Sexually Transmitted Infections
Both chlamydia and gonorrhoea infections can pass to the baby during delivery causing eye infections.
Gonorrhoea is quite rare in the UK, occurring in less than 1 per 1000 women. Chlamydia is more common, affecting around 5% of pregnancies. It can also lead to chest infections in the baby or infections of the lining of the womb for the mother after delivery.
Both of these infections are treatable during pregnancy but a second swab should be taken afterwards to confirm that they are cleared. It is most important to screen and treat sexual partners, otherwise they will pass the infection back again.
Genitourinary medicine clinics (previously known as STD or VD clinics) have come a long way since the 1970’s. They are really sexual health clinics and many young women use them for smear tests, contraceptive advice or any unusual vaginal itch or discharge – not necessarily sexually transmitted.
They have facilities not available to GP’s, obstetricians or gynaecologists and are the best place to go for any vaginal discharge that proves troublesome to clear.
Testing for HIV infection is routine in some hospitals, but is not usual outside of high-risk areas. If you feel that you may have been at risk, any GUM or hospital clinic will be able to arrange one, often the same day if necessary.
HIV infection passes to the baby in about 15% of cases, but this can be reduced to 8% with drug treatment and perhaps even lower with an elective caesarean section, so there is definitely a benefit to knowing for sure if you are concerned.
Urinary Tract (Water) Infections
Urinary tract infections (UTI’s) are more common during pregnancy than at other times, mostly because of a slowing down of the urine flow on its way from the kidney to the bladder.
Around 1 in 25 women get a UTI during pregnancy, the common symptoms being a discomfort or burning sensation on passing urine, an aching pain over the bladder or needing to pass water very frequently.
This last symptom is unfortunately very common in pregnancy anyway and is not very reliable in making the diagnosis. If the infection passes up to the kidneys and into the blood stream (pyelonephritis or septicaemia) it causes loin pain, vomiting, a fever and can even start premature labour.
By treating early UTI’s, kidney infections and their complications can be prevented. The infection is diagnosed by looking at the urine under a microscope and seeing if a bug can be grown from the sample. This can also confirm which antibiotic is the best to use.
A mild infection is treated with a course of antibiotic tablets for at least a week, but a more severe one would need admission to hospital, intravenous antibiotics and rest.
After one UTI, further infections are more common and monthly checks on the urine are suggested to see if one is developing even before symptoms appear.