Last data update: Nov 11, 2024. (Total: 48109 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Machefsky AM[original query] |
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The case for motivational interviewing in the clinical prevention of STIs during pregnancy
Williams SP , Loosier PS , Machefsky AM . Sex Transm Dis 2021 49 (1) e4-e6 Screening for sexually transmitted infections (STIs) during pregnancy is vital for maternal and neonatal health, and adverse birth outcomes can occur if diagnosis and treatment are delayed. Sexually transmitted infections, such as chlamydia, trichomoniasis, and bacterial vaginosis, have been implicated in preterm birth.1 Herpes simplex virus can be transmitted during a vaginal delivery, requiring a cesarean section during active or recent infection.2 Infants who do acquire neonatal herpes simplex virus infections may suffer from a range of outcomes, from localized skin infections to meningitis or encephalitis to disseminated infections involving multiple organs, or even death.3 Similarly, infants born to mothers infected by chlamydia or gonorrhea are at increased risk of acquiring neonatal ophthalmia or other complications.4,5 Syphilitic infections during pregnancy can result in spontaneous abortion, stillbirth, preterm delivery, neonatal death, and live infants born with congenital syphilis,6,7 the latter of which has been increasing throughout the United States. During 2015 to 2019, the rate of congenital syphilis in the United States increased by 291.1% (12.4–48.5 per 100,000 live births), making the importance of STI prevention in pregnancy all the more urgent.8 Given its impact on the health care system, the extent to which the SARS-CoV-2 (COVID-19) pandemic may have impacted STI care for pregnant women is not yet clear. |
A New Call to Action to Combat an Old Nemesis: Addressing Rising Congenital Syphilis Rates in the United States
Machefsky AM , Loosier PS , Cramer R , Bowen VB , Kersh EN , Tao G , Gift TL , Hogben M , Carry M , Ludovic JA , Thorpe P , Bachmann LH . J Womens Health (Larchmt) 2021 30 (7) 920-926 Congenital syphilis (CS) is on the rise in the United States and is a growing public health concern. CS is an infection with Treponema pallidum in an infant or fetus, acquired via transplacental transmission when a pregnant woman has untreated or inadequately treated syphilis. Pregnant women with untreated syphilis are more likely to experience pregnancies complicated by stillbirth, prematurity, low birth weight, and early infant death, while their children can develop clinical manifestations of CS such as hepatosplenomegaly, bone abnormalities, developmental delays, and hearing loss. One of the ways CS can be prevented is by identifying and treating infected women during pregnancy with a benzathine penicillin G regimen that is both appropriate for the maternal stage of syphilis and initiated at least 30 days prior to delivery. In this article we discuss many of the challenges faced by both public health and healthcare systems with regards to this preventable infection, summarize missed opportunities for CS prevention, and provide practical solutions for future CS prevention strategies. |
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