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(BQ) Part 1 book “ABC of sexually transmitted infections” has contents: STI control and prevention, provision and modernisation of sexual health services, the sexual health consultation in primary and secondary care, examination techniques and clinical sampling, main presentations of sexually transmitted infections in male patients,… and other contents.
es Mother • The risk of vertical transmission of genital herpes depends whether it is the first episode or recurrent herpes • It can be difficult to distinguish between recurrent and first episode genital herpes; type-specific herpes simplex virus (HSV) serology may be helpful First episode • • • • • • Figure 11.3 Congenital syphilis of infant Courtesy of CDC/Dr Norman Cob Give oral or intravenous aciclovir depending on the clinical severity (Aciclovir is not licensed for use in pregnancy but has been used extensively in pregnant women with no reported problems.) Vaginal delivery should be planned Daily suppressive aciclovir from 36 weeks reduces the likelihood of HSV lesions at term and the need to offer caesarean section (CS) The risk of transmission is greater (up to 40%) when the first episode occurs in the third trimester CS should be offered to all women with first episode at the time of delivery, or within weeks of expected date of delivery (EDD) or onset of labour If vaginal delivery is unavoidable, aciclovir treatment of the mother and baby should be considered Recurrent episodes • • • • (a) • (b) Figure 11.4 Congenital syphilis on: (a) teeth, and (b) mouth Recurrences during pregnancy pose no threat to the pregnancy or fetus The risk of neonatal herpes with recurrent HSV at onset of labour is 90% are diagnosed before delivery • Screening for STIs and genital infections should be performed early in the pregnancy • HIV probably has little effect on pregnancy outcome but highly active antiretroviral therapy (HAART) appears to increase preterm birth • HIV can be transmitted to the infant in utero, at delivery, and by breastfeeding; the majority of cases occur during delivery • Risk of transmission depends on maternal HIV viral load; higher viral loads are associated with increased risk • Prior to the routine use of HAART, the transmission rate was 13% in Europe in non-breastfeeding women Breastfeeding adds about a further 15% transmission rate • 63 With HAART and/or elective CS, transmission rate can be reduced to