If a woman has active genital herpes at delivery a

If a woman has active genital herpes at delivery, a cesarean delivery is usually
performed
 Fortunately, infection of a baby from a woman with herpes infection is rare.
 Fetal effects: skin infection +/or CNS abnormalities
 Medications used for Genital Herpes are anti-virals such as Acyclovir
 Acyclovir is not recommended in pregnancy
Human Immunodeficiency Virus: HIV (retrovirus, single stranded RNA
virus)
 Most devastating STI in the world today
 Heterosexual transmission now the most common means of transmission in
women
 Women are the fastest-growing population of HIV infection and AIDS
 Transmission of HIV occurs primarily through exchange of body fluids, also
exposure to affected blood and blood products, perinatal transmission from
mother to infant & through affected needle sharing with drug abuse
 Presence of any STI makes one more susceptible to acquiring HIV
 * HIV testing is now available over the counter, cheek swabs produce results
in 20 minutes.
Human Immunodeficiency Virus: HIV
 AIDS: A cquired I mmuno- D eficiency S yndrome (end-stage infection) is a
failure of the immune function caused by HIV
 Early symptoms of HIV infection similar to mononucleosis including: fever,
headache, night sweats, malaise, lymphadenopathy, myalgias, nausea,
diarrhea, weight loss, sore throat, and rash
 Usually occur within 3 weeks of initial exposure

 Pregnancy: Important to diagnose and treatment w/antiretroviral drugs
 Maternal treatment decreases risks for the infant
 Infant infection can occur during pregnancy (transplacental transfer), labor
and delivery, or with breastfeeding
 Cesarean delivery
 Breastfeeding contraindicated in developed countries
Hepatitis
 In the USA there are generally 3 types of Hepatitis: A, B and C
 Hepatitis A is spread primarily through fecal contamination and can be
eliminated by simple hygiene
 Hepatitis C is still a curiosity and researchers are not sure how it is spread.
But, they do know that hepatitis C is hard to get through sexual contact
 Hepatitis B is spread through body secretions: blood, saliva, vaginal
secretions, semen & breast milk and readily crosses the placental
barrier
Hepatitis B
 Accounts for 40-45% of Hepatitis cases in the USA
 Can be transmitted to the infant perinatally before the mother develops
clinical symptoms
 The disease is prevalent in Africans, Asians, Southeast Asian immigrants,
Native Americans and Eskimos and intravenous drug abusers
 Symptoms include: vomiting, abdominal pain, jaundice, fever, rash and
painful joints
 Most infected adolescent & adults recover within 6 months and acquire long-
lasting immunity
 Chronic hepatitis B develops in 10% of infected adults who can transmit the
disease to others
 Chronic hepatitis B patients are at higher risk for chronic liver disease,
cirrhosis and liver cancer
Hepatitis B: Fetal and Neonatal Effects
 The incidence of prematurity, LBW & neonatal death increases with maternal
Hepatitis B
 These babies are at increased risk for developing acute infection at birth
 Babies and Children under 5 who develop Hepatitis B are more likely to
become chronic carriers of the virus & becoming reservoirs for continued
infection in the population