High Risk Pregnancy - LIAQUAT UNIVERSITY OF MEDICAL ：高危妊娠的医疗Liaquat大学.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * E. STD’s Chlamydia Caused By: bacterium Chlamydia trachomatis Most common STI in USA PID infertility by blocking tubes. Often asymptomatic. Thin/purulent discharge, burning frequency w.urination, lower abd. pain. Pregnant women: Zithromax 1 g single dose; amoxicillin x 7 days. Newborn conjunctivitis (erythromycin ointment), neonatal pneumonia, PTL, fetal death. Perinatal transmission occurs in 50% infants where mom is infected @ time of del. Gonorrhea Caused by Neisseria Gonorrhea. Bacterial STI. Can lead to PID infertility. Green frothy dc. Often asymptomatic in females; males have burning with urination penile dc. Dx - vaginal or urine cx.DOH notifies partners. Rx with Rocephin IM [ceftriaxone]. Zithromax [azithromycin] 1 g single dose or amoxicillan po. PID – caused by both. Cramping, fever, chills, purulent dc, N/V, uterine swelling, adnexal cervical tenderness. Multiple sex partners, no condoms. Tx with Doxycycline po (contraindicated in pregnancy) Rocephin IM. Clinda/genta/rocephin if pregnant. May need hospitalization. Herpes Viral infection – no cure. HSV I – oral [cold sore] outer lesion. HSV 2 – genital – painful, open lesions. Vesicles rupture appear right after exposure or within 20 days. Burning sensation with urination is 1st sign. Prodrome “tingling” occurs before new outbreak. Outbreaks several times/yr. Dx: vaginal cx or blood test Rx: Acyclovir or Valtrex 500 mg once/day during pregnancy reduces viral load enough to deliver vaginally. Syphilis: Treponema Palladium [Spirochete] Primary Stage: painless sores, “chancre”, approximately 2-3 wks initial exposure. fever, malaise. Secondary Stage: 6 wks to 6 mos. Skin eruptions, arthritis, liver enlarged, sore throat, Dx: VDRL, RPR, FTA-ABS (more specific), Dark field exam: for spirochetes. Tx: 1 yr 2.4 million u benzathine penicillin x 1 do