Pregnant women should not be in Hot tubs and saunas
Increases their temperature therefore increases fetla temp
Good Dental care - alteration of gingival tissue, increased gingivitis & periodontitis; oral health is priority
Exercise - usually well tolerated, encouraged, adequate hydration, individualize
Contraindications
Heat
History of preterm labor
Sexual Activity & Sexuality
Safe in the absence of ROM, bleeding, placenta previa, risk of PTL, PTL, infection, cervical insufficiency
Employment: assess
Screen for environmental & occupational hazards
Immunizations
Flu vaccine
Hep B
DtaP: tetanus & diphtheria
COVID vaccine
Page 419, Box 12.5
Contraindications: any vaccine with live virus
Rubella
Varicella (chickenpox)
Typhoid HSV 1 or HSV 2 (majority of cases)
Chronic, lifelong viral infection, underdiagnosed
Vesicular lesions
Fetal / Neonatal Outcome
First trimester: SAB (spontaneous pregnancy loss)
Later: Preterm labor and delivery
Significance
Can have Vaginal delivery w no visible lesions or prodromal symptoms
Must have cesarean delivery C/D with visible lesions or prodromal symptoms
Transmission
Vaginal, anal, or oral sex
Skin-to-skin contact with an infected site
Symptoms
Primary outbreak
Single or multiple blister like vesicles that are painful
Enlargement of inguinal lymph nodes
Flu like symptoms, genital pruritus, or tingling
Lesions open, weep, crust over, dry and disappear
Diagnosis
Visualization, based on symptoms
Lesions
Culture
Titre
Treatment
No known cure
Medications to reduce or suppress symptoms, shedding & recurrent episodes
Treatment, CDC, 2021
acyclovir 400 mg orally 3x/day for 7-10 days
OR Famciclovir 250 mg orally 3x/day for 7-10 days
OR Valacyclovir 1 gm orally 2x/day for 7-10 days
Nursing Considerations
Pregnancy - Neonatal mortality rate up to 50% with exposure to active, primary lesion
Vertical transmission
ROM
During birth More than ½ of sexually active women and men infected at some point in their lives
Most infections are asymptomatic, transient and resolve without treatment
Genital warts, Pap test abnormalities and/or cervical cancer
Women with multiple sex partners have an increased risk of developing cervical cancer
No known treatment
More than 100 types of HPV
At least 40 infect genital area
High Risk: 16, 18, 31, 35, 39, 45, 52, 56, 58, 59, 68, 82
Cervical Cancer
Low Risk: 6, 11, 40, 42, 43, 44, 54, 61, 72, 73, 81
Genital Warts
Prevention
HPV 9-valent vaccine = Gardasil 9
Protect against certain cancers and diseases caused by 9 types of HPV (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58).
These 9 types are responsible for the majority ofHPV-related cancers and diseases.
Ages 11 - 12 ideal start
Dosing schedule
2 or 3 doses
FDA expanded indication of vaccine to include adults ages 27 - 45