Sexually transmitted and genital tract infections during pregnancy

Sexually transmitted diseases comprise one of the most common medical complications of pregnancy. Prompt treatment is essential to minimize the risk of fetal and neonatal adverse consequences. At this time, however, no pharmacologic therapy is routinely employed for the viral STDs during pregnancy, including HIV, HSV, and hepatitis B virus. Appropriate antibiotic treatment, considered in the context of fetal drug effects, provides high cure rates for many of the other sexually transmitted agents. The approach of the emergency physician to STDs centers on recognition and treatment; however, all physicians encountering this patient population have a responsibility to facilitate access to primary prophylaxis for STD. This means ensuring that issues related to education regarding transmission of STDs, safer sex, and sexual contact counseling are addressed initially or via a primary care referral. In the appropriate setting, complications of pregnancy due to STDs should also be addressed.