Infections during Pregnancy Nursing Care Plan & Management


  1. Maternal infections during pregnancy may contribute significantly to fetal morbidity and mortality.
  2. Two of the most common groups of infections present during pregnancy are sexually transmitted infections and TORCH infections.
Sexually transmitted infections include:
  1. Chlamydia
  2. Gonorrhea
  3. Group B streptococcus
  4. Hepatitis B
  5. Human papillomavirus
  6. Syphilis
  7. Trichomonas
  8. Candidiasis
  9. Bacterial vaginosis
  10. Human immunodeficiency virus (HIV)
TORCH infections include:
  1. Toxoplasmosis
  2. Other infections- hepatitis A, infectious hepatitis, hepatitis C, or syphilis
  3. Rubella
  4. Cytomegalovirus
  5. Herpes simplex virus
  1. Infections in this category may be caused by various viruses. Other organisms such as bacteria, spirochetes, protozoa, or yeast also may cause maternal infections, which are harmful to the developing fetus. Even though the infection in the mother may be very mild, the effects on the fetus can be catastrophic.
  2. The infections organism may be acquired during sexual intercourse, through the use of contaminated articles, such as needles; from human body fluids (semen, saliva, blood, urine, cervical mucus, breast milk, and stool); by eating undercooked meat; or by contact with infected cat feces in the litter box, sand box, or garden soil.
  3. Most organisms cross the placenta and infect the fetus, causing birth anomalies. The fetus may also acquire the organism as it travels the birth canal during labor, causing illness after birth.
  1. These infections organisms are capable of crossing the placenta and adversely affecting the development of the fetus. Spontaneous abortion or fetal newborn abnormalities may occur.
  2. In some instances, the infection can also cause infertility or sterility in the mother.
Assessment Findings For Sexually Transmitted Diseases

1. Associated findings

  1. Previous history of sexually transmitted disease or pelvic inflammatory disease.
  2. Numerous sexual partners
  3. Use of intravenous drugs or partners who use intravenous drugs

2. Common clinical manifestations

  1. PROM
  2. Preterm birth
  3. Systemic fetal infection

3. Laboratory and diagnostic study findings. Serologic and culture testing will reveal infection.

Assessment Findings For Torch Infections

1. Common clinical manifestations

  1. Influenza-type symptoms
  2. Rash
  3. Lymphedema and lymphadenopathy

2. Laboratory and diagnostic study findings. Serologic and culture testing will reveal infection.


1. Carefully screen for infections during pregnancy and treat possible infections as ordered.

  • At the first prenatal visit, the pregnant woman should have a rubella titer drawn. A titer of 1:8 provides evidence of immunity. If the titer is below 1:8, rubella vaccine is offered to the woman before discharge postpartum. Those women who require the vaccine should be cautioned not to become pregnant for at least 3 months afterward.
  • Cytomegalovirus currently has no effective therapy. This is important to remember because the highest rate of maternal infections occurs between the ages of 15 and 35. Usually, the infection is symptomatic.
  • Women who are presumed to be susceptible to varicella-zoster (chicken-pox) should have immune testing. Varicella-zoster immune globulin should be administered to those who are susceptible or who have been exposed. Varicella-zoster immune globulin should be administered to the exposed newborn within 72 hours of their birth.
  • All pregnant women should be screened for HbsAg, the hepatitis B surface antigen. The hepatitis B immune globulin can prevent infection in both mother and newborn. An initial injection can be given to the newborn, followed by doses given at 1 month and 6 months of age. Adults receive three injections that are given over a 6- to 12-month period.

2. Provide client and family teaching regarding the diagnosis of infection to promote compliance with the treatment plan.

  • Explain how maternal infections are acquired and transmitted to the developing fetus during pregnancy.
  • Demonstrate proper handwashing technique, stressing that it is the single most successful means of preventing infection.
  • Discuss hygienic and dietary measures that reduce the risk of infection.
  • Explain the organism, test, treatment, and fetal effects of the specific infection to the client and family.
  • Include the client in planning solutions for possible fetal effects.
  • Discuss “safe sex” with the client and partner.
  • Seek the couple’s input for development of a plan for follow-up care.


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Nursing Care Plan

Risk For Maternal/Fetal Infection

Risk for Infection: At increased risk for being invaded by pathogenic organisms.

Risk Factors
  • Inadequate primary defenses (e.g., broken skin, stasis of body fluids).
  • Inadequate secondary defenses (e.g., decreased hemoglobin, immunosuppression).
  • Inadequate acquired immunity.
  • Environmental exposure.
  • Malnutrition.
  • Rupture of amniotic membranes.