Physiciansʼ Practices and Opinions Regarding Prenatal Screening for Human Immunodeficiency Virus and Other Sexually Transmitted Diseases

Mills, W; Martin, David T.; Bertrand, Jolene; Belongia, Edward A.

doi:10.1097/00007435-199803000-00011

Cited by 19 publications

(6 citation statements)

References 9 publications

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“…Was die Rolle von GynäkologInnen in der Prävention der HIV-Infektion und in der Behandlung von HIV/AIDS-Patientinnen betrifft, war ebenso eine Diskrepanz zwischen Einstellung und tatsächlichem Verhalten zu beobachten: Eine überwiegende Mehrheit der GynäkologInnen befürworten zwar z.B. das pränatale HIV-Routine-Screening, aber deutlich weniger GynäkologInnen führen dieses auch tatsächlich durch [20,21]; HIV-Schwangerenmanagement wird von nur etwa einem Drittel der GynäkologInnen angeboten [22,23]; zudem konnten Barrieren gegen die Durchführung umfassender Sexualund Risikoanamnesen gefunden werden [24].…”

Section: Die Rolle Von Niedergelassenen ¾Rztinnen In Der Behandlung Vunclassified

HIV/AIDS in der Gynäkologie1 - Zur Behandlungsbereitschaft niedergelassener Gynäkologen und Gynäkologinnen für HIV-positive Frauen -

Baldaszti

Wimmer-Puchinger²,

Vetter³

2000

Z Geburtshilfe Neonatol

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Section: Die Rolle Von Niedergelassenen ¾Rztinnen In Der Behandlung Vunclassified

HIV/AIDS in der Gynäkologie1 - Zur Behandlungsbereitschaft niedergelassener Gynäkologen und Gynäkologinnen für HIV-positive Frauen -

Baldaszti

Wimmer-Puchinger²,

Vetter³

2000

Z Geburtshilfe Neonatol

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“…2 Screening pregnant women for syphilis has been the foundation of CS prevention; however, the lack of published studies that fully document screening practices and associated outcomes (testing and clinical) is disappointing. Some studies have documented reported screening practices from provider surveys, [5][6][7][8][9] but these data are limited because the actual practices are unknown. Other studies have used data from patient-related records but are limited by not clearly specifying the number of tests performed (i.e., 0, 1, 2, and 3).…”

mentioning

confidence: 99%

Congenital Syphilis: A Persisting Sentinel Public Health Event

Beltrami

Berman

2006

Sexually Transmitted Diseases

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CONGENITAL SYPHILIS (CS) IS A sentinel public health event because of its devastating consequences and persistence throughout the United States. 1 Within 4 years of becoming infected with syphilis, a pregnant woman has a 70% probability of transmitting the infection to her fetus. Untreated syphilis among pregnant women may result in spontaneous abortions, stillbirths, and perinatal death. Infected liveborn infants may develop a highly infectious nasal discharge, experience deafness, and have abnormalities of the skin, liver, teeth, bone, and nervous system.The prevention of CS is based on screening pregnant women for syphilis and providing to those infected timely treatment with penicillin, which is highly effective, safe, and the only recommended medication for pregnant women with syphilis. 2 Guidelines from the Centers for Disease Control and Prevention (CDC) and other organizations recommend that all pregnant women be screened for syphilis. [2][3][4] In areas or populations at high risk for syphilis, pregnant women should be screened 3 times. CDC guidelines, for example, recommend screening with a nontreponemal test at the first prenatal care (PNC) visit, at 28 weeks of gestation, and at delivery. Whereas the purpose of the test at delivery is primarily to detect CS cases (in addition to treating infected women), the purpose of the first 2 tests is prevention of CS. The management of infected women who are treated includes follow-up nontreponemal titers to assess the response to treatment and to document that reinfection has not occurred. In persons for whom PNC is not optimal, rapid screening and treatment should be conducted at the time pregnancy is confirmed and based on a reactive rapid plasma reagin-card test. 2 Screening pregnant women for syphilis has been the foundation of CS prevention; however, the lack of published studies that fully document screening practices and associated outcomes (testing and clinical) is disappointing. Some studies have documented reported screening practices from provider surveys, 5-9 but these data are limited because the actual practices are unknown. Other studies have used data from patient-related records but are limited by not clearly specifying the number of tests performed (i.e., 0, 1, 2, and 3). 10 -15 The relationship between syphilis screening and the adequacy of PNC and prenatal clinic type (public vs. private) has been minimally addressed.In this issue of Sexually Transmitted Diseases, Trepka et al describe a study that uses patient records to document the proportion of pregnant women who received at least one screening test during PNC (83%), 2 tests during PNC (11%), and 3 tests-2 during PNC and one at delivery (9%). These results, from an area of high syphilis prevalence, suggest that an unacceptably low proportion of pregnant women were screened according to guidelines. In contrast to the other studies, 5-15 the authors use regression analysis to account for PNC adequacy (assessed by 2 different measures) and prenatal clinic type. The results show that attendi...

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“…1 All prior reports on physician practices of maternal screening for STI have focused on physicians providing care for pregnant women. [2][3][4][5][6] No study has evaluated pediatrician practices and documentation of this information in neonatal charts. The aim of this study was to evaluate the adequacy of neonatal risk assessment based on documentation of prenatal screening test results and maternal risk factors in the charts of newborn infants.…”

mentioning

confidence: 99%

Physician documentation of neonatal risk assessment for perinatal infections

Kumar¹

2006

The Journal of Pediatrics

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Physiciansʼ Practices and Opinions Regarding Prenatal Screening for Human Immunodeficiency Virus and Other Sexually Transmitted Diseases

Abstract: Most physicians reported routinely screening prenatal patients for syphilis and hepatitis B. Although many physicians agreed with recommendations for universal prenatal HIV screening, their reported screening practices varied considerably from this approach.

Cited by 19 publications

References 9 publications

HIV/AIDS in der Gynäkologie1 - Zur Behandlungsbereitschaft niedergelassener Gynäkologen und Gynäkologinnen für HIV-positive Frauen -

HIV/AIDS in der Gynäkologie1 - Zur Behandlungsbereitschaft niedergelassener Gynäkologen und Gynäkologinnen für HIV-positive Frauen -

Congenital Syphilis: A Persisting Sentinel Public Health Event

Physician documentation of neonatal risk assessment for perinatal infections

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