Pregnancy and STIs Management Quiz

Nursing Care of Women with High Risk Pregnancy

• This presentation covers nursing care for women experiencing high-risk pregnancies.

Sexual Transmitted Diseases Infections in Pregnancy

• Toxoplasmosis: Caused by the protozoan toxoplasma gondi, transmitted through raw meat, unpasteurized goat milk, or cat feces.

Effects of Toxoplasmosis

• Pregnant woman: Spontaneous abortion.
• Fetus/newborn: Microcephaly, hydrocephaly, chorioretinitis, hepatosplenomegaly, jaundice, mental retardation.

Investigations

• TORCH screening:
  • Toxoplasmosis.
  • Others (hepatitis B, HIV, Chlamydia, Varicella).
  • Rubella.
  • Cytomegalovirus.
  • Herpes simplex.
• Blood serum study for high antibodies and toxoplasma gondi.
• Indirect immunofluorescent test to diagnose toxoplasmosis.

Rubella

• Caused by the rubella virus.
• Effects on fetus/newborn:
  • Fetal death.
  • Low birth weight.
  • Congenital rubella syndrome (deafness, cataract, jaundice, purpura, hepatosplenomegaly, congenital heart diseases, or mental retardation).

Assessment and Management

• Assessment: Personal history, virological tests.
• Management:
  • Early diagnosis may lead to pregnancy termination options.
  • Informing the pregnant woman about the disease's impact on pregnancy.
  • Vaccination within the first week after delivery to prevent future complications.
  • Counseling on birth spacing methods for three months after vaccination.
  • Avoidance of rubella vaccination during pregnancy.

Chlamydia Trichomoniasis

• Signs and symptoms: Mucopurulent vaginal discharge, abdominal pain, frequent urination, dysuria.
• Effects on mother: Salpingitis, cervicitis, vulvitis, secondary infertility.
• Effects on newborn: Conjunctivitis, ophthalmia neonatorum, blindness due to corneal scarring, and upper respiratory tract infection.
• Management: Good hygiene practices, erythromycin 500mg BD during pregnancy, treatment of the husband.

Herpes Genitalis

• Caused by herpes simplex virus.
• Signs and symptoms: Close-packed vesicles, severe dysuria, retention of urine, enlarged and tender inguinal lymph nodes, mild fever, severe pain due to nerve involvement.
• Diagnosis: ESR (erythro sedimentation rate), clinical examination of vesicles and enlarged lymph nodes.
• Management: Bed rest, keeping the lesion clean, analgesics for pain relief, antiviral agent (acyclovir), preventing secondary infection, avoidance of recurrence.

Viral Hepatitis

• Hepatitis A, B, and C are serious pregnancy complications.
• Signs and symptoms: Low fever, general malaise, anorexia, abdominal pain, nausea and vomiting, jaundice.
• Effects on mother: Postpartum hemorrhage, hepatic coma.
• Effects on fetus: Abortion, preterm birth, intrauterine death.
• Diagnosis: Blood screening for antibodies HBsAg, serum bilirubin, clinical examination.
• Management: Isolation of the woman (especially in labor), bed rest until bilirubin levels normalize, high-calorie, easily digestible diet, vitamin K injection before labor onset, prophylactic oxytocin, hepatitis B immunoglobulin to newborn.

Moniliasis

• Caused by Candida Albicans.
• Signs and symptoms: White, crusted vaginal discharge, dysuria, severe itching, dyspareunia.
• Diagnosis: Presence of hyphae and spores in vaginal smears.
• Effects on pregnancy: Fetus may contract thrush during vaginal delivery.
• Management: Intravaginal insertion of clotrimazole suppositories at bedtime for one week.

Trichomoniasis

• Caused by Trichomonas vaginalis.
• Signs and symptoms: Frothy, greenish-gray vaginal discharge, pruritus, urinary symptoms (dysuria, frequent urination).
• Diagnosis: Motile flagellated trichomonads on vaginal smears.
• Management: Antibiotics prescribed for both the woman and husband.

Syphilis

• Caused by Treponema pallidum.
• Effects on pregnancy: Abortion, preterm delivery, prenatal death (20%).
• Prevention: Identifying and treating infected mothers during pregnancy.
• Treatment: Antibiotics for both mother and infant, if necessary.

Gonorrhea

• Caused by Neisseria Gonorrhoeae.
• Effects on mother: Risk of septic infection, chorioamnionitis, premature delivery, premature rupture of membranes.
• Effects on fetus/newborn: Intrauterine growth retardation, ophthalmia neonatorum.

AIDS (Acquired Immune Deficiency Syndrome)

• Caused by Human Immunodeficiency Virus (HIV).
• Effects on mother: Premature rupture of the membranes, postpartum endometritis, high incidence of infectious diseases.
• Effects on fetus/newborn: Fetal death, preterm birth, low birth weight, HIV infection.
• Diagnosis: Blood test for HIV presence.
• Management: Treating infections, high-protein, high-calorie diet, antiretroviral therapy, spiritual care, and social support.