Presented by: Diana Grill, Ventura County Public Health Epidemiology and Health Statistics Group

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• Presented by Diana Grill, Ventura County Public
  Health Epidemiology and Health Statistics Group

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Are STDs common in pregnant women?
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Guidelines for STD Testing in Pregnant Women

• The CDC 2002 Guidelines for Treatment of Sexually
  Transmitted Diseases recommend that pregnant
  women should be screened on their first prenatal
  visit for STDs which may include
• Chlamydia
• Gonorrhea
• Hepatitis B

• Hepatitis C
• HIV
• Syphilis

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But Are Chlamydia and Gonorrhea Highly Prevalent
in Ventura County?

• Of all the V. Co. reportable diseases, Chlamydia
  and Gonorrhea have the 1st and 3rd highest amount
  of case reports

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Chlamydia

• 75 of infected women have no symptoms
• Some evidence that untreated chlamydial
  infections in pregnancy can lead to premature
  delivery
• Leading cause of early infant pneumonia and
  conjunctivitis in newborns

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Chlamydia Increasing in Ventura County Women
15-44 yrs
HP 2010 (women 15-24 yrs)300
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Chlamydia Rates in women 15-44 yrs Across Ventura
County Cities in 2004 (NNumber of Cases)
(N495)
HP 2010 (women 15-24 yrs)300
(N61)
(N35)
(N50)
(N43)
(N133)
(N22)
(N82)
(N89)
(N70)
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Gonorrhea

• In women symptoms are often mild or non-specific
  enough to be mistaken for a bladder or vaginal
  infection
• Passage to a baby at delivery can cause
  blindness, joint infection or a life threatening
  blood infection

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Gonorrhea Rates in Ventura County Women 15-44 yrs
in 2004
HP 2010 (all population)19
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Gonorrhea Rates in Women 15-44 yrs Across Ventura
County Citiesin 2004 (NNumber of Cases)
(N7)
(N34)
HP 2010 (all population)19
(N12)
(N9)
(N2)
(N7)
(N1)
(N2)
(N1)
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Pelvic Inflammatory Disease (PID) Prevalence

• Within the US, over 1 million women are estimated
  to have an acute PID episode annually
• More than 100,000 women becoming infertile
• A large proportion of ectopic pregnancies due to
  PID
• Other negative outcomes Abcess formation,
  chronic pelvic pain

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Pelvic Inflammatory Disease (PID) Causes

• PID is primarily associated with Gonorrhea and
  Chlamydia
• Gonorrhea causes an inflammation that can
  permanently scar the fallopian tubes
• Due to the mild symptoms of Chlamydia, it can
  linger in the tubes for months prompting a
  violent immune response
• Quick diagnosis and treatment is key to
  preventing PID

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The Annual Rate of PID in Ventura County in women
15-44 yrs?

• PID is under reported due to the fact that
  symptoms are often subtle and mild

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Important Points

• Rates of Chlamydia and Gonorrhea among women of
  childbearing age are high in Ventura County and
  have increased since 2000
• Left untreated, Chlamydia and Gonorrhea can
  evolve into Pelvic Inflammatory Disease (PID)
  which often goes undiagnosed
• Chlamydia, Gonorrhea, and PID can cause serious
  complications before, during, and after pregnancy
• Complications are preventable by rapid diagnosis
  and treatment of Chlamydia and Gonorrhea. Its
  important to screen pregnant women at the first
  prenatal visit.

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Sources and Questions

• Sources for more information
• 1. CDC STD fact sheets
• http//www.cdc.gov/std/healthcomm/fact_sheets.htm
  
• 2. CDC Sexually Transmitted Diseases Treatment
  Guidelines 2002
• http//www.cdc.gov/STD/treatment/TOC2002TG.htm
• 3. NIAID Fact Sheet, Gonorrhea
• http//www.niaid.nih.gov/factsheets/stdgon.htm
• 4. University of Washington Online Textbook
  Pelvic Inflammatory Disease
• http//depts.washington.edu/nnptc/online_training
  /std_handbook/pdfs/ch8_pid.pdf
• Ventura County Health Data and Statistics
  Website
• http//www.vchca.org/ph/stats/index.htm