Gonorrhea in pregnancy

Introduction to pregnancy combined with gonorrhea Gonorrhea is a sexually transmitted disease mainly caused by urogenital system purulent infection caused by Neisseria gonorrhoeae (referred to as gonococcus). Its incidence rate is the first in China's sexually transmitted diseases. The gonococcus is a Gram-negative diplococcus, and the kidneys form a double arrangement. The affinity for the glandular epithelium is extremely easy to invade, often concealing infection in the female genitourinary tract. About 20%-80% of gonorrhea patients have no obvious symptoms, and most pregnant women are asymptomatic. The most common site of gonorrhea in pregnant women is still cervicitis. Others have urethritis, paraurethralitis and vestibular gland inflammation, but about 7%-10% of pregnant women only have colitis in the rectum. If gonococcal cervicitis is not treated in time, it can continue to be transmitted to sexual partners, and can be transmitted to the fetus during childbirth. Han Yukun (1996) reported that gonococcal cervicitis can cause cervical adhesions and hinder delivery. Therefore, for high-risk pregnant women, including single parents, adolescent girls, multiple sexual partners, drug abuse, prostitution and other sexually transmitted diseases, gonococcal screening should be performed early in pregnancy or at the first prenatal examination and in the third trimester. basic knowledge The proportion of illness: 0.15%, more common in patients with multiple sexual partners Susceptible population: pregnant women and newborns Mode of transmission: sexual transmission mother-to-child transmission Complications: endometritis salpingitis

Pregnancy combined with the cause of gonorrhea

Direct sexual contact transmission (40%):

Direct sexual contact is the main route of transmission of gonorrhea. Most gonorrhea occurs in people with multiple sexual partners and history of fornication.

Indirect contact propagation (30%):

Indirect contact transmission mainly refers to daily necessities used by people who come into contact with gonorrhea, such as bath towels, sitting basins, inner clothes, etc., because there are patients with Neisseria gonorrhoeae left on these daily necessities, it is easy to contact these products. Causes the appearance of gonorrhea.

Birth transmission (30%):

When the disease of the gonorrhea patients is not completely cured, sexual life, fertility, etc. will be transmitted to the other party and the fetus in the abdomen.

Pregnancy combined with gonorrhea prevention

In areas with high incidence of gonorrhea, pregnant women should be routinely screened for gonococcus in the prenatal period. It is best to have a cervical smear smear microscopy in the early, middle and late stages of pregnancy. It is recommended to carry out gonococcal culture for early diagnosis and thorough treatment. Newborns born to gonorrhea pregnant women should be prevented from taking medicine, penicillin 100,000 u, intravenous infusion every 8 hours, erythromycin eye ointment coated with double heels, at least 2 times a day. It is worth noting that the newborn can develop disseminated gonorrhea, and soon after birth, gonococcal arthritis, meningitis, sepsis, etc., treatment can not cause death.

Pregnancy with complications of gonorrhea Complications endometritis salpingitis

(1) Endometritis: Generally occurs in women who have gonorrhea and have undergone production or premature labor. Patients have increased vaginal discharge, abdominal pain, uterine swelling, and acute body temperature.

(2) Salpingitis: often 2 to 3 after the menstrual period, the patient has fever, chills, general malaise, vomiting, pain in the lower abdomen and waist, can be radiated to the perineum. There are many vaginal discharges with pus and blood. When palpation, there are tenderness on both sides of the lower abdomen. You can feel a small mass with tenderness and tenderness in the uterus. If the treatment is not timely, not completely become chronic salpingitis, it can cause ectopic pregnancy, the fallopian tube can cause adhesions due to inflammation, stagnant water or empyema, both sides can cause infertility.

Pregnancy with gonorrhea symptoms Common symptoms Increased vaginal discharge vaginal mouth local redness heat pain fever work burnout shiver

About 20%-80% of gonorrhea patients have no obvious symptoms, and most pregnant women are asymptomatic. The most common site of gonorrhea in pregnant women is still cervicitis. Others have urethritis, paraurethralitis and vestibular gland inflammation, but about 7%-10% of pregnant women only have colitis in the rectum. If gonococcal cervicitis is not treated in time, it can continue to be transmitted to sexual partners, and can be transmitted to the fetus during childbirth. Han Yukun (1996) reported that gonococcal cervicitis can cause cervical adhesions and hinder delivery. Therefore, for high-risk pregnant women, including single parents, adolescent girls, multiple sexual partners, drug abuse, prostitution and other sexually transmitted diseases, gonococcal screening should be performed early in pregnancy or at the first prenatal examination and in the third trimester.

Others such as acute salpingitis or acute pelvic inflammatory disease are less common during pregnancy, but within 12 weeks of pregnancy, before the uterine cavity has not been filled with the fetal sac, the gonococcal cervix can go up to the fallopian tube and cause acute infection. Before the diagnosis of acute salpingitis in pregnancy, it is necessary to exclude acute appendicitis, accessory mass torsion or tubal pregnancy.

The disseminated gonorrhea during pregnancy is much more common than non-pregnancy, accounting for 40%-50% of all gonococcal sepsis. After gonococcus enters the blood circulation, it first manifests as fever, chills, burnout, etc., about half of which are abscesses on the distal side of the fingertips. In addition, there is migratory joint pain, which develops into arthritis or synovitis. Upper limb joint damage is more common than lower limbs, with wrist and hand joints being the most common. Simultaneous and acute gonococcal endocarditis.

In addition, in gonorrhea during pregnancy, non-fertilization genus gonorrhea is more common than non-pregnancy, such as gonococcal pharyngitis and proctitis, may be related to changes in sexual behavior during pregnancy.

Pregnancy combined with gonorrhea

1. Take the smear of the urethra, cervical canal and other secretions for Gram staining, and see multiple Gram-negative diplococcus in the polynuclear leukocytes, which can make a preliminary diagnosis.

2. Secretory culture is currently the gold standard method for screening gonorrhea. It can be seen as round, convex, moist, smooth, translucent colonies with petal-like edges. Take colonies for smear, see typical diplococcus can be diagnosed.

Diagnosis and diagnosis of pregnancy combined with gonorrhea

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

First, non-gonococcal urethritis is mainly caused by Chlamydia trachomatis and decomposition of urea mycoplasma, its incubation period is longer, urethral inflammation is lighter, urethral secretion is less, secretions can not find Neisseria gonorrhoeae, conditional can be used for chlamydia, mycoplasma Detection.

Second, the soft sputum has a history of unclean sexual intercourse, caused by Ducey streptococci infection, short incubation period, acute onset, inflammation, multiple genital ulcers, purulent discharge on the surface, urethral redness, severe pain, secretion The smear of the smear showed Gram-negative Streptococcus mutans.

Third, non-specific urethritis has obvious causes of the disease, such as catheterization or indwelling catheter, as well as urogenital tract or adjacent organ inflammation, etc., secretions can be seen Gram-positive or negative bacteria.

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