STI Treatments During Pregnancy

STI Treatments

STI Treatments During Pregnancy

STIs during pregnancy can be safely treated with appropriate medications to protect both mother and baby. UK antenatal care routinely screens for HIV, syphilis and hepatitis B early in pregnancy, and treatment is tailored for pregnancy safety. Understanding what’s involved helps you feel confident about the care you’ll receive.

Here’s what to know.

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Routine Antenatal Screening

Treatment by Infection

Chlamydia

• Doxycycline is avoided (not suitable in pregnancy)
• Azithromycin is the usual alternative
• Test of cure recommended
• Partners also need treatment

Gonorrhoea

• Ceftriaxone injection is safe in pregnancy
• Test of cure recommended
• Partners also treated

Syphilis

• Penicillin injection is the only recommended treatment in pregnancy
• Women with penicillin allergy may need desensitisation
• Treatment is highly effective at preventing congenital syphilis

HIV

• Antiretroviral therapy started or continued
• Pregnancy-safe regimens chosen
• Aim for undetectable viral load by 36 weeks
• Reduces mother-to-baby transmission to under 1%

Hepatitis B

• Antiviral treatment in some cases
• Baby receives vaccine and immunoglobulin at birth
• Prevents mother-to-baby transmission

Herpes

• Antiviral (aciclovir) is safe in pregnancy
• Caesarean may be offered if active outbreak at delivery
• Most women with herpes have healthy babies

Trichomoniasis

• Metronidazole is used
• Treatment reduces pregnancy complications

Safe Medications in Pregnancy

Most STI treatments have pregnancy-safe versions:

• Azithromycin instead of doxycycline for chlamydia
• Penicillin for syphilis
• Ceftriaxone for gonorrhoea
• Specific ART regimens for HIV
• Aciclovir for herpes
• Metronidazole for trichomoniasis and BV

What to Avoid

• Doxycycline — avoided due to effects on developing teeth and bones
• Tetracyclines in general
• Some fluoroquinolones
• Certain HIV drugs (individual decisions based on regimen)

Working With Specialist Teams

Women with STIs in pregnancy are usually cared for by a multidisciplinary team:

• Obstetrician or midwife
• Sexual health or infectious diseases specialist
• HIV specialist if relevant
• Paediatrician for newborn care

Preventing Complications

• Early screening identifies infections promptly
• Treatment reduces risks to baby
• Delivery plan is tailored to your situation
• Most women with STIs in pregnancy have healthy babies

Read more: STIs and pregnancy | HIV and pregnancy | Getting pregnant with HIV

Frequently Asked Questions

Are STI treatments safe for the baby?

Pregnancy-safe alternatives are used. Most treatments don’t harm the baby.

Can I still have a vaginal birth with an STI?

Usually yes, though active herpes outbreaks or unsuppressed HIV may warrant caesarean.

Should my partner also be treated?

Yes. Partner treatment prevents reinfection and protects both mother and baby.

Related reading

• Getting Pregnant When You Have HIV
• How STIs Affect Pregnancy and Breastfeeding
• Should I Be Tested for STIs During Pregnancy?
• STIs and Pregnancy: What You Need to Know
• Safer Breastfeeding Rules for Women Living with HIV

Sources

• NHS — Sexual health conditions
• BASHH — UK clinical guidelines for STI management
• British HIV Association (BHIVA) — HIV treatment guidelines
• Terrence Higgins Trust — sexual health information
• UK Health Security Agency — STI surveillance data

Steve Page

Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.