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Infectious Diseases in Pregnancy

• Editor's Note
• List of Articles

List of Articles

• Ebola Virus Disease and Pregnancy
  The review provides general background information on Ebola virus disease (EVD) and specifically addresses what is known about EVD in pregnancy and the implications for practicing obstetricians and gynecologists. Limited evidence suggests that pregnant women are at increased risk for severe illness and death when infected with Ebola virus, but there is no evidence to suggest that pregnant women are more susceptible to EVD. It is important that all health care providers are prepared to respond to ensure that Ebola virus transmission is contained. Specifically, U.S. health care providers, including obstetricians and gynecologists, should ask patients about recent travel to affected countries in West Africa, know the signs and symptoms of EVD, and know what to do if they have a patient with compatible illness. For all healthcare providers, infection-control procedures are recommended, including standard, contact, and droplet precautions. Pregnant women with EVD appear to be at an increased risk for spontaneous abortion and pregnancy-associated hemorrhage. Neonates born to mothers with EVD have not survived.
  
  
• Preventing Mother-to-Child Human Immunodeficiency Virus Transmission
  Human immunodeficiency virus (HIV) is a scourge which continues to fatally wound the physical, cultural, social, economic, political, and spiritual health achievements, hopes and aspirations of individuals, families, communities and nations. This review describes the utility of antenatal surveillance for monitoring and evaluating prevention of mother-to-child HIV transmission programs in resource limited countries and generalized HIV epidemics. Population-based data sources regarding the incidence and morbidity that are associated with perinatal HIV infection are improving and indicate that prevention efforts have been enormously successful. There have been major advances with the prevention of mother-to-child HIV transmission, and this review summarizes the successes and current challenges and provides suggestions for future directions. Viewing preventing the mother-to-child transmission as a gateway to family-based HIV care and treatment will help strengthen ties between these programs. Site-specific interventions to increase the uptake of prevention of mother-to-child transmission programs based on experiences in sub-Saharan Africa are discussed. Lessons learned can apply to many resource-constrained settings.
  
  
• Group B Streptococci Perinatal Infections: A Comprehensive Review
  Group B streptococci (GBS) emerged dramatically in the 1970s as the leading cause of neonatal infection and as an important cause of maternal uterine infection. In 2002, new national guidelines were released recommending: 1) solely a screen-based prevention strategy, 2) a new algorithm for patients with penicillin allergy, and 3) more specific practices in certain clinical scenarios. In the pre-prevention era, active surveillance for invasive neonatal GBS disease estimated that approximately 6,100 early-onset cases and 1,400 late-onset cases occurred annually in the United States.  The purpose of this document is to address clinical issues of group B streptococci (GBS) perinatal infection, implementation of new diagnostic techniques, management of preterm rupture of membranes, use of alternative antibiotic approaches, improvement of compliance, prevention of low birth-weight infants, emergence of resistant organisms and vaccine development.
  
  
• Syphilis in Pregnancy: Prevention of Congenital Syphilis
  The purpose of this document is offers recommendations for treating infants and adults. It will also high-light the need to view syphilis screening and control programs through the perspectives of multiple stakeholders so as to identify barriers to, and opportunities for improving the formulation and implementation of national policies. Devising an effective political strategy might represent one of the most challenging facets of implementing a sustainable program. Both structured and unstructured approaches are useful, and applying aspects of both may provide rich analysis of why an intervention like antenatal syphilis screening is not being implemented. In USA a record low incidence of congenital syphilis, 20.6 cases per 100,000 live births, was recorded in 1998 by the Centers for Disease Control and Prevention (CDC) (1999a), resulting in creation of the National Plan for Syphilis Elimination.
  
  

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