Sexually Transmitted Diseases

Sexually Transmitted Diseases

Gonorrhea

If untreated will give rise to much ill-health and pelvic discomforts.

Signs and Symptoms

·              Profuse, purulent discharge.

·              Pain and frequency of micturition.

·              Vaginitis-infection of the Skene's gland. Bartholin's gland and cervical glands. On microscopical examination.

·              Gonococcus may be found. Treatment- Penicillin group of drugs.

Nursing Care;

·              Hands must be carefully washed after the treatment is given. Gloves should be worn, especially if any abrasion is present on the hand.

·              Toilet requisites, kept separate and sterilised carefully after discharge.

·              The eyes of the newborn must carefully be wiped before opening and prophylactic drops can be instilled.

·              While giving bath to the baby, prevent the water from head or face from entering the eyes.

Complications

a. To the mother Salpingitis, ectopic gestation, sterility.

b.  For the baby Ophthalmia neonatorum.

Syphilis

Effect of Untreated Syphilis on Pregnancy

1.           Sterility

2.           Abortion may occur after the 20th week

3.           Premature labour

4.           Intrauterine death

5.           Congenital syphilis of the baby

Treatment

Prophylatic routine blood test of all pregnant women for Wasserman and Khan.Early treatment of infected person and thus preventing congenital syphilis. Penicillin therapy is used and if the treatment is started after the 28th week, the result is good.

Nursing Care

If infected lesions are present, barrier nursing to protect the other patients. After the birth of the baby the mother must attend the clinic for repeated check-up for three months. If necessary treatment must be repeated for subsequent pregnancies but if the treatment has been adequate and Khan test is negative, no further treatment is necessary.

Congenital Syphilis

Babies are very rarely born with syphilis, the skin lesion of the palm of the hand, and sole of the feet at birth are suspicious and snuffles at about 4 weeks. The cry become hoarse, fissures at the centre of the lips, the angles of the mouth and around the anus, sore buttock and saddle nose at about 12 months.

Treatment

·              Prevent by early recognition of maternal condition

·              Treatment in early pregnancy

·              Isolate the baby and give intensively penicillin therapy

·              Baby must have a Wasserman test every 3 months for 2 years.

Human Immunodeficiency Virus (HIV)

Recent studies have shown that increasing number of women of child-bearing age is infected with HIV; 30 to 40% of whom will transmit the infection to their infants in utero or during perinatal period. There is no known treatment for pregnant woman with acquired immunodeficiency syndrome (AIDS). There are poor maternal and perinatal outcome 25 to 40% of infected infants will die before their second birthday.

Those at risk of developing AIDS are sexual patners of men with AIDS, intravenous drug abusers, recipients of blood transfusion and women from tropical countries of Africa and Asia. It is recommended that these women are screened in pregnancy and if found to be seropositive early treatment and care can commence before she carries the pregnancy to term, long-term follow-up studies on mother and child are needed as antiviral treatment may be beneficial if started in infancy.

Non-venereal Vaginal Infections

Vaginal discharges

Because the normal acid medium of the vagina is altered sometimes in pregnancy; the vaginal discharge are quite common. Certain organisms grow readily if it is slightly less acid or more acid. Leucorrhoea is a white creamy discharge which is merely excessive discharge from the cervical gland. It is normal, and if there is no irritation, requires no treatment.

Trichomonas vaginalis is an offensive, purulent discharge greenish yellow in colour and is associated with soreness and extreme irritation to the vulva. Though it is common in pregnancy it can occur at other times also.

Causative organism is protozoa. Trichomonas vaginalis is seen under microscope while examining a fresh vaginal discharge. It grows readily in a less acid medium.

Treatment

·              Medical aid

·              Clean and vagina with dry swab

·              Apply gentian—violet

·              metronidazole gel or tablet cotrimazole pessaries daily for 7days..

Vaginal Thrush

This is fungi infection of the vagina and is caused by Monilia albicans. It readily grows on an acid moist mucus surface. The mouth of the newborn babies, and the vagina of the pregnant women being the common site of infection.

Signs and Symptoms

·              Soreness and irritation of the vagina with intense itching.

·              Profuse white or yellow discharge, which patches fungus in the vaginal wall. Microscopic examination of vaginal discharge shows the organisms.

Treatment

Medical aid; swab the vagina and vulva dry paint with an aqueous solution of gentian violet 1 per cent 2 or 3 times a day.

Vulva Warts

May occur which are not due to syphilis or gonorrhea. Cause is thought to be viral infection and vaginal discharge and lack of cleanliness

Treatment

·              Clean with soap and water.

·              Small warts may be touched with collodion salicylate.

·              Extensive warts are cured by removing them by an electric cautery under local anaesthesia.

Diseases which pre-exist or occur during pregnancy do not confine to pregnancy alone. Some of them can affect pregnancy adversely and pregnancy can affect this condition also adversely. Sometimes they prove fatal to the mother.