From the Guidelines
Yes, Trichomonas vaginalis can be transmitted to an infant during vaginal delivery, though this is relatively uncommon. The risk of transmission is estimated to be around 2-17% for babies born vaginally to infected mothers. When transmission occurs, it typically affects female infants and can cause vaginal discharge in the first few weeks of life.
Key Considerations
- Pregnant women should be screened for trichomoniasis, particularly those with symptoms such as abnormal vaginal discharge, itching, or discomfort 1.
- The standard treatment for pregnant women is metronidazole, typically given as a 2-gram single oral dose or 500 mg twice daily for 7 days.
- Treatment during pregnancy is considered safe and is recommended to prevent complications such as preterm birth and low birth weight 1.
- Infants who develop trichomoniasis may require treatment with metronidazole, though the dosage must be carefully determined by a pediatrician based on the infant's weight.
Transmission and Prevention
- The parasite primarily affects the urogenital tract and transmission occurs through direct contact with vaginal secretions containing the organism during birth.
- To prevent transmission, it is essential to screen and treat pregnant women with trichomoniasis, especially those with symptoms or at high risk of complications.
Treatment and Management
- Metronidazole is the recommended treatment for trichomoniasis in pregnant women, and its use has been shown to reduce the risk of preterm birth and low birth weight 1.
- Infants who develop trichomoniasis should be treated with metronidazole under the guidance of a pediatrician, taking into account the infant's weight and potential risks.
From the Research
Transmission of Trichomonas vaginalis
- Trichomonas vaginalis can be vertically transmitted at birth, as stated in the study 2.
- Perinatal transmission of T. vaginalis from an infected, untreated, pregnant woman to her neonate can occur, as reported in the case study 3.
- Neonatal infection with Trichomonas vaginalis is an unusual occurrence, but it has been documented in several cases, including a case report of a five-day-old neonate born at 29 weeks gestational age 4.
Risk of Transmission during Vaginal Delivery
- The risk of transmission during vaginal delivery is present, as Trichomonas vaginalis can be found in the pharynx and lower respiratory tract of neonates with respiratory disease, as mentioned in the study 2.
- A case report of a patient with untreated trichomoniasis who had an uncomplicated spontaneous vaginal delivery of a healthy female infant, who was later diagnosed with trichomoniasis at day of life 19, suggests that perinatal transmission can occur during vaginal delivery 3.