I.

DEFINITION
STD (Sexually Transmitted Diseases)
- Spread through sexual contact with an infected partner
- Although STD’s can be serious, during pregnancy certain STD’s place patient at greater
risk for problems because of their potential effect on the pregnancy, fetus, or neonate.

II. ETIOLOGY/ CAUSE

- STD’s can be caused by numerous organisms
Fungi
Bacteria
Protozoas
Parasites
Viruses

III. TYPES AND SIGNS/ SYMPTOMS

TYPES CAUSE SIGNS/ SYMPTOMS

Trichomoniasis
- common cause of vaginitis
in 10%-50% of pregnant
women.
Chlamydia
- most common STD in US.
Fetus maybe infected
during birth and suffer
neonatal.
Syphilis
- if untreated, the infection
may cross the placenta to
the fetus and may result in
spontaneous abortion,
stillbirth or premature
labor and birth.
Genital Herpes
- one the most common
STIs.
Gonorrhea
- not transmitted via the
placenta.
Protozoan Trichomonas •yellow-gray, frothy, odorous
vaginalis vaginal discharge
•vulvar itching, edema, and
redness
•vaginal discharge pH is
usually greater than 4.5
Chlamidia trachomatis •asymptomatic
•heavy, gray-white vaginal
discharge
•dysuria
Spirochete Treponema •painless ulcer on vulva
pallidum (primary syphilis)
•hepatic and splenic
enlargement, headache,
anorexia (second syphilis)
•cardiac, vascular and central
nervous system changes
(tertiary syphilis)
Herpes simplex virus •painful, small vesicles with
erythematous base on vulva
or vagina rupturing within 1 to
7 days to form ulcers
•fever
•dyspareunia
Neisseria gonorrhoeae •asymptomatic
•yellow-green vaginal
discharge
IV. NURSING DIAGNOSIS
• Risk for infection r/t preterm rupture of membrane
• Acute pain r/t irritation and inflammation of perineal area
• Anxiety r/t having contracted reportable STI
• Anxiety r/t unexpected development of complications

V. MANAGEMENT
Medical and Pharmalogical
• Administer antifungal or antimicrobial.
• Advise patient to comply with therapy, completing the entire course of the drug.
• Syphilis: Penicillin is the primary treatment to cure the disease in both the woman and the
fetus.
•Gonorrhea: Ceftriaxone or cefixime plus amoxicillin or azithromycin are now
recommended for penicillin-resistant organisms.
•Chlamydial Infection: Erythromycin or amoxicillin is the recommended treatment and
Azithromycin is an alternate treatment.
•Trichomoniasis: Metronidazole (Flagyl) may be given to the pregnant woman as a 2-g
single oral dose.
•Genital Herpes: Acyclovir may be given orally during pregnancy to reduce the likelihood of
active lesions at term.

Nursing
• Urge the patient to refrain from sexual intercourse until the active infection is completely
gone.
• Provide comfort measures to reduce vulvar and vagina irritation.
• Encourage follow-up care.