Other Viral Infections
Syphilis is a sexually transmitted disease and places a fetus at risk for intrauterine or congenital syphilis. This maternal infection is caused by a spirochete Treponema Pallidum. Suspicion or presence of this infection requires great concern for the maternal-fetal population despite the availability of accurate screening tests and proven medical treatment.
Clinical Manifestations of Syphilis
Newborns born with congenital syphilis may have the following:
- Congenital anomalies
- Extreme rhinitis (sniffles)
- Characteristic syphilitic rash
- Oddly shaped primary teeth
Nursing Diagnosis for Syphilis
- Serologic testing – either VDRL or rapid plasma regain should be done at the first prenatal visit. The diagnostic test may be repeated again close to term, about the 8th month age of gestation if the concern is exposure.
- Increasing titer means that reinfection has occurred in the woman.
This is a multisystem disease caused by the spirochete Borrelia Burgdorferi. Lyme disease is contracted through the bite of a deer rick and the highest incident of infection is during summer and fall.
Clinical manifestations of Lyme Disease
The symptoms of Lyme disease is chronic not dramatic. Thus, women may not report them at prenatal visit unless proper education about the importance of reporting a migratory rash and joint pain is known to be related to this infectious illness. The nurse should ask the pregnant woman during prenatal visits for the presence of the following clinical manifestations:
- Erythema chronicum migrans – large macular lesions with a clear center. This typical rash develops after the tick bite.
- Pain in large joints (such as the knee) may be present
- Spontaneous miscarriage can result from the infection during pregnancy
- Severe congenital anomalies
- To prevent contracting the disease women who are anticipating to be pregnant must avoid wooded or tally grassy areas where they are apt to be bitten by ticks.
- In case where women are taking nature trips, it is not advisable to take tick repellent lotions as these products contain diethyltoluamide because the ingredient is teratogenic.
- To prevent exposure to tick the woman should be advised to wear long and light-colored slacks tucked to the socks to help prevent the legs from possible exposure.
- Instruct the woman to inspect her body carefully and immediately remove any ticks found.
Nursing Management for Lyme Disease
Treatment of Lyme disused for pregnant and non-pregnant women differs.
- For nonpregnant adults tetracycline and doxycycline may be used. These drugs cannot be used in pregnant women since it causes tooth discoloration and possibly, long-bone formation in fetus.
- For pregnant women, a course of penicillin will be prescribed to reduce the symptoms.