| Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc |
| Journal website http://www.jcgo.org |
Review
Volume 3, Number 4, December 2014, pages 123-128
Sexually Transmitted Diseases in Pregnancy in Urgent Care Setting
Tables
| Sexually transmitted disease | Estimated number of pregnant women |
|---|---|
| Adapted from Department of Health and Human Services CDC Fact Sheet. STDs & Pregnancy. February 2012. | |
| Herpes simplex virus 2 | 880,000 |
| Trichomoniasis | 124,000 |
| Chlamydia | 100,000 |
| Hepatitis B | 16,000 |
| Gonorrhea | 13,200 |
| HIV | 6,400 |
| Syphilis | < 1,000 |
| Peripartum complications | Early onset of labor (gonorrhea, HSV, trichomoniasis) Postpartum endometritis (chlamydia, gonorrhea) Premature rupture of membranes (chlamydia, gonorrhea) |
| Neonatal complications | Acute hepatitis Low birth weight (HSV, trichomoniasis) Meningitis (HSV) Neonatal sepsis (chlamydia, gonorrhea, HIV, HSV, trichomoniasis, syphilis) Neurologic insult (HSV, syphilis) Ophthalmia neonatorum (chlamydia, gonorrhea) Pneumonia (chlamydia) Pneumonitis (chlamydia) Spontaneous abortion (gonorrhea, syphilis) |
| Chronic maternal complications | Cervical cancer (HPV serotypes 16 and 18) Chronic hepatitis Infertility (chlamydia, gonorrhea) Pelvic inflammatory disease (chlamydia, gonorrhea) |
| BV | |
| Preferred | Metronidazole 500 mg PO twice daily × 7 days Metronidazole 250 mg PO three times daily × 7 days |
| Alternative | Clindamycin 300 mg PO twice daily × 7 days |
| Chlamydia | |
| Preferred | Azithromycin 1 g PO once Amoxicillin 500 mg three times daily × 7 days |
| Alternative | Erythromycin 500 mg PO four times daily × 7 days Erythromycin 250 mg PO four times daily × 14 days |
| Gonorrhea | |
| Preferred | Ceftriaxone 250 mg IM once |
| Alternative | Cefixime 400 mg PO once Azithromycin 2 g PO once |
| HIV | Individualized highly active antiretroviral therapy (HAART) |
| HPV | Trichloroacetic acid |
| HSV | |
| First episode | Acyclovir 400 mg PO three times daily × 7 - 10 days Acyclovir 200 mg PO five times daily × 7 - 10 days Valacyclovir 1 g PO twice daily × 7 - 10 days |
| Recurrent | Acyclovir 400 mg PO three times daily × 5 days Valacyclovir 1 g PO daily × 5 days |
| Suppressive therapy | Acyclovir 400 mg PO twice daily Valacyclovir 500 mg PO daily |
| Trichomoniasis | |
| Preferred | Metronidazole 2 g PO once |
| Alternative | Metronidazole 500 mg PO twice daily × 7 days |
| Syphilis | |
| Primary | Benzathine penicillin G 2.4 million units IM × 1 dose |
| Asymptomatic, positive serology | Benzathine penicillin G 2.4 million units IM once weekly × 3 weeks |