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STI screening recommendations in pregnant and post-partum women

STI testing guidelines for asymptomatic* pregnant and post-partum women have recently changed in WA to reduce the risk of negative health outcomes in both the mother and neonate.

	Women living in WA*	Women living in regions affected by the ongoing outbreak in Aboriginal  communities, i.e. Kimberley, Pilbara and Goldfields*
At booking visit	Chlamydia and gonorrhoea (SOLVS + if history of unprotected oral or anal sex, throat and ano-rectal swab) Hepatitis B and C serology Syphilis serology HIV serology	Chlamydia and gonorrhoea (SOLVS + if history of unprotected oral or anal sex, throat and ano-rectal swab) Hepatitis B and C serology Syphilis serology HIV serology
28 weeks^	Syphilis serology	Syphilis serology HIV serology
36 weeks or at time of any preterm birth	Syphilis serology	Chlamydia and gonorrhoea (SOLVS + if history of unprotected oral or anal sex, throat and ano-rectal swab) Syphilis serology
Delivery		Syphilis serology
6 weeks post-partum^		Syphilis serology

*For symptomatic patients, refer to sexually transmitted syndromes

**More frequent testing may be indicated for pregnant/ birthing women on a case-by-case basis if they have STI symptoms, unsafe sex and/or partner change in between these testing intervals. STI risk is higher in women to whom one or more of the following risk factors apply

• one or more new sexual partners after her first syphilis blood test in pregnancy
• a sexual partner who is a man who has sex with men
• sexual partners who have had one or more new sexual partners after the woman became pregnant
• infectious syphilis in a previous pregnancy
• a sexually transmitted infection during the current pregnancy or within the previous 12 months
• has used methamphetamine and/ or injected drugs in the previous 12 months
• is a person who is from, or has had sex with someone who is from a high prevalence country
• is a person experiencing homelessness
• is an Aboriginal person
• is from a geographical area with high prevalence of one or more of the above risk factors

^ The mental health assessment (including screening for drug and alcohol use and domestic violence) conducted at 28 weeks as part of MBS items 16590 and 16590 and at 6 weeks post-partum as part of MBS item number 16407 can be used to identify women at risk of STIs.