Department of Reproductive Health and Research (RHR), World Health Organization
Sexually transmitted and other reproductive tract infections
A guide to essential practice
Management of STIs/RTIs
Chapter 7 discussed STIs/RTIs in the context of routine care of women during pregnancy, childbirth and the postpartum period. This chapter looks at some important STI/RTI-related problems that can occur during or following pregnancy, and addresses the management of infectious complications that can occur in such situations. Management of miscarriage, complicated induced abortion (endometritis, septic abortion), and postpartum infection (endometritis, puerperal sepsis) is emphasized because these are among the most serious conditions that affect women’s health during their reproductive years, and are largely preventable.
While this chapter focuses on STI/RTI management, infection may not be the woman’s chief concern or reason for her visit to the clinic. Women with abortion complications or postpartum infection often present with bleeding and pain, and may be in shock. Other WHO guidelines1 provide guidance on comprehensive management including assessing and stabilizing patients, and starting intravenous fluids and antibiotics. Once stabilized, the patient should be referred to a centre that can provide appropriate emergency services.
Advice on preventing infection when performing medical and obstetrical procedures is given in Chapter 2.
1 Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice. Geneva, World Health Organization, 2003, and
Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Geneva, World Health Organization, 2000.
Infections of the male and female reproductive tract and their consequences:
Preventing STIs/RTIs and their complications
STI/RTI education and counselling
Promoting prevention of STI/RTI and use of services
STI/RTI Assessment during Routine Family Planning Visits
STI/RTI Assessment in pregnancy, childbirth and the postpartum period
Management of symptomatic STIs/RTIs
STI/RTI complications related to pregnancy, miscarriage, induced abortion, and the postpartum period
Annex 1. Clinical skills needed for STI/RTI
Annex 2. Disinfection and universal precautions
Annex 3. Laboratory tests for RTI
Annex 4. Medications