There are State mandates requiring syphilis, gonorrhea and HIV testing of all pregnant women to reduce newborn transmission. In addition to these tests, your clinician will screen for other STI’s. The following information details why these screenings are done in pregnancy.
Syphilis is caused by the bacterium Treponema pallidum. It can be passed through the placenta at any time during pregnancy, and can have long-term consequences for both mother and baby if left untreated. There are two screening blood tests used to diagnose syphilis; the Venereal Disease Research Laboratories (VDRL) test and the Rapid Plasma Reagin (RPR) test. A VDRL or RPR will be performed in the first and third trimesters.
Gonorrhea is caused by the bacterium Neisseria gonorrhea. Gonorrhea that generally is transmitted to the baby during its passage through the birth canal can cause eye infections, blood infections and joint problems.
In some cases, gonorrhea is transmitted earlier in the pregnancy and can be responsible for pre-term delivery and fetal death. If detected, gonorrhea can be treated with antibiotics. All babies receive antibiotic eye ointment at birth in case the disease was present but not detected. Gonorrhea cultures will be done during the first and third trimesters.
Chlamydia is caused by an organism called Chlamydia trachomatis. It causes infection in the cervix, similar to gonorrhea, and has been associated with premature rupture of membranes and premature labor. A simple swab of the cervix can easily diagnose it and treatment with erythromycin is effective and safe during pregnancy. Chlamydia cultures are routinely done in the first trimester and only done in the third trimester with high-risk women.
Hepatitis B is a virus transmitted sexually in blood and saliva, as well as through breast milk and the placenta. Hepatitis B vaccine became available in 1982, so you may already be vaccinated.
Hepatitis B is associated with low birth weight, premature labor, and even fetal loss. Some women may be carriers without displaying signs of infection, and can pass on the infection to their baby. If exposure occurs, the newborn is treated at the time of delivery with immunoglobulin. All newborns are now given their first hepatitis vaccine in the first few months of life. Hepatitis screening will be done with the first trimester blood work.
Human Immunodeficiency Virus (HIV) is the virus known to cause AIDS. It has been mandated by the State that HIV testing be ordered as part of the first trimester blood work. Treatment for HIV can be started during pregnancy and may prevent transmission of the disease to the fetus. Transmission of HIV from mother to fetus occurs in about 25-35% of pregnancies.