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 DesignQUALITY 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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