Managing Infections in Pregnancy Toolkit

COMMON URINE and REPRODUCTIVE TRACT INFECTIONS in PREGNANCY

A Systems Approach to Optimize Screening, Treatment, and Follow-up

This toolkit aims to

  • Increase awareness and knowledge of urine and reproductive tract infections as preventable sources of pregnancy complications and adverse outcomes;
  • Enhance the ability of clinical providers and their staff to identify and care for women with common urinary and reproductive tract infections; and
  • Support recommended screening, treatment and follow-up for genitourinary infections by increasing the knowledge and skills to design efficient and effective office systems.

The toolkit synthesises a range of information and materials, including:

  • Academic literature explaining the link between infection and pregnancy complications;
  • Clinical recommendations for screening, treatment and follow-up;
  • Examples and resources for use by healthcare providers and staff;
  • Continuing educational materials that target clients;
  • Recommendations for ensuring efficient office processes to support optimal prenatal care.

Objectives

Use of this toolkit will enhance knowledge, skills, and clinical systems.

How to use this toolkit

  • Click on a Section Heading in the Table of Contents below to jump to that secition. Click on the Section name to download a pdf file of that section.
  • Click on links to CDC and health department brochures to download them individually from the source. These links will take you to external websites. (Lower resolution copies are also included in the toolkit pdfs.)
  • To download the complete toolkit, click here (large file, 166 pages).

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TABLE OF CONTENTS

Jump to Section

 

Overview

  

Key Recommendations

  
Preconception and Gestational Age-Specific Perinatal Infection Screening Recommendations
  

Checklist of Common Errors & Steps to Check Your Clinical Practice

 

Background

  

Urinary Tract Infections

  
Complications in Pregnancy and Preventive Strategies
  
Screening and Diagnosis for Asymptomatic Bacteriuria
  
Guidelines for Asymptomatic Bacteriuria in Pregnancy
  
Key Principles of Best Practices for Screening, Treatment and Follow-up
  
Patient Instructions and Patient Educational Handouts and Resources
  

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Group B Streptococcus

  
Complications from GBS in Pregnancy
  
Guidelines for Universal Prenatal Screening for GBS to Prevent Neonatal Infection
  
Antenatal Algorithm for Management of GBS
  
 
Patient Educational Handouts and Resources
  
 
 
 

Chlamydia

  
Frequency of Complications Associated with Untreated Chlamydia Infection
  
Guidelines for Chlamydia Screening and Management in Pregnancy
  
Key Principles of Best Practices for Chlamydia Screening, Treatment and Follow-up During Pregnancy
  
Chlamydia Screening Treatment and Follow-up Algorithm
  
Comparison of Chlamydia Testing Technologies
  
Patient Educational Handouts and Resources about Chlamydia
  

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Gonorrhea

  
Complications Associated with Untreated Gonorrhea in Pregnancy
  
Guidelines for Gonorrhea in Pregnancy
  
Key Principles of Best Practices for Gonorrhea Screening, Treatment and Follow-up During Pregnancy
  
Comparison of Gonorrhea Testing Technologies
  
Gonorrhea Screening and Treatment Algorithm
  
Patient Educational Handouts and Resources
  

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Syphilis

  
Syphilis Rates in California, 2008
  
Complications Associated with Untreated Syphilis in Pregnancy
  
Screening and Diagnosis of Syphilis in Pregnancy
  
Clinical Manifestations of Syphilis
  
Guidelines for Screening, Treatment and Follow-up for Syphilis in Pregnancy
  
Key Principles of Best Practices for Syphilis Screening, Treatment and Follow-up During Pregnancy 
  
Management of Sexual Partners
  
Algorithm of CDC Guidelines for Management and Treatment of Sexual Partners of Adults with Syphili
  
Patient Educational Handouts and Resources
  

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Bacterial Vaginosis

  
Complications of Bacterial Vaginosis in Pregnancy
  
Bacterial Vaginosis Diagnosis
  
Bacterial Vaginosis Diagnostic Tests: Sensitivity & Specificity
  
Guidelines for Screening, Treatment and Follow-up for Bacterial Vaginosis in Pregnancy
  
Key Principles of Best Practices for Bacterial Vaginosis Screening, Treatment and Follow-up During Pregnancy
  
Algorithm for Screening, Treatment, and Follow-up for Bacterial Vaginosis in Pregnancy
  
Patient Educational Handouts and Resources
  
  • What You Should Know About Bacterial Vaginosis—English, The Female Patient
  • What You Should Know About Bacterial Vaginosis—Spanish, The Female Patient

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Genital Herpes

  
Complications of Genital Herpes in Pregnancy
  
Prevention of Neonatal Herpes
  
Screening, Diagnosis and Clinical Manifestation of Herpes Virus
  
Herpes Simplex Virus Clinical Syndromes
  
Guidelines for Diagnosis, Treatment and Follow-up for Genital Herpes in Pregnancy
  
Key Principles of Best Practices for Genital Herpes Screening, Treatment and Follow-up During Pregnancy
  
CDC Treatment Recommendations for Genital Herpes
  
Patient Educational Handouts and Resources
  

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Partner Treatment

  
Partner Notification and Treatment
  
Patient Delivered Partner Therapy
  
California Law
  
Patient-Delivered Partner Therapy (PDPT)—Guidance for Medical Providers in California, from CA STD/HIV Prevention Training Center
  
 
 
 

Treatment and Screening Guidelines

  

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Mandatory Reporting

  
 
 

System Design—QUALITY IMPROVEMENT TOOLS

  
Definition of Quality Health Care
  
Office System Inventory Tool
  
Cause and Effect Diagram
  
Model for Improvement Key Points
  
  • Question 1: “What are we trying to accomplish?”
    Example “Aims Statement” Related to Urine and Infection Screening
  • Question 2: “How will we know that a change is an improvement?”
    Example Performance Measures for Infection Screening in Pregnancy
    Example of Measurement During PDSA
  • Question 3: “What changes can we make that will result in an improvement?”
  
 
 
 
 
 
Change Concept and Change Idea Definitions
  
Example: Moving from Change Concept to Testable Change Ideas
  
Example PDSA
  
PDSA Form Template
  
Tips to Make the Most of PDSA Cycles and Tests of Change
  
Example Data Collection Form for Infection Measure
  
Care Model for Perinatal Health
  
Change Concepts and Change Ideas to Consider Related to Urine and Reproductive Tract Infections
  

Resources

  
Website Links to Clinical Screening and Treatment Guidelines
  
Taking a Sexual History—The 5 Ps Approach
  

Glossary

  

References

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