The management of sexually transmitted infections in pregnancy

Key content • Sexually transmitted infections (STIs) have increased in the past decade in the UK in all age groups. • Any woman with one STI is at higher risk for another and comprehensive STI testing should be recommended, including repeat HIV testing. • Women under 25 years should be referred for chlamydia screening. • In pregnancy, STIs should be managed in conjunction with genitourinary medicine colleagues. • Pregnant women with STIs should receive public health interventions, including partner notification and advice on sexual abstinence during treatment and on safer sex. Learning objectives • To be able to describe the epidemiology of STIs. • To be able to list the indications for screening and testing. • To know about the evidence supporting treatment of STIs in pregnancy. Ethical issues • Should screening for chlamydia in pregnant women aged less than 25 years be part of routine antenatal screening rather than through a different screening programme? • How can research on the pharmaceutical treatment of STIs in pregnancy be conducted safely? • Should child protection measures be taken for neonates born to mothers at high risk for HIV infection, (e.g. from an area of high prevalence or who are found to have an STI such as syphilis in pregnancy) whose mothers decline HIV screening in pregnancy?