Publication:

Sexually transmitted diseases in laboring women: trend over a decade

Background Center for Disease Control (CDC) recommends routine screening in all pregnant women at first visit for syphilis, HIV, Hepatitis B infection as they have high vertical transmission rate. Syphilis is brought to control by screening and early treatment with penicillin, whereas HIV and Hepatitis B are incurable viral infections till date. Hence prevention is the only way to control the disease in the population. The purpose of the study is to know the burden of sexually transmitted diseases, so that prevention programme is better planned.

Methods This is a retrospective analytical study conducted from January 2005 to December 2014, in Karnataka Institute of Medical Sciences, Hubli, Karnataka. All the patients who delivered in septic ward, who were more than 28 weeks of gestation and who were HIV, HBsAg or VDRL positive were included in the study.

Results Among the total of 79,472 deliveries, the prevalence of HIV, HBsAg and VDRL were 0.90, 1.06 and 0.31 respectively. There were 4 cases of co-infection. The prevalence of HIV was 0.79 in 2005 and reached its peak of 1.33 in 2008 and then showed a steady decrease, reaching a lowest of 0.52 in 2014. The prevalence of HBsAg was 0.70 in 2005 and reached a peak of 1.57 in 2014. The prevalence of VDRL was highest of 0.08 in 2005 and lowest of 0.02 in 2014. Highest operative deliveries were seen in HBsAg positive women. Stillbirths were maximum in VDRL positive women and least in HBsAg positive women. There were 9 maternal deaths in HIV positive women and 3 maternal deaths in HBsAg positive women.

Conclusions In our study HIV prevalence is showing a down trend and syphilis is at the verge of elimination as seen globally. However prevalence of Hepatitis B has shown a rising trend over a decade in our institute, unlike a down trend seen globally. Intensifying the screening of Hepatitis B in pregnancy and Immunisation programme of neonates, reducing overcrowding and providing better living conditions, improving hygiene and health education should be done in order to reduce the prevalence of Hepatitis B infection.