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Infectious Diseases in Pregnancy

• Editor's Note
• List of Articles

List of Articles

• 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.
  
  
• Perinatal Viral Infections
  Many viral infections are associated with significant maternal and fetal consequences if acquired during pregnancy. In the United States, some the most commonly encountered infections with subsequent perinatal effects include cytomegalovirus (CMV), parvovirus B19 (fifth disease), varicella zoster virus (VZV). The purpose of this document is to describe these infections, their mode of transmission, and their maternal and fetal effects. Guidelines for counseling about and management of these infections during pregnancy are also discussed. In general, perinatal infections have more severe fetal consequences when they occur early in gestation, because first-trimester infections may disrupt organogenesis. Second and third trimester infections can cause neurologic impairment or growth restriction.
  
  
• Genital Herpes Simplex Virus Infection during Pregnancy
  Herpes simplex virus (HSV) infection of the genital tract is one of the most common viral sexually transmitted diseases (STDs). Approximately 45 million adolescent and adult Americans have been infected with genital herpes based on positive serology test results for HSV-2 and estimates of genital HSV-1 infection. About 30% of the female population in the United States has antibodies to HSV-2. The purpose of this document is to define the stages of herpetic infection, outline the spectrum of maternal and neonatal infection and provide the management guidelines.
  
  

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