When pregnant women undergo hospital examinations, doctors may request testing for sexually transmitted infections (STIs) such as HIV and syphilis. Few expectant mothers readily agree to such tests without hesitation; most harbor reservations, with some believing they have not engaged in unsafe sexual practices.However, recent clinical observations indicate a significant rise in the incidence of sexually transmitted infections during pregnancy. These infections pose serious threats to fetal health, making comprehensive testing under medical guidance essential. This is particularly important for women who did not undergo premarital health examinations; it is advisable to complete such testing before pregnancy as a "remedial measure."
Most Pregnant Women Reluctant to Undergo STI Testing
HIV and syphilis are mandatory screenings for every pregnant woman. However, clinical observations show that the vast majority are reluctant to undergo STI testing, with most only agreeing after repeated persuasion from their doctors. Some women only discover their syphilis infection during the second or third trimester, by which time the fetus has already been affected.
Since HIV and syphilis transmission is linked to unsafe sexual practices, some pregnant women feel they cannot be infected and refuse testing. Others perceive these screenings as personally humiliating. In reality, STIs can occur even without unsafe sexual behavior. Many pregnant women with syphilis were completely unaware of their infection prior to diagnosis.Pinworms: The Invisible Parasite in Young Children
Without Mandatory Marriage Screening, Don't Be Picky About Prenatal Tests
Previously, under mandatory marriage screening, syphilis was detected during premarital exams, and screening departments would recommend postponing marriage. After mandatory marriage screening was abolished, this safety barrier was lost. Yet when undergoing prenatal tests at hospitals, STI and HIV testing is often neglected.
Many believe that as long as everything appears normal, there will be no impact on the next generation. Since they assume they cannot contract STDs, most people opt out of STD or HIV testing when choosing voluntary screening items. In reality, if a pregnant woman contracts certain STDs, they can be transmitted to the fetus through the placenta—syphilis being the most classic example.If a pregnant woman contracts early-stage syphilis and remains untreated, the infection affects the fetus nearly 100% of the time. Half of these cases result in maternal or neonatal perinatal death, while the other half transmit syphilis to the newborn through the placenta. For late-stage syphilis in pregnant women, 10% of cases lead to congenital syphilis.Another STI posing significant fetal risks is genital herpes. Primary genital herpes infection in pregnant women affects approximately one-third to half of fetuses, leading to miscarriage, intrauterine growth restriction, preterm birth, low birth weight, neonatal congenital herpes, congenital malformations, and even fetal death. Recurrent genital herpes infection in pregnant women affects about 5% of fetuses.
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Avoiding Prenatal Checkups May Lead to "Regrets"
The direct causes of birth defects include genetic factors, environmental factors, or the combined effects of both. However, at least 70% of birth defects are preventable. Birth defects can be prevented through a "three-tiered prevention" strategy.Primary prevention includes premarital screening, genetic counseling, selecting optimal childbearing age, and early pregnancy care to prevent birth defects. Secondary prevention focuses on early detection, diagnosis, and intervention during pregnancy to reduce the birth of affected infants. Tertiary prevention involves treating birth defects.
When both parents are asymptomatic carriers of a disease-causing gene, it may create the illusion that the condition is non-hereditary. However, if two carriers marry, their offspring face a 1 in 4 risk of developing the disease, a 1 in 4 chance of being healthy, and a 50% chance of being asymptomatic carriers.Affected offspring inherit two disease-causing alleles from their parents. If such individuals marry another affected person, the four disease alleles will inevitably result in both alleles being disease-causing in the offspring, leading to near-certain disease onset. However, actual surveys show approximately 70% of offspring remain unaffected. This occurs because most parents carry non-allelic recessive genes, resulting in double heterozygosity without disease manifestation.
Phenylketonuria, Wilson's disease, Marfan syndrome, and albinism also fall under autosomal recessive disorders. Genetic counseling principles dictate that when the disease risk exceeds 10%, couples should be advised against procreation.
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