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Pregnancy is a special time in a woman’s life, during which particular attention should be paid to health – both that of the mother-to-be and the developing child. One important, yet often overlooked topic is sexually transmitted diseases. Some of them may be asymptomatic, but nevertheless pose a serious threat to the course of pregnancy, the health of the mother and the life of the newborn. In this article, we will discuss the topic of sexually transmitted diseases and pregnancy, because it is very important to perform appropriate tests and take a conscious approach to prevention.
What are sexually transmitted diseases?
Sexually transmitted diseases (STDs) are infections spread primarily through sexual contact – vaginal, oral, or anal. They are caused by bacteria, viruses, or parasites. The most common STDs include:
- chlamydia
- gonorrhea
- syphilis
- HIV
- hepatitis B and C (HBV, HCV)
- genital herpes (HSV)
- HPV (human papillomavirus)
- trichomoniasis
Many of these infections may not cause symptoms for a long time, so a woman may be unaware she is infected – even though the condition poses serious risks to her pregnancy.
Why are STDs dangerous during pregnancy?
STDs can lead to various complications in pregnancy, such as:
- miscarriage
- premature birth
- premature rupture of membranes
- intrauterine infection
- low birth weight
- congenital malformations
- stillbirth
- neonatal infection during vaginal delivery (due to contact with infected fluids or blood)
Some infections, such as syphilis, HIV, or herpes, can cross the placenta and infect the fetus. Others, like chlamydia or gonorrhea, can be transmitted during childbirth.
What tests should be done during pregnancy?
In Poland (and many other countries), several STD-related tests are part of routine prenatal care. Some are mandatory, while others are strongly recommended, especially if the woman has a history of risky sexual behavior, multiple partners, or other risk factors.
1. Mandatory tests:
- HIV – at least once during pregnancy, preferably before the 10th week, and again in the third trimester
- Syphilis (VDRL test) – twice: before the 10th week and again between the 33rd and 37th week
- HBs antigen (hepatitis B) – tested before the 10th week of pregnancy
- Urinalysis – may indicate urinary or genital tract infections
2. Recommended additional tests:
- HCV (hepatitis C) – especially for women with risk factors (e.g. past surgeries, transfusions, substance use)
- Chlamydia trachomatis – PCR test from a cervical swab
- Gonorrhea (Neisseria gonorrhoeae) – PCR or culture test
- Herpes (HSV-1 and HSV-2) – serological tests (IgM, IgG antibodies)
- HPV – Pap smear and possibly HPV DNA test (usually not performed during pregnancy unless medically indicated)
If a test result is positive, treatment should begin immediately. Most STDs can be treated during pregnancy with medications that are safe for both the mother and the fetus.
What to do in case of infection?
If an STD is diagnosed during pregnancy, the following steps are crucial:
- initiate treatment quickly (e.g. antibiotics for chlamydia, antivirals for HSV or HIV)
- inform and test the sexual partner, and treat if necessary
- consult with a gynecologist and infectious disease specialist
- plan delivery with transmission risks in mind – in some cases, a cesarean section may be recommended (e.g. with active herpes or a high HIV viral load)
Modern medicine offers effective treatment options and ways to reduce the risk of transmission to the baby – as long as the condition is detected early.
How to protect yourself?
The best ways to protect yourself from STDs during and outside of pregnancy include:
- using condoms, especially with new or non-monogamous partners
- avoiding casual sexual encounters
- regular STD screenings (not just during pregnancy)
- mutual testing and monogamy in a committed relationship
- vaccinations (e.g. HPV and hepatitis B)
Pregnancy is a time to be especially cautious – for your health and your child’s well-being.
Sexually transmitted diseases and pregnancy. Summary
Sexually transmitted diseases during pregnancy pose a serious threat and can lead to a range of complications. Fortunately, many of these infections can be detected through simple lab tests and treated safely – even during pregnancy. For this reason, STDs should not be ignored. Following medical recommendations, getting the necessary tests, and practicing safe sexual behavior are the best ways to protect both the mother and the unborn child. Early detection remains the most effective form of prevention.
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Do all pregnant women have to be tested for STDs?
Yes. Some tests are mandatory in prenatal care. Every pregnant woman should be tested for HIV, syphilis (VDRL), and hepatitis B (HBs). These are essential to detect infections that could harm the baby.
Can STDs harm the baby even if there are no symptoms?
Yes. Many STDs such as chlamydia, HIV, or syphilis can be asymptomatic while still crossing the placenta and infecting the fetus. That’s why proper testing is important, even in the absence of symptoms.
Can STDs be treated during pregnancy?
In most cases, yes. Treatments are chosen to be safe for both the mother and the fetus. For example, antibiotics are used for chlamydia and gonorrhea, and antivirals for HIV and herpes. Early diagnosis allows for safer and more effective treatment.
What happens if an STD is diagnosed before delivery?
Treatment begins immediately, and the delivery plan may be adjusted. In some cases (e.g. active genital herpes or HIV), a cesarean section may be recommended to minimize the risk of transmission to the newborn.
Should the partner also be tested?
Absolutely. If a pregnant woman is diagnosed with an STD, her partner should be tested and treated if needed. Treating only one partner increases the risk of reinfection, so a coordinated approach is essential.
