Page 335 - Critical Maternity & Newborn Health Nursing

Trichomoniasis:

It is caused by trichomonas vaginalis, a microscopic motile protozoan that thrives

in an alkaline environment. Asymptomatic disease is common in both men and

women, thus screening for disease is important.

C/P: Trichomoniasis symptoms in women range from none to severe pelvic

inflammatory disease (PID). Women with trichomoniasis frequently report an

abnormal vaginal discharge, which may be purulent, frothy, or bloody. Frothy

vaginal discharge, which is thought to be the classic presentation of trichomoniasis,

may be observed in only 12% of patients with this infection.

Women with trichomoniasis also commonly report abnormal vaginal odor (often

described as musty); vulvovaginal itching, burning, or soreness; dyspareunia (pain

during sexual intercourse), which is often the major complaint; and dysuria (pain

during urination).

Patients may also complain of postcoital bleeding and lower abdominal pain.

Diagnosis is usually made from wet mount microscopy and direct visualisation,

which are insensitive. Pregnant women with trichomoniasis may be at increased

risk for premature rupture of membranes, preterm birth, and low birth weight.

TTT: Recommended treatment for trichomoniasis is metronidazole (flagyl)

administered in a single 2-g dose or, alternatively, metronidazole 500 mg twice
daily for 7 days for both male and female sexual partners. Partners should avoid

intercourse until both are cured (therapy is completed and both are symptoms free).

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