygiene.
  • Avoid intercourse until treatment is finished.

Candidiasis

Candidiasis is caused by the fungus Candida Albicans.

Signs and Symptoms

  • Pruritus
  • Thick and white vaginal discharge

Treatment

  • Both husband and wife should treat at once.
  • Antifungal nystatin pessaries are inserted into the vagina at bedtime.

Gonorrhea

Neisseria gonorrhea is a gram-negative diplococcus with a preference for columnar epithelial tissues that causes gonorrhea. The vagina of childbearing age is made up of transitional and stratified squamous epithelium, which protects it against infection; however, resistance may be reduced in prepubertal and postmenopausal women.

Clinical Features

  • 50% of the patient is on asymptomatic
  • Dysuria
  • Vaginal discharge is greenish or yellowish and profuse.
  • Signs and symptoms of urethritis and cystitis may be seen.

Effects on Pregnancy

  • PID (Pelvic Inflammatory Disease)
  • Ophthalmic neo natrum is caused by gonococcus infection conveyed through the birth canal to the neonate's eyes.
  • Cervicitis and bartholinitis are possible complications.
  • If the infection spreads, arthritis may be the culprit.
  • Premature membrane rupture, premature labor

Management

  1. Patients who are clinically suspicious should be referred for proper therapy.
  2. Inj. Procaine penicillin 1.2 mega units I/M twice a day for two days, and cap Ampicillin 500 mg six hours a day. Ceftriaxone 250mg IM in combination with erythromycin 500mg 6 hourly for 7 days.
  3. For neonatal eyes, fortified penicillin eye drops are utilized.
  4. After three months, the patient should be followed up.

Syphilis

Syphilis is a condition caused by Treponema pallidum, and the infection can occur before, during, or after pregnancy. During pregnancy, the symptoms may be suppressed. Six weeks is the incubation period.

Clinical Features

  • Primary syphilis: A rare, painless ulcer develops at the site of inoculation. It will mend on its own in a few weeks.
    • The lymph nodes in the inguinal region are swollen but not uncomfortable.
  • Secondary syphilis: A diffuse coppery rash emerges 6-8 weeks after the initial lesion has healed.
    • Labia, condylomata surrounding the anus. The skin lesions are very infectious, and they can remain dormant for 2-10 years.
  • Tertiary syphilis: The skin, bones, viscera, and mucosal surfaces are all affected by devastating non-infectious lesions.

Effect on Pregnancy

  • Abortion is legal after 20 weeks of pregnancy.
  • Fetal death in utero
  • Stillbirth or macerated death?
  • The birth of a highly infected baby results in neonatal mortality.
  • The infant was born with congenital syphilis.
  • Premature labor is possible.

Management

  • All patients should be tested for VDRl throughout the prenatal period.
  • As soon as a diagnosis is made, treatment should begin.
  • Inj. benzathine penicillin 2.4 million units IM as a single dose for primary or secondary syphilis; if allergic to penicillin, oral erythromycin 2mg daily for 15 days.
  • The patient should be advised to refrain from intercourse until cured.
  • Special precautions should be taken before delivering the patient.
  • The infected baby should be treated in isolation with the mother, and IM aqueous penicillin G 50,000 units per kg/body weight should be given every day for 10 days.
Things to remember
  • Sexually transmitted illnesses are diseases that are mostly spread through sexual contact.
  • Other means of transmission of the disease exist.
  • Trichomoniasis, Candidiasis, Gonorrhea, Syphilis, and Acquired Immune Deficiency Syndrome are among them (AIDS).
  • Trichomoniasis is caused by trichomonas vaginitis, an anaerobic bacterium that is extremely harmful to the vaginal epithelium. Sexual intercourse is the most common mechanism of transmission. Male and females are both affected.
  • Candidiasis is caused by the fungus Candida Albicans. Candidiasis is characterized clinically by pruritus and thick, white vaginal discharge. vaginal discharge is thick and white.
  • Neisseria gonorrhea is a gram-negative diplococcus with a preference for columnar epithelial tissues that causes gonorrhea.
  • The vagina of childbearing age is made up of transitional and stratified squamous epithelium, which protects it against infection; however, resistance may be reduced in prepubertal and postmenopausal women.
  • Syphilis is a condition caused by Treponema pallidum, and the infection can occur before, during, or after pregnancy.
  • During pregnancy, the symptoms may be suppressed. Six weeks is the incubation period.
Questions and Answers

Sexually transmitted diseases are illnesses that are mostly spread through sexual activity. There are more ways that the disease might spread. Which are:

  • Trichomoniasis
  • Candidiasis
  • Gonorrhea
  • Syphilis
  • The syndrome of acquired immune deficiency
  • Give birth too soon.
  • Give birth to a child that is underweight at birth.
  • To acquire gestational diabetes.

 

Trichomoniasis

Trichomonas vaginitis, an anaerobic organism that is highly pathogenic to the vaginal epithelium, is the cause of trichomoniasis. The main method of transmission is through sexual activity. Equal numbers of males and females are infected.

Clinical Features

  • Increase in vaginal discharge, which may be mild to profuse, greenish in color, and bubbly in nature.
  • The traditional appearance involves a friable, erythematous cervix and a green, foamy discharge.
  • Urinary frequency and urethritis may both be present.
  • Examination of swabs reveals the presence of protozoa.

Management

  • The treatment of the husband and wife should occur simultaneously.
  • After 12 weeks of pregnancy, 400 mg of oral metronidazole taken three times daily for five days.
  • Hints for maintaining and enhancing personal hygiene/vaginal hygiene.
  • Encourage delaying sexual activity until after treatment is finished.

Effects on Pregnancy

  • PID (Pelvic Inflammatory Disease) (Pelvic Inflammatory Disease).
  • Ophthalmic neo natrum caused by gonococcus infection that reached the neonate's eyes through the birth canal.
  • Bartholinitis and cervicitis are possible.
  • If the infection spread, arthritis might develop.
  • Preterm labor and premature membrane rupture.

Management

  • Patients who are clinically suspect should be referred for the proper care.
  • For two days, inject 1.2 mega units of procaine penicillin and take a cap of ampicillin 500 mg every six hours. Ceftriaxone 250 mg IM is combined with erythromycin 500 mg six times daily for seven days.
  • Neonatal eyes are treated with drops of fortified penicillin.
  • The patient should be checked on in three months.

Treponema pallidum, which causes the illness syphilis, can infect a person before conception, during conception, or at any point throughout pregnancy. When a woman is pregnant, the symptoms could be muted. There is a six-week incubation period.

Clinical Features

  • Primary Syphilis
    • A painful but unlikely ulcer develops at the injection site. It will naturally heal in a few weeks..
      • Although enlarged, inguinal lymph nodes are not painful..
  • Secondary Syphilis
    • A generalized coppery rash begins to manifest 6–8 weeks after the primary lesion has healed.
      • Labia and condylomata around the anus. Skin lesions can remain dormant for two to ten years and are very contagious.
  • Tertiary Syphilis
    • Characterized by obliterative, non-infectious lesions of the mucosal surfaces, viscera, bones, and skin.

Clinical features

Symptoms of hepatitis B may come and go, and may include:

  • Flu-like symptoms, such as tiredness, aches and pains.
  • Stomach pains, nausea, vomiting, diarrhoea.
  • Loss of appetite.

Effect on Pregnancy

  • Abortion is possible after 20 weeks of pregnancy.
  • Fetal intrauterine death
  • Macerated death or a recent stillbirth
  • Neonatal death results from the delivery of a newborn with a serious infection.
  • Congenital syphilis-affected infant
  • Preterm labor is a possibility.

Management

  • All patients should get a VDRl screening throughout the prenatal trimester.
  • As soon as a diagnosis is made, treatment should begin.
  • For either primary or secondary syphilis, administer benzathine penicillin 2.4 million units intramuscularly (IM) in a single dose; if penicillin allergy exists, administer oral erythromycin 2 mg once daily for 15 days.
  • Patient should be advised to refrain from sexual activity till healed.
  • Special precautions should be taken when delivering the patient.

The infant with the infection should receive IM aqueous penicillin G 50,000 units per kg/body weight every day for 10 days while being treated in isolation with the mother.

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