**6.1 Detection of bacterial sexually transmitted infection in pregnancy**

The transmission of infections sexually during the intrauterine or perinatal period is associated with enormous consequences for both the woman and her fetus(es) or the newborn baby(ies) and even her partner. Sexually transmitted infections (STI) are risk factors for a number of adverse pregnancy outcomes, including spontaneous abortion, stillbirth, prematurity, low birth weight (LBW), postpartum endometritis, and various sequelae in surviving neonates. Preterm birth and low birth weight (LBW) are major determinants of infant morbidity and mortality, especially in developing countries, where neonatal intensive care facilities are often unavailable. In a study in Kenya, the incidence of LBW was 7.5%, and the perinatal mortality in LBW babies was 222 per 1000 live births [41]. STIs are believed to be of particular importance in determining pregnancy outcomes in the developing world because the prevalence of infection is so high [42]. During pregnancy, the gravidae and their partners should discuss with the health workers on the STIs and the risks of intrauterine/perinatal transmission to the fetus/neonate. They should also have access to the screening and treatment options available in their locality. In Nigeria and some other resource-limited settings, the only bacterial STI that has a routine screening at the first antenatal visit is syphilis using the VDRL test. Women with positive results from the VDRL test undergo the confirmatory tests (see the section on TP) and receive appropriate treatment as necessary. In many instances, the only available test in the rural and suburban areas of these developing countries is the VDRL or not at all. And so, treatment is given based on the positive VDRL (nontreponemal) test. The treatment may be inadequate based on wrong drug choice or inappropriate dosage of the correct drugs. Many women do not get tested and do not receive treatment for STIs because they receive care from unskilled personnel outside the health center settings.
