STIs in pregnancy. An update for GPs

Pregnancy and sexually transmitted infections (STIs) are both consequences of unprotected vaginal sex. In addition to causing maternal morbidity in their own right, many STIs including human immunodeficiency virus (HIV) can be transmitted to the neonate. Antenatal screening during pregnancy provides an opportunity to minimise or eliminate the antepartum, intrapartum and postpartum consequences of most STIs.

This article discusses the diagnosis, management and treatments available for STIs in pregnancy to minimise morbidity and mortality for both mother and child.

HIV testing in antenatal care should be added to routine syphilis and hepatitis B serology, as effective HIV interventions can significantly reduce the risk of mother-child transmission. Consideration should be given to testing in women less than 25 years of age for chlamydia and those women at increased sexual risk. Male partners should not be forgotten and contact tracing, treatment and follow up offered. Due to the very small risk associated with genital warts and genital herpes, normalisation, information and reassurance are appropriate for the majority of women affected.