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Pregnancy and STD’s, STI’s

STIs, STDs and Pregnancy

Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are not fun or easy to talk about. It can be embarrassing to talk about STIs or STDs, but they are more common than you might realize. And, when it comes to pregnancy and STIs and STDs, it is best to learn about how to protect yourself from and treat STIs and STDs.

Pregnancy and STIs STDsSTIs and STDs are infections that are spread by having sex with someone that has a sexually transmitted infection. This could include oral, vaginal or anal intercourse. While STIs are common among men and women who are sexually active, many people do not know they have been infected. Some women may not find out that they have an STI until their first prenatal appointment when pregnant. Prenatal STI screening is standard because it is best to find out about an STI early in your pregnancy.

How do I know if I have an STI or STD?
At the first prenatal appointment, many women are tested (screened) for STIs including: chlamydia, gonorrhea, HIV, syphilis, Hepatitis B, and Hepatitis C. Testing may be done through blood tests, vaginal swabs and urine tests. If you suspect you might have an STI/STD, you should ask for testing. Testing is routinely done on pregnant women who are less than 25 years of age as well as those women that have new or multiple sexual partners, have a sexual partner that has other partners, past or current needle drug users, not in a monogamous relationship, no or sporadic condom use, a sexual partner that has an STI, sex workers, exchanging sex for drugs or money, and/or those living in high risk areas.

What happens if I have an STI or STD?
If you test positive, you will be notified by your healthcare professional in several days or about a week. Usually, immediate treatment with antibiotics can clear up an STI. A follow-up test in the third trimester may be performed, depending on your age or risk factors. In the case of HIV, on-going treatment for you and your baby will be required. With all STIs, the sooner treatment is started, the sooner the infection can be treated and reduce the incidence of passing the STI on to your baby.

Will my pregnancy be affected?
Early testing during the first trimester and follow up testing during the third trimester, as well as treatment if an STI has been detected, will have a major impact on the chance of you and your baby being affected. In most cases, early detection and treatment will resolve any potential complications.

If untested and/or untreated, sexually transmitted infections in pregnant women could cause problems during pregnancy such as: preterm labor, premature rupture of membranes, and low birth weight. The infant could contract the STI during the pregnancy, during vaginal delivery, or after birth through breastfeeding, such in the case of HIV. Some STIs could have lifelong implications for your child. For these reasons, we strongly encourage women to have STI testing early in their pregnancy and to follow recommended treatment protocol(s).

Women who want to know more about STIs/STDs in pregnancy are welcome to talk to the team at Support Circle. Our caring staff will maintain your confidentiality while addressing your most pressing questions and can provide a list of clinics that provide STI/STD testing. We have three Bay Area clinics in San Francisco, Oakland and Redwood City for your convenience. Call or walk-in today.

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References
1. https://www.cdc.gov/std/pregnancy/stdfact-pregnancy-detailed.htm
2. http://www.webmd.com/baby/pregnancy-sexually-transmitted-diseases

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Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

An “ectopic pregnancy” occurs when the fertilized embryo implants outside of the uterus; most commonly in fallopian tube. When attached to the fallopian tube, this is referred to as a “tubal pregnancy.” Approximately 16%1 of women seeking emergency medical attention due to cramping and/or vaginal bleeding in the first trimester are diagnosed as having an ectopic pregnancy. Overall, ectopic pregnancies are rare, occurring in 1%-2%2 of all pregnancies. As the embryo grows, it can cause the tube to rupture (burst), which can cause major internal bleeding. This can be life threatening3 and/or cause future fertility issues if not discovered early.

Bleeding and cramping are the most common symptoms of an ectopic or tubal pregnancy. Women who are pregnant or may be pregnant should seek immediate medical attention for a possible ectopic pregnancy if they experience any or all of the following symptoms:

  • Cramping pain in the lower abdomen that may worsen with coughing, moving, or bowel strain
  • Sharp, steady pelvic pain
  • Vaginal bleeding
  • Nausea and vomiting
  • Dizziness or weakness
  • Shoulder pain
  • Feeling of pressure in the rectum

Risk factors leading to a greater risk for an ectopic pregnancy include: previous tubal surgery, sterilization, previous ectopic pregnancy, current use of an intrauterine device (IUD), history of pelvic inflammatory disease (PID), infertility for two years or longer, women over the age of 35 years, and smoking.

When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination and imaging with transvaginal ultrasound can usually confirm the diagnosis. In some cases, a blood test may also be used to determine diagnosis.2 The ultrasound is performed to check where the embryo implanted, if not found in the uterus. An ultrasound is one of the best methods to determine where the embryo may have implanted and alert if there are other health concerns to be aware of.

Since ectopic pregnancies may be life threatening, they must be treated as an emergency situation and the doctor will determine how best to end the pregnancy, as the embryo cannot be transplanted into the uterus. Many cases of ectopic pregnancy, if caught early enough, can be treated with medicine and not surgery. Early detection may help preserve the fallopian tube for future pregnancy attempts.

In all cases of suspected tubal pregnancies, the Support Circle technician or nurse will immediately refer the woman to the emergency room. If you have questions, Support Circle staff at our three Bay Area clinics are available.

 

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Reference:

  1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071024/
  2. http://www.aafp.org/afp/2014/0701/p34.html
  3. http://www.acog.org/Patients/FAQs/Ectopic-Pregnancy

 

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Why is my period late?

Why is my period late?

Women who are in their childbearing years sometimes miss a period. While a missed menstrual period is the hallmark of early pregnancy, missing a period can be due to a number of factors and conditions. If you’ve missed a period, try not to stress out. However, you’ll want to rule out pregnancy. You do not have to wait until you miss a period if you suspect you are pregnant. The trained staff at Support Circle can help by administering a free pregnancy test prior to expecting your period. This test is more than 99% accurate and performed by a nurse.

Once you have a negative pregnancy test, you may wish to repeat the test in a few days or your missed period may be due to the following:

  • Stress and anxiety– Stress isn’t good for your body, and it can cause you to have delayed ovulation.
  • Excessive weight loss, or weight gain– Losing a substantial amount of weight, or gaining too much weight too quickly can cause you to experience menstrual problems, like a missed period or a delayed period.
  • Contraceptives– Some women who take certain birth control don’t have regular periods.
  • Breastfeeding– When you breastfeed exclusively, the hormones that are allowing lactation to occur can block ovulation and your regular menstrual cycle.
  • Eating disorders– When you have excessively low body weight this can interfere with hormonal functions, which might stop ovulation.
  • Rigorous Exercise– Women who participate in activities and sports that require them to undergo rigorous training often experience skipped periods or no periods at all.
  • Medication– There are some medications that can disrupt menstrual cycles.
  • Hormonal imbalance– When you have hormonal problems, it can change the levels of hormones that your body requires to support ovulation and the menstruation process.
  • Problems with your thyroid
  • Uterine scarring– If your uterus is scarred from disease or medical procedures, this can prevent the normal buildup and shedding of the uterine lining common to a regular menstrual cycle.
  • Perimenopause – This is the time period before the complete cessation of menstrual periods and, in some women, may begin as early as their mid-thirties.

If you have a late or missed period, we encourage you to visit one of our three Bay Area clinics to have a pregnancy test or to talk to a nurse.

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Zika Virus – Other Common Questions

CDC Zika Virus Information

CDC Zika Virus Information

Zika Virus – Other Common Questions

In an effort to provide our Support Circle clients with information on Zika virus, a virus that has garnered much media attention due to the potential effects on the fetus, we have compiled this list of information directly from the Center for Disease Control (CDC) website.

How is Zika transmitted?

Zika is primarily transmitted through the bite of infected Aedes mosquitoes, the same mosquitoes that spread Chikungunya and dengue. These mosquitoes are aggressive daytime biters and they can also bite at night. Mosquitoes become infected when they bite a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites. Men and women with a pregnant partner should use a condom or abstain from intercourse for the duration of the pregnancy. The virus can also be transmitted from a pregnant mother to her fetus during pregnancy or around the time of birth. Spread of the virus through blood transfusion and sexual contact have been reported.

Update July 2016: There is an increased need for women in the U.S. to take precautions to reduce their chances of becoming infected with Zika if pregnant. According to the CDC, there have been over 1,300 reported cases of Zika virus in the United States, including 14 sexually transmitted cases. In U.S. Territories, there have been over 2,900 reported cases of Zika infected people. There have been over 645 cases of pregnant women reported to have Zika in the United States and U.S. Territories.

What are the symptoms of Zika?

About one in five people infected with Zika will get sick. For people who get sick, the illness is usually mild. For this reason, many people might not realize they have been infected. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.

Does Zika in pregnant women cause birth defects?

Brazil has been having a significant outbreak of Zika virus since May 2015. Officials in Brazil have also noted an increase in the number of babies with congenital microcephaly (a birth defect in which the size of a baby’s head is smaller than expected for age and sex) during that time. Congenital microcephaly is often a sign of the brain not developing normally during pregnancy. Health authorities in Brazil, with assistance from the Pan American Health Organization, CDC, and other agencies, have been investigating the possible association between Zika virus infection and microcephaly. Additional studies are needed to determine the degree to which Zika might be linked with microcephaly.

More lab testing and other studies are planned to learn more about the risks of Zika virus infection during pregnancy. Because of the possible association between Zika infection and microcephaly, pregnant women should take steps to prevent mosquito bites.

How do I find the most recent CDC updates?

Visit the CDC’s website for more information about the Zika virus: http://www.cdc.gov/zika.

How to Protect Against Zika Virus

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