1.

BACTERIAL VAGINOSIS
2. 20. BACTERIAL VAGINOSIS Organism-  Gardnerella vaginalis, Mobiluncus, Mycoplasmas
hominis, Prevotella, and Atopobium vaginae.
3. 21. Transmission  sexual intercourse, hormonal changes, pregnancy, antibiotic
administration, or use of nonoxynol-9 spermicidal products, douching.
4. 22. Signs and symptoms  Thin, gray or white homogeneous vaginal discharge.  Increased
vaginal discharge odor (fishy) after intercourse.  Alkaline pH (> 4.5); bacterial vaginosis
does not cause vaginal itching or dysuria.
5. 23. Treatment symptomatic metronidazole (Flagyl), 500 mg orally twice daily for 7 days .
Asymptomatic  asymptomatic pregnant patients with antibiotics for bacterial vaginosis to
prevent pre term labour.
6. 24. Effect on pregnancy outcome  spontaneous abortion, premature rupture of membranes
and pre term labour.  chorioamnionitis and postpartum endometritis.  May cause neonatal
septicemia.
7. 25. CANDIDIASIS
8. 26. CANDIDIASIS Organism:  Candida albicans, Candida tropicalis
9. 27. Transmission  cause vaginal pH to be more alkaline and high estrogen levels causing
increased production of vaginal glycogen.
10. 28. Signs and symptoms  Vaginal and vulvar irritation (erythematous and edematous) 
Pruritic, white, curd like vaginal discharge  Yeasty odor  Dysuria  Dyspareunia
11. 29. Screening  Saline or KOH wet mount microscopically examined: shows hyphae,
pseudohyphae and budding yeast  Usually pH lower than 4.7  Whiff test absent amine
(fishy) odor
12. 30. Treatment in pregnancy  Use an antifungal, intravaginal agent such as butoconazole,
clotrimazole, miconazole or terconazole  Sitz baths
1. GONORRHOEA
2. 34. GONORRHOEA Organism:  Neisseria gonorrhoeae Transmission:  Gonorrhea is
transmitted by close sexual contact. The incubation period is 3 to 5 days.
3. 35. Signs and symptoms  Vaginal discharge: may be profuse purulent and yellow green 
Itching or swelling of vulva  Dysuria  Dyspareunia  Joint and tendon pain  Anal
discharge, discomfort and pain with rectal infection.
4. 36. Screening  Molecular diagnostics .  Endocervical culture
5. 37. Treatment in Pregnancy  cefixime, 400 mg orally, or one dose of Ceftriaxone, 125 mg
intramuscularly.  Sexual partners within the preceding 60 days should be identified,
examined, cultured and treated.
6. 38. Effect on pregnancy outcome  It can affect pregnancy outcome in any trimester,
causing chorioamnionitis, pre term delivery, PROM, IUGR or postpartum sepsis.  If the
organism is present at the time of delivery, the greatest neonatal risk is gonococcal
ophthalmia, which can cause blindness.
7. 39. SYPHILIS
8. 40. SYPHILIS  Syphilis is a sexually transmitted disease caused by Treponema pallidum.
9. 41. Signs and symptoms  Incubation- 10 to 90 days  Primary syphilis Stage one is evident
by a chancre, which is highly infectious, painless, round ulcerated sore that does not get
better fast. It may last 3 to 6 weeks.
10. 42. Secondary syphilis:  evident by a maculopapular rash  This rash usually exhibited
between 1 week and 3 months after primary chancre. It typically clears in 2-6 weeks but can
last upto one year.  Other manifestations include wart like genital growth,
lymphadenopathy, fever, sore throat, patchy hair loss, head ache weight loss, muscle aches
and tiredness.
11. 43. Latent syphilis:  Stage three is usually asymptomatic. The spirochete goes to hiding for
5 to 20 years. The patient is seroactive during this stage.  During the first year of this stage,
the patient is infectious.
12. 44.  Tertiary syphilis:  The fourth stage is remanifestation of the disease. It slowly destroys
the heart eyes, brain, CNS, and occasionally the liver, bones and skin.
13. 45. Investigations:  Serological test- VDRL  fluorescent treponemal antibody absorption
test (FTA- ABS)  Treponema pallidum micro –haemagglutination (MHA- TP) test which are
specific.
14. 46. Treatment For Mother:  For primary and secondary syphilis(<I year duration):
Benzathine penicillin 2.4 million units intramuscularly single dose.  When the duration is
more than 1 year- Benzathine penicillin 2.4 million units intramuscularly weekly for 3 doses is
given.
15. 47.  For Baby:  Positive serological reaction with a single intramuscular dose of penicillin
G 50,000 units per kg body weight.  Infected baby with positive serological reaction- (1)
isolation with mother (2) IM administration of aqueous procaine penicillin G 50,000 units per
kg body weight each day for 10 days.
1. AIDS
2. 59.  Organism:  the HIV organism is a retrovirus of the lentivirus family that has an affinity
for the T- lymphocytes, macrophages and monocytes.
3. 60. Transmission  infected blood or body secretions of semen or vaginal fluid. 
unprotected sexual activity  sharing of contaminated needles.  Pediatric HIV primarily
results from perinatal or breast feeding transmission
4. 61. Immunopathogenesis  leads to slow but progressive destruction of T cells  The
incubation period is about 1 to 3 weeks.  After a peak viral load there is gradual fall  more
destruction of host cells  progressive immunosupression  opportunistic infections and
cancers
5. 62. Clinical presentation:  fever, malaise, headache, sore throat, lymphadenopathy and
maculopapular rash.  constitutional symptoms like weight loss, lymphadenopathy or
protracted diarrhea.  multiple opportunistic infections with candida, tuberculosis,
pnemocystitis, and others
6. 63. Diagnosis:  enzyme immunoassay  Western blot test or immunofluroscence assay
7. 64. Management:  Prenatal care  Voluntary serological testing for HIV  Counseling 
assessed by – CD4+ T lymphocyte counts and HIV RNA at every 3 to 4 months interval
8. 65.  Highly active antiretroviral therapy(HAART) (1) Nucleoside reverse transcriptase
inhibitors (Zidovudine, Zalcitabine, Lamivudine, Stavudine) (2) Nonnucleoside reverse
transcriptase inhibitors (Nevirapine, Delavirdine) (3) Protease inhibitors (Indinavir,
Saquinavir, Ritonavir) (4) Entry inhibitors (Efavirenz).
9. 66.  Intrapartum care  Zidovudine is given IV infusion starting at the onset of labour or 4
hours before caesaren section. Loading dose 2 mg/kg/hr until cord clamping is done. 
Amniotomy and oxytocin augmentation for vaginal delivery should be avoided whenever
possible.  Elective caesarean delivery is recommended at 38 weeks of women receiving
HAART
10. 67.  Postpartum care  Breast feeding  Zidovudine syrup- 2mg/kg, is given to the neonate
4 times daily for first 6 weeks of life.
11. 68. TORCH INFECTIONS  Toxoplasmosis  This is a systemic infection caused by the
protozoan Toxoplasma gondii
12. 69. Consequences of fetal infection  The classic triad of hydrocephalus, intracranial
calcification and chorioretinitis.  The common manifestations are mental retardation, seizure
disorder, hepatosplenomegaly and central nervous system (CNS) involvement.
13. 70. Management  Prenatal counselling  Prevention  Medications: Pyrimethamine and
sulphadiazine plus folinic acid.
14. 71. Rubella  RNA toga virus  spread by nasopharyngeal droplets, with an incubation
period of 14- 21 days.  A disease prodrome of malaise, fever, headache, conjunctivitis and
pharyngitis, lasting 1-5 days, precedes the classic manifestations of widespread pink/red
maculopapular rash and generalized lymphadenopathy.
15. 72. Effect of maternal infection on the fetus and newborn  Spontaneous abortion 
Congenital rubella syndrome causing symmetric IUGR, congenital heart disease, hepato-
splenomegaly and thrombocytopenic purpura.  CNS manifestations include deafness, eye
lesions such as congenital cataract, retinopathy, microphthalmia, microcephaly, pan-
encephalitis, brain calcification and psychomotor disorders.
16. 73. Management  Immunization of all adult women.  Education of parents about the
dangers of rubella infection.  All pregnant women should be screened for rubella antibodies
at the first prenatal visit.
17. 74. Cyto megalo virus  It is a double stranded DNA virus that belongs to the herpes virus
family. Humans are the only known hosts of this virus.
18. 75. Transmission  CMV is transmitted through blood via transfusion or transplacental route
commonly and droplet infection. Body fluids: semen, vaginal secretions, saliva, urine, breast
milk (rare), organ transplant and rarely through direct contact.
19. 76. Effect of maternal infection on the fetus and the newborn  About 15% of the infants are
symptomatic non-immune hydrops, symmetric IUGR, hepatosplenomegaly, CNS sequeale
like chorioretinitis, microcephaly, hydrocephaly and calcifications.  Almost 85% of infants
are asymptomatic
20. 77. Management  Prenatal counselling is highly recommended.  Drugs such as
ganciclovir, forcarnet and cidoforvir.
21. 78. Herpes simplex virus  simplex virus is a member of the herpes virus family. It is a DNA
virus
22. 79. Transmission  Transmission is through intimate mucocutaneous contact. It is one of the
most contagious sexually transmitted diseases (STDs).
23. 80. Significance:  Spontaneous abortion  Intra uterine growth retardation  Fetal death 
Preterm labour  Neonatal infection  Neonatal herpes
24. 81. Management  Acyclovir administered 200mg, four times daily for 14 days.  Topical
application of acyclovir cream  Severe infections : IV administration of Acyclovir 5 mg/kg
body weight/ 8 hourly for 5 days.
25. 82. HEPATITIS B  The virus is transmitted by parenteral route, sexual contact, and vertical
transmission and also through breast milk.
26. 83. Maternal infection  The acute infection is manifested by flu like illness as malaise,
anorexia, nausea and vomiting. There may be arthralgia and skin rash.
27. 84. Diagnosis  Diagnosis is confirmed by serological detection of HBsAg (denote high
infectivity) and antibody to hepatitis B core antigen (HBcAg).
28. 85. Management  Rest  Isolation  Nutrition  Drugs  Prevention of complications
1. CHLAMYDIA  Organism:  Chlamydia trachomatis
2. 95. NURSING MANAGEMENT
3. 96.  Primary prevention of STI  Secondary prevention  Tertiary prevention
4. 97. Nursing diagnosis  Acute pain related to excoriation from scratching pruritic areas,
ulcerations etc.  Impaired skin integrity related to presence of skin infections.  Risk for
complications, IUGR; spontaneous abortion; PROM; preterm labour and fetal death related
to presence of STDs or other infections.  Risk for fetal or neonatal infections, fetal
malformations and anomalies related to complications of maternal TORCH or STDs.
5. 98.  Sexual dysfunction or ineffective sexuality patterns related to perineal discomfort and
prescribed abstinence during treatment.  Self esteem disturbance related to the diagnosis
of sexually transmitted disease.  Ineffective coping related to diagnosis of STDs. 
Knowledge deficit related to disease condition, mode of transmission, fetal outcome, possible
 treatment opportunities etc.  Fear and anxiety related to the possible fetal outcome
secondary to the infections.
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