STD 妊娠与性传播疾病

PregnancywithSexuallyTransmittedDiseasesEmmaLiu

Pregnancywith

SexuallyTransmittedDiseases（STD）

pregnancywithseverecomplications

morbidityis1.06%inChinaneonataldiseasesSTDsareinfectiousdiseasesthatspreadfrompersontopersonthroughintimatecontact.STDsexuallytransmitteddiseases8kindsoforganisms：8kindsofSTDforespeciallycontrol：

①gonorrhea②syphilis③HIV④condylomaacuminata⑤chancroid⑥LymphogranulomaVenereum⑦GenitalHerpes⑧nongonococcalurethritis8kindsoforganisms：bacteriavirusspirochetechlamydiamycoplasmafungusprotozoonparasiteSTDsexuallytransmitteddiseases8kindsoforganisms：8kindsofSTDforespeciallycontrol：

①gonorrhea②syphilis③HIV④condylomaacuminata⑤chancroid⑥LymphogranulomaVenereum⑦GenitalHerpes⑧nongonococcalurethritis【AboutHIV】Organism:humanimmunodeficiecyvirus(HIV)AttackCD4MultipleopportunisticinfectionRaremalignanttumordeath【Routoftransmission】SexuallyTransmittedBloodtransmissionSharesyringeverticaltransmissiontheorganismHumanpapillomavirus(HPV)6,11RoutoftransmissionItisspreadthroughdirectskin-to-skincontactduringoral,genital,oranalsexwithaninfectedpartner.【Aboutcondylomaacuminata】Whatarethesignsandsymptoms？【Aboutgenitalherpes】Organism:herpessimplexvirus–II(HSV-II)HSVisspreadthroughskin-to-skincontactordirectmucocutaneouscontact.

verticaltransmission【Obstetricconsiderations：fetus&neonate】PregnancyBefore20wPregnancyafter20wneonatalmortalityratespontaneousabortionPrematuredeliverylowbirthweight10-14d,70%HepatosplenomegalyJaundiceFeverbleedingtendencyViasoftbirthcanal【AboutCT】Organism:chlamydiatrachomatisSexuallyTransmitted：directviamucosaverticaltransmission：intrauterineinfectionviasoftbirthcanal【Obstetricconsiderations：fetus&neonate】Pneumonia3~4Meyeinfection1~3W

【AboutMycoplasma】Organism:MycoplasmahominisMHUreaplasmaurealyticum,UUM.genitalium，MGM-pneumonie，MpSexuallyTransmitted：directviamucosaverticaltransmission：intrauterineinfection，viasoftbirthcanalChorioamnionitisspontaneousabortionPrematuredeliveryStillbirthPostpartumpelvicinflammationmycoplasmapneumoniachronicpneumonia【Obstetricconsiderations】STDsexuallytransmitteddiseases8kindsoforganisms：8kindsofSTDforespeciallycontrol：

①gonorrhea②syphilis③HIV④condylomaacuminata⑤chancroid⑥LymphogranulomaVenereum⑦GenitalHerpes⑧nongonococcalurethritisSECTION1

GONORRHEA【aboutgonorrhea】Organism：gram-negativediplococcusNeisseriagonorrhoeaeThemortalityisthe1stoneoftheSTDsinChina.Mainsymptom：

purulentinfectionofurogenitalsystem

morbidityofpregnancy1～8%【routeoftransmission】SexuallyTransmitted：directviamucosaindirecttransmission：publicgoodsVerticaltransmission：viasoftbirthcanal【Obstetricconsiderations】gravidafetusneonateBeinfectedinanytrimesterofpregnancywillhavebadeffectsonbothpregnantwomanandfetus，aswellastheneonate.【Obstetricconsiderations：gravida】chorioamnionitisPretermlaborprematureruptureofmembranes【Obstetricconsiderations：fetus】【Obstetricconsiderations：neonate】gonococcalconjunctivitispneumoniasepticemiaincubationperiod：1-14days【Diagnosis】medicalhistorySymptomslaboratoryexamination【laboratoryexamination】goldenstandardculturesmearRestrictedPCR【therapy】principle：timely、fulldose、standard，thedrugofchoiceisthird-generationcephalosporin，sexualpartnertreateddrug：Ceftriaxone

0.25g（orcefotaxime1g）

singledoseIM

&azithromycin1g

singledosePO

ordoxycycline0.1g2/d×7dGonococcalPID，Disseminatedgonorrhea

Ceftriaxone

1gIM

1/d×10d

orspectinomycin2gIM

2/d×10d

&metronidazoleordoxycyclinePO10dgravida：Ceftriaxone

1gsingledoseIM

&erythrocin0.5g4/d×7～10dNeonate：

1%silvernitrate&Ceftriaxone25～50mg/kg（＜125mg）

singledoseIM

thiskindofpreparationsiseffectiveinpreventingmostcaseofophthalmianeonatorum【therapy】CriteriaforRecovery：symptomsdisappear&laboratoryexamination（-）3timescontinuously【therapy】Section2

syphilis1.Organism：Treponemapallidum2.Symptom：primarysecondarytertiaryneurosyphilis【about

syphilis】

SexuallyTransmitted

：<1year,mostinfectious；

>4year,hardlyinfectiousverticaltransmission：TheT.PallidumcanpassthroughplacentaVerticaltransmission：viasoftbirthcanalItcanbetransmittedviabloodtransfusion.Theriskoftransmissionfromsharingneedlesappearslimited.【routeoftransmission】【classificationofsyphilis】

【Verticaltransmission】PrimaryorsecondaryEarlylatentTertiaryLatelatent【Obstetricconsiderations：

fetus&neonate】spontaneous

abortionstillbornCongenitalsyphilisT.Pallidumcancrosstheplacentaandi