20. Infections of the genital tract

Genital infections, especially sexually transmitted infections (STIs) form a large burden for sexually active women globally. Public health efforts are of great importance to limit their detrimental effects at the population level. Both gynaecologists and obstetricians should be aware of the nature and adverse outcomes STIs, and other genital infections can have in their patients. The asymptomatic nature of many genital infections can hinder a timely diagnosis. In this chapter, key populations at risk for STIs and the most commonly used preventive interventions are highlighted. Subsequently, the most common pathogens are discussed, including C. trachomatis, N. gonorrhoea, T. vaginalis, T. pallidum, herpes simplex viruses and human immunodeficiency virus (HIV). These pathogens are addressed where relevant in paragraphs that cover the syndromic spectrum of STIs: from lower tract infections such as vulvitis and vaginitis, to upper tract infections as cervicitis and pelvic inflammatory disease, including genital tuberculosis, to systemic infections caused by syphilis and HIV. Lastly, STIs in pregnancy are covered.