Neonatal Conjunctivitis…
Optional Testing During Pregnancy
By Valerie Jacques, RN, CPM, NHCM
This is the third in a series of articles exploring testing procedures available for you and your baby during pregnancy.
Neonatal Conjunctivitis is a red eye condition in your newborn, which can be caused by an irritation, an infection, or a blocked tear duct. Conjunctivitis is also known by other names, such as Conjunctivitis of the newborn, Newborn conjunctivitis, and Opthalmia Neonatorum
If Newborn Conjunctivitis is caused by a blocked tear duct, or by an irritation (usually from antibiotic eye drops given shortly after birth), it is not considered a serious condition. If, however the cause is determined to be from infection, then the condition can be very serious. The most common bacterial infections causing Newborn Conjunctivitis are Gonorrhea and Chlamydia. Both are easily passed from Mom to baby during birth. Gonorrhea induced conjunctivitis may cause perforation of the cornea along with severe damage of other deeper eye structures…Chlamydia induced conjunctivitis is usually less destructive.
Genital and oral herpes viruses can also cause neonatal conjunctivitis, with severe eye damage a real possibility. As with Gonorrhea and Chlamydia, these viruses are usually passed to your baby as he/she passes through the birth canal, however herpes conjunctivitis is less common than Gonorrhea and Chlamydia.
The previous named viruses are usually transferred to Mom as sexually transmitted diseases (STD’s). Chlamydia is thought to be the most common STD in the US today and therefore Chlamydia conjunctivitis is seen on average 10 times greater than that of gonorrheal conjunctivitis. Mom may be without symptoms at delivery time, yet still pass bacteria or viruses to her newborn, which are capable of causing conjunctivitis.
In order to help prevent disease, all hospitals routinely administer some form of eye drops to every newborn. Silver nitrate used to be the standard, however some form of antibiotic drops (such as erythromycin) is becoming more standard.
Symptoms include:
Watery, bloody drainage from your baby’s eye(s)
Thick puss-like drainage from your baby’s eye(s)
Swollen, tender, or puffy red eyelids
Available testing:
Laboratory culture of the drainage from the eye
Slit-lamp examination – detects corneal ulcerations, perforations and other abnormal eye conditions.
Standard ophthalmologic exam
Complications can include:
· Corneal scarring
· Blindness
· Perforation of the cornea
· Inflammation of the iris
· Chlamydial pneumonia
Treatment depends on the severity of your baby’s condition. Topical antibiotic eye drops and ointments may be prescribed for mild cases. For more severe conditions, oral or intravenous antibiotics may be necessary in conjunction with ointment and eye drops. The eye(s) are usually irrigated with a saline solution on a regular schedule in order to remove accumulated drainage.
Conjunctivitis caused by irritation from the eye drops given routinely after birth at a hospital usually corrects itself. And if your baby develops conjunctivitis from a blocked tear duct, a warm gentle massage between the eye and nose may help.
Babies who develop conjunctivitis, and are quickly treated, generally have good outcomes. Early recognition and treatment of infected Moms (for STD’s) has helped to keep conjunctivitis to relatively low levels. If Mom’s infection goes unnoticed, then the standard regiment of eye drops given to newborns help prevent infection.
So what are your options? First, consult your copy of the Informed Consent Agreement, which was given to you by your health provider; this will answer many of your questions. Second, if you suspect that you have an STD, you should seriously consider testing, and if the presence of an STD is found, treatment should be obtained to prevent transmission to your baby during birth. Although administration of antibiotics to newborns is the standard of care, discussing your STD with your provider may offer other options.
The more informed you are, the better prepared you will be to make decisions regarding your health and the health of your baby. For more information on these and other tests during pregnancy, speak with your health provider. Also, look for more information contained in the Informed Consent Agreement provided by your health professional. Knowledge is power.
Valerie Jacques is a NH Certified Midwife, a Certified Professional Midwife, an RN, and the owner/operator of Coastal Family Birth Retreat in Stratham, NH. She can be reached at 603-502-9452, or at http://www.coastalfamilybirthretreat.com/.
Optional Testing During Pregnancy
By Valerie Jacques, RN, CPM, NHCM
This is the third in a series of articles exploring testing procedures available for you and your baby during pregnancy.
Neonatal Conjunctivitis is a red eye condition in your newborn, which can be caused by an irritation, an infection, or a blocked tear duct. Conjunctivitis is also known by other names, such as Conjunctivitis of the newborn, Newborn conjunctivitis, and Opthalmia Neonatorum
If Newborn Conjunctivitis is caused by a blocked tear duct, or by an irritation (usually from antibiotic eye drops given shortly after birth), it is not considered a serious condition. If, however the cause is determined to be from infection, then the condition can be very serious. The most common bacterial infections causing Newborn Conjunctivitis are Gonorrhea and Chlamydia. Both are easily passed from Mom to baby during birth. Gonorrhea induced conjunctivitis may cause perforation of the cornea along with severe damage of other deeper eye structures…Chlamydia induced conjunctivitis is usually less destructive.
Genital and oral herpes viruses can also cause neonatal conjunctivitis, with severe eye damage a real possibility. As with Gonorrhea and Chlamydia, these viruses are usually passed to your baby as he/she passes through the birth canal, however herpes conjunctivitis is less common than Gonorrhea and Chlamydia.
The previous named viruses are usually transferred to Mom as sexually transmitted diseases (STD’s). Chlamydia is thought to be the most common STD in the US today and therefore Chlamydia conjunctivitis is seen on average 10 times greater than that of gonorrheal conjunctivitis. Mom may be without symptoms at delivery time, yet still pass bacteria or viruses to her newborn, which are capable of causing conjunctivitis.
In order to help prevent disease, all hospitals routinely administer some form of eye drops to every newborn. Silver nitrate used to be the standard, however some form of antibiotic drops (such as erythromycin) is becoming more standard.
Symptoms include:
Watery, bloody drainage from your baby’s eye(s)
Thick puss-like drainage from your baby’s eye(s)
Swollen, tender, or puffy red eyelids
Available testing:
Laboratory culture of the drainage from the eye
Slit-lamp examination – detects corneal ulcerations, perforations and other abnormal eye conditions.
Standard ophthalmologic exam
Complications can include:
· Corneal scarring
· Blindness
· Perforation of the cornea
· Inflammation of the iris
· Chlamydial pneumonia
Treatment depends on the severity of your baby’s condition. Topical antibiotic eye drops and ointments may be prescribed for mild cases. For more severe conditions, oral or intravenous antibiotics may be necessary in conjunction with ointment and eye drops. The eye(s) are usually irrigated with a saline solution on a regular schedule in order to remove accumulated drainage.
Conjunctivitis caused by irritation from the eye drops given routinely after birth at a hospital usually corrects itself. And if your baby develops conjunctivitis from a blocked tear duct, a warm gentle massage between the eye and nose may help.
Babies who develop conjunctivitis, and are quickly treated, generally have good outcomes. Early recognition and treatment of infected Moms (for STD’s) has helped to keep conjunctivitis to relatively low levels. If Mom’s infection goes unnoticed, then the standard regiment of eye drops given to newborns help prevent infection.
So what are your options? First, consult your copy of the Informed Consent Agreement, which was given to you by your health provider; this will answer many of your questions. Second, if you suspect that you have an STD, you should seriously consider testing, and if the presence of an STD is found, treatment should be obtained to prevent transmission to your baby during birth. Although administration of antibiotics to newborns is the standard of care, discussing your STD with your provider may offer other options.
The more informed you are, the better prepared you will be to make decisions regarding your health and the health of your baby. For more information on these and other tests during pregnancy, speak with your health provider. Also, look for more information contained in the Informed Consent Agreement provided by your health professional. Knowledge is power.
Valerie Jacques is a NH Certified Midwife, a Certified Professional Midwife, an RN, and the owner/operator of Coastal Family Birth Retreat in Stratham, NH. She can be reached at 603-502-9452, or at http://www.coastalfamilybirthretreat.com/.
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