Pregnancy is the most important moment in a woman's life. It is during this period that any infections can irreparably affect the health of the unborn baby. After all, the use of most drugs during the period of bearing a baby is prohibited, which further complicates the fight against diseases. It is especially unpleasant to get sick at the time of bearing a baby with venereal ailments, which include gonococcal infection or gonorrhea. What should a woman do if gonorrhea is detected during pregnancy, and the desired pregnancy so needs to be preserved? How is it dangerous for the health of the fetus and is it possible for the expectant mother to get rid of this danger without causing irreparable consequences for the health of the baby?
Gonorrhea (popularly - gonorrhea) is an infectious disease. It is caused by bacteria of the gonococcus type. This ailment belongs to venereal - it is transmitted through sexual contact.
For a pregnant woman's body, gonorrhea is especially dangerous, since it affects all her female organs. And the health of the reproductive system is most reflected in the bookmark of fetal health.
Tripper is often referred to as a social stigma for a woman. Many immediately begin to condemn the expectant mother for promiscuity in sexual contacts.
In reality, a woman, due to minor symptoms, may not even be aware of this enemy at all. And you can get infected with gonorrhea even in a legal marriage.
Gonorrhea affects most of the internal organs of the female genital area (vagina, cervical canal, uterus with appendages). If the timely detection and treatment of this insidious ailment does not occur, then gonococci spread to many organs and systems (from the rectum to the larynx) of the future mother.
The main insidiousness of the gonorrhea is that it may not appear in any way even for several years. Therefore, it is important for a woman “on the run” to pass all the necessary tests in a timely manner and as early as possible to identify an insidious enemy who has settled in her susceptible body.
Symptoms of gonorrhea
Self-diagnosis of gonorrhea is often difficult for a woman. Signs of this disease are attributed by many to some other "sores" and do not sound the alarm until the test results are received.
The signs of gonorrhea are not special (not specific).
Self-diagnosis can be difficult for most women, as it has much in common with the manifestations of many urological ailments.
The most common symptoms of gonorrhea are:
- acute pain at the time of urination;
- purulent discharge with an unpleasant, pungent odor;
- itching or burning in the genitals;
- the temperature is higher than usual (37.5-38.5 degrees);
- lower abdominal pain (worse after "intimacy");
- headaches.
Depending on where the pathogen settled, the following forms of this disease are distinguished:
- colpitis, cervicitis (inflammation of the vagina, cervical canal or urethra);
- endometritis or salpingo-oophoritis (inflammation of the uterus or appendages);
- pharyngeal or anorectal form (inflammation of the larynx or anus).
A feature of gonorrhea is that all symptoms appear only in the acute period (about two weeks). Then, even without any treatment, these manifestations gradually decrease.
In addition, gonorrhea can damage other organs (depending on the type of intercourse). Oral sex can damage the mouth and throat, causing pain and inflammation. When a gonococcus falls into the eyes, there may be pain and burning sensation in them. If the anus is infected, itching, pain and discharge will occur in this organ.
Many women experience relief when their symptoms subside on their own, unaware that this is a false recovery. Not rushing to see a doctor, expectant mothers make a fatal mistake. At the same time, the health of women themselves and their future children can be seriously affected.
Forms of the disease
In medicine, there are 2 main gonorrheal forms:
- fresh (lasting less than 2 months), which is divided into acute, subacute and torpid (or oligosymptomatic) phases;
- chronic (mild, lasting more than 2 months).
A typical feature of this disease is asymptomatic (in about half of the cases). At the same time, people become carriers of this dangerous disease without any signs of this disease.
Gonorrhea during pregnancy: consequences for women
Gonorrhea refers to an insidious ailment and is dangerous for a woman at any stage of her life. In a pregnant woman, this disease can lead to the following problems:
- the threat of termination of pregnancy;
- placental insufficiency;
- septic miscarriage;
- premature outpouring of water;
- premature birth;
- chorionic amnionitis (inflammation of the placenta + fetal membranes).
Gonorrhea during pregnancy is most often hidden and painless. The changes in the woman's health are attributed to the physiological characteristics of pregnancy, ignoring the visit to specialists.
Only a third of expectant mothers report pain in the lower abdomen or "bad" discharge. Most women do not worry at all, but in vain!
In addition to the possible serious complications of this disease, the presence of gonorrhea increases the likelihood of even more dangerous diseases, including HIV.
Frequent consequences of gonorrhea for women in labor are postpartum complications, manifested in inflammatory diseases of the genitourinary system.
In the chronic form of gonorrhea, adhesions form in the woman's tubes, which leads to infertility. causes severe abdominal pain. Also, chronic tubal pathology is a push factor for ectopic pregnancy.
Women with gonorrhea have a 3 times higher risk of developing endometritis
Childbirth with gonorrhea is carried out in special observational departments, in compliance with the rules of the sanitary and hygienic regime (to avoid cross-infection of other women).
Consequences for the baby
What will happen if you do not treat gonorrhea during pregnancy? Will the baby suffer from this? The answer is yes! Often, at the time of delivery, the baby is also infected. The eyes of the child are the first to suffer. If treatment is not started on time, the newborn may simply go blind. In Tsarist Russia, as you know, almost half of the population suffered from gonorrhea of \u200b\u200bthe eyes. Now, most women are aware of the dangers of such ailments for a baby and do not ignore tests to identify dangerous infections. Nevertheless, it is precisely the pathologies of the eyes (purulent inflammation of the eyelids and eyes - gonoblenorrhea) that most often complicates the condition of newborns.
If, at the same time, urgent treatment is not taken up, then the baby's eyelids grow together and blindness occurs.
With gonorrhea, delivery is often premature, with many pathologies and with high mortality of newborns. At the same time, infants have reduced body weight and prolonged jaundice.
Also, with gonorrhea, developmental delays, intrauterine infection, prematurity and generalized gonococcal infection of newborns are common.
Other dangerous consequences of gonorrhea for a newborn can be joint diseases, skin lesions of the head, meningitis, or even sepsis. In meningitis, damage to the brain (brain or spinal cord) can render the child disabled or fatal.
Sepsis of newborns with gonococcal infection is an extremely dangerous complication for newborns: it leads to irreversible consequences in the body, up to the death of the baby.
Diagnosis of the disease
Pregnancy is not a time to experiment. Due to the fact that gonorrhea is characterized by scanty symptoms, only tests can help to find out about the presence of gonococcus in the body.
A pregnant woman should not be arrogant and ignore medical appointments. After all, the health and life of the child is at stake.
To identify gonorrhea during pregnancy, the following methods are used:
- Medical examination: mandatory manipulation (one for each trimester) to determine the state of the cervix and the nature of the discharge.
- A smear on microflora (three times per pregnancy), requires clarification in the form of additional studies.
- (gives almost 100% result).
- PCR (requires clarification due to frequent errors).
- An ELISA (blood test) test can make a diagnosis in most cases.
Treatment
Treatment for gonorrhea in pregnant women should be started immediately!
Although women "in position" are protected as much as possible from taking chemical drugs, gonorrhea is an exceptional case. In this disease, the harm from drugs is much lower than the consequences from gonorrheal complications.
Treatment of pregnant women from gonorrhea differs little from the treatment of women in other categories. However, during this period, all manipulations at the level of the cervix are contraindicated, so as not to harm the fetus by prematurely induced childbirth.
Traditional treatment regimens for gonorrhea mainly include:
- Taking immunomodulators to activate the woman's immune system to fight the disease. Compulsory antibiotic treatment, minimally dangerous for the baby.
- Usually, they try not to continue the course of antibiotics for pregnant women for more than a week: it is compiled individually for each case of the disease (taking into account the severity of the disease, general health and the presence of concomitant diseases).
- Local treatment (lubrication or douching with disinfectant solutions, swabs with chemicals, antiseptic powders with talcum powder).
- An obligatory stage is the parallel examination and treatment of the partner. Otherwise, re-infection of an already cured woman is possible.
If gonorrhea is detected, the pregnant woman is sent to an infectious diseases hospital. Home treatment is not carried out due to the risk of infection of others.
As it turned out, gonorrhea in pregnant women is characterized by little or no symptoms. However, the consequences of this pathology are fraught with serious complications for the mother and the unborn baby. That is why it is so important to examine a pregnant woman according to the recommended regimens for the earliest possible detection and timely treatment of this ailment, which is dangerous for a woman "on demolition" and a fetus. Take care of your health and those of your loved ones!
Gonorrhea, at least as the name of one of the most common sexually transmitted diseases, is known to everyone. The people call this disease "French runny nose" or "gonorrhea" (translated from a foreign "tourist"). The latter name was invented by the romantic Dutch, linking gonorrhea with travel and casual romantic relationships. Even the Bible mentions gonorrhea as a source of ritual impurity. Many people do not know how dangerous this disease is and whether it can be treated at all. We'll discuss these topics and learn some basic information about gonorrhea, its symptoms and treatment.
Characteristics of gonorrhea
Gonococcal infection, or gonorrhea, is an infectious disease caused by gonococci of the species Neisseria gonorrhoeae. They are gram-negative diplococci, do not move, are bean-shaped and do not form spores.
Epidemiology
Tripper is a very common sexually transmitted infection. About 60 million cases of gonorrhea are reported worldwide each year. In Russia, since the beginning of the 2000s, there has been a decrease in the incidence rate compared to previous years. In the adult population, this is 24 cases per 100 thousand souls.
It seems that the situation is uncritical, especially since gonorrhea is easy to cure. However, there is one big "but". In 2018, a new strain of gonorrhea was discovered in Britain that does not respond to treatment. If such gonorrhea begins to spread everywhere, then the whole world is threatened with a real epidemic.
Infection routes
The main route of transmission of infection is sexual intercourse of all types. Gonorrhea can affect not only the genitals, but also the rectum, as well as the oral cavity. Women have an increased risk of infection due to the structure of their genitals.
Despite the fact that gonorrhea quickly dies in the external environment, the transmission of the disease is carried out not only sexually, but also by contact-household means. It is almost impossible to get infected in swimming pools, in the metro and in cafes, since outside the carrier gonococci die very quickly. Infection can occur upon contact with fresh biomaterials of an infected person: sperm, vaginal secretions, saliva. For example, if a family member suffers from oral gonorrhea and shares a towel or toothbrush with his relatives.
Another way to contract gonorrhea is to infect a baby during childbirth. For a baby, this is very dangerous, since a fragile body practically does not resist infection.
Disease stages
There are several stages of gonorrhea:
- Incubation period. Gonococci have just entered the human body and have not yet had time to cause a response. However, an infected person can already infect others. The incubation period for gonorrhea lasts from 12 hours to 10 days (in rare cases, up to 3 months). During this time, the causative agent of the infection spreads through the body through the lymph and can cause inflammation of the more distant organs of the genitourinary system (testicles, prostate gland, fallopian tubes, etc.).
- Fresh gonorrhea. It manifests itself within two months after the incubation period. The fresh form is subdivided into acute (at this stage the first clinical signs of gonorrhea appear), subacute (symptoms are present, but not pronounced) and torpid (without clinical manifestations).
- Chronic gonorrhea. It is characterized by a latent course of the disease and blurred symptoms. During this time, chronic gonorrhea can invade the urethra and lead to a blockage.
Clinic of the disease
The symptoms of gonorrhea have a characteristic clinical picture. As a rule, with gonorrhea, patients have an increased body temperature and general weakness. The mucous membranes at the site of penetration of the pathogen are very vulnerable and are greatly affected by the gonococcus, which causes a variety of unpleasant sensations. It is also worth noting that in the vast majority of cases with gonorrhea there is purulent discharge.
Consider how gonorrhea manifests itself depending on the location of the infection.
- Gonorrhea of \u200b\u200bthe lower genitourinary tract
The infection can cause abscess formation (purulent inflammation) of the urethral (paraurethral) and sperm-producing glands or pass without it.
Visually, representatives of the stronger sex note the swelling of the opening of the urethra. Otherwise, gonococcal infection of the lower urinary tract in men goes away with the following symptoms:
- purulent discharge from the urethra;
- itching and burning in this area, both during urination and at rest, as well as pain radiating into the rectum;
- frequent urge to urinate;
- soreness during intercourse.
Women often do not experience any unpleasant sensations at all when infected with gonorrhea, but in 50% of cases they have to suffer from the following symptoms of the disease:
- purulent discharge from the urethra and genital tract;
- itching and burning in the genital area and discomfort during intercourse;
- soreness in the lower abdomen;
- swelling of the mucous membranes of the urethra, vagina, cervix, as well as erosion of these surfaces.
With abscess formation of the paraurethral and accessory glands in both women and men, the symptoms are similar to the previous case, but are less pronounced. In addition, hard, painful formations the size of a grain can be felt near the glands.
- Gonococcal anorectal infection
Due to anal intercourse with an infected partner, gonococcal proctitis may occur. Signs of gonorrhea in the anorectal region in men and women are the same:
- itching and burning in the anus with a slight amount of yellowish discharge, there may be an admixture of blood;
- hyperemia (overflow of blood vessels) of the anus and skin folds;
- soreness during bowel movements, constipation.
- Gonococcal pharyngitis
Gonorrhea can take a liking to the throat of a person who is infected after oral sex, and then gonococcal pharyngitis occurs. Very often it goes away completely asymptomatic. If gonorrhea in the mouth still makes itself felt, then both sexes will feel such clinical manifestations of it:
- feeling of dry mouth;
- pain when swallowing;
- hoarseness of voice;
- the tonsils are enlarged and covered with a film.
- Gonococcal eye infection
Gonococcal conjunctivitis is rare in adults and can be caused by an infection in the eyes with dirty hands with particles of genital secretions. Gonococcal eye infection affects newborns whose mother had gonorrhea during childbirth. Both men and women note the following symptoms with this type of disease:
- swelling and hyperemia of the eyelids;
- sore eyes;
- profuse purulent discharge;
- lacrimation and photophobia.
Possible complications
Gonorrhea is a rather serious disease that without treatment can end very unfavorably. Tripper is cunning and likes to metastasize to other organs, which causes complications of the infection:
- gonococcal arthritis with one-sided involvement of 1–2 joints with fever, pain and stiffness;
- gonorrheal perihepatitis - inflammation of the fibrous membrane of the liver, causing acute pain, and subsequently adhesions in the peritoneum;
- myositis - inflammation of a muscle with the risk of its future atrophy;
- gonorrheal meningitis with damage to the nervous system and mental disorders.
Skin lesions
If it enters the bloodstream, gonococci can cause sepsis with concomitant damage to internal organs. This condition can cause a hemorrhagic rash - a hematogenous skin lesion. At first, it is characterized by small spots (up to 2 cm in diameter), then these spots turn into pustules with hemorrhagic contents.
But most often, a rash with gonorrhea after a while forms ulcers with a necrotic center, surrounded by a purple corolla. These spots disappear within 4-5 days, leaving behind scars and pigmentation.
The very lesion of the skin with gonococci is not as scary as the reason for its appearance - gonococcal sepsis. Infection of the blood with gonorrhea pathogens can cause diseases of the heart, kidneys and other internal organs, in severe cases, death.
Diagnostics
If you suspect gonorrhea in the pelvic area, you should consult a urologist or gynecologist. Gonorrhea of \u200b\u200bthe mouth, anus, gonococcal conjunctivitis is a reason to contact specialized specialists: ENT, proctologist and ophthalmologist. Doctors must confirm the diagnosis in order to refer the infected person to a dermatovenerologist for consultation.
A biomaterial serving as a subject for research is:
- scraping from the urethra, rectum;
- discharge from the oropharynx, eyes;
- the first portion of urine collected no earlier than three hours after the last urination;
- for women - a smear from the vagina, cervical canal;
- for men - the secret of the prostate gland.
All test materials for gonorrhea should be sent to the laboratory as soon as possible in compliance with the transportation rules. If more than three hours have passed from the date of the analysis to laboratory research, the result may be doubtful.
Laboratory diagnosis of gonorrhea comes down to the following research methods:
- microscopic examination with staining the biomaterial with a 1% solution of methylene blue - gonococci become clearly visible under a microscope;
- culture research using selective nutrient media - identifies the pathogen and determines its sensitivity to certain antibiotics;
- molecular biological tests (PCR) - allow you to find the smallest particles of bacteria in the blood and establish a diagnosis.
Additional methods that clarify the stage of gonorrhea, and also allow to determine concomitant diseases, include instrumental diagnostics. These are ureteroscopy, colposcopy, anoscopy, ultrasound and diagnostic laparoscopy.
Treatment of various forms of gonorrhea
The question of how to treat gonorrhea can be answered unequivocally - with antibiotics. Most often, treatment is prescribed after determining the sensitivity of the pathogen to antibiotics, but it will take a long time to wait for the result - about two weeks. Therefore, sometimes, in the case of a neglected process and obvious suffering of the patient, antibiotics for gonorrhea are prescribed immediately.
Treatment for different forms of gonorrhea involves different regimens. Infection of the genitourinary system without abscess formation of the paraurethral and accessory glands will respond to drugs such as ceftriaxone 500 mg intramuscularly once or cefixime 400 mg orally once. Abscess formation significantly complicates treatment. Complicated gonorrhea lends itself to the following scheme: ceftriaxone 1 g intramuscularly or intravenously every two days for two weeks; cefixime 400 mg orally 2 times a day for the next two weeks. Anorectal gonorrhea and other forms of gonorrhea, besides ocular, are recommended to be treated in a similar way.
An eye infection can be overcome fairly quickly. Ceftriaxone 500 mg intramuscularly once a day for three days will help to cure gonococcal conjunctivitis.
If the infection does not respond well to treatment, then it is recommended to undergo physiotherapy courses, as well as observe a daily regimen and a moderate diet.
Gonorrhea and pregnancy
Each pregnant woman takes an analysis for gonorrhea at least three times: upon registration, at 27–30 weeks and at 37–40 weeks of pregnancy. Such close monitoring is done for a reason. Gonorrhea is dangerous for the baby and requires special treatment during pregnancy.
Features of the disease
If a pregnant woman contracted gonorrhea before conception, then in most cases the symptoms of the disease will be very scarce, since the infection quickly becomes chronic. Therefore, it is so important to recognize the disease in time and provide appropriate treatment, despite the absence of complaints.
Infection during pregnancy manifests itself quite clearly against the background of unstable hormonal status. The discharge is profuse, itching and redness are obvious. In this case, it is also important to confirm the diagnosis and quickly select a drug in order to prevent the influence of gonococci on the fetus.
Diagnostics and treatment
For the diagnosis of such a dangerous disease during pregnancy as gonorrhea, two methods are most often used: bacterioscopic and cultural. The second method is great for identifying chronic, sluggish gonorrhea.
If there is a suspicion of gonorrhea, but there are no gonococci in the smear, a so-called provocation can be prescribed for a pregnant woman: chemical or biological. In the first case, the urethra, cervical canal and rectum are lubricated with a solution of Lugol with glycerin or silver nitrate. After that, after 24 hours, a smear is taken, in which gonococci should appear if the woman is infected. With the biological method of provocation, a gonovaccine is injected intramuscularly with a certain number of gonococci. It will provoke an infection already present in the body to come out of the hidden corners to be detected in a smear. If a woman is healthy, then she will not be able to get infected from such a meager dose of pathogens.
If gonorrhea is found in a pregnant woman, treatment should be carried out immediately, regardless of the period. The drugs are prescribed with the participation of obstetricians and gynecologists. Typical treatment regimen: ceftriaxone 500 mg intramuscularly as a single dose or cefixime 400 mg orally as a single dose.
Consequences for the fetus
Gonorrhea of \u200b\u200bthe genitourinary tract is especially dangerous in the first three months of pregnancy, since the entrance to the uterus has not yet been blocked by the membranes and is the gateway for infection. Therefore, in the first trimester, gonorrhea can cause miscarriage or future premature birth.
If gonorrhea is not cured before childbirth, then the danger of infection is already in the newborn baby. Possible consequences: gonococcal conjunctivitis, gonococcal arthritis, and even sepsis.
Prevention of the disease
It is important to understand the symptoms of gonorrhea and how the infection is treated. But it is even more important to know how to prevent illness.
Prevention of gonorrhea is the use of a barrier method of contraception during sex with a casual partner. Only a condom can prevent gonococci from entering the body. The use of local antiseptics after intercourse will not save you from gonorrhea.
In order to prevent gonococcal conjunctivitis, all newborns are lubricated with antiseptic ointment, for example, tetracycline.
Any problems with the health of the expectant mother negatively affect the body of a child developing in her womb. Gonorrhea and other sexually transmitted infections are no exception in their effect on the course of pregnancy. That is why examination for pathogens of venereal diseases and their timely elimination are an important point for parents planning and already expecting a baby.
How can you get infected
Gonorrhea (another name - gonorrhea) refers to the classic sexually transmitted diseases, since the main route of transmission is recognized as sexual. The causative agent of the infection is paired diplococci of the family Neiseria gonorheae (gonococci). Among the predominant localization of the inflammatory process, the urethra, cervix, rectum, pharynx and eyes are distinguished. Most often, the disease proceeds with the development of gonorrheal urethritis, cervicitis, proctitis, pharyngitis, conjunctivitis. A special form of lesion of the eyes of newborns when infected with gonococci is called blenorrhea.
Most often, gonorrhea in pregnant women develops as a result of unprotected intercourse with a sick person. The most dangerous in terms of infection are traditional vaginal and anal contacts. It is possible to become infected with oral sex, but the risk remains small.
Women are more at risk of entering the body with gonorrhea pathogens than men. In fact, even a single sexual contact with a sick person leads to infection in 80-85% of cases.
Note! The transmission of the pathogen is also dangerous during petting - contact of the genitals without direct penetration of the penis into the vagina.
In addition to sexual, the vertical transmission of infection from a sick mother to a child is widespread. Most often, infection occurs during the expulsion of the newborn’s head through the birth canal of a woman.
Clinical manifestations
Despite widely used preventive measures, gonorrhea during pregnancy is quite common. On average, from the moment of infection to the appearance of the first signs of disease, 5 to 10 days pass.
Exposure to pathogenic bacteria on the body leads to the following symptoms:
- increased vaginal discharge (have a yellowish-white color and an unpleasant odor);
- cutting pain when urinating;
- pain in the lower abdomen;
- intermenstrual bleeding is possible.
Gonorrhea during pregnancy can cause inflammation of the large vestibular vaginal glands - bartholinitis. With this disease, a painful formation with a diameter of up to 4-5 centimeters appears near the labia. The woman's general condition worsens, signs of intoxication appear.
The penetration of pathogens into the uterine cavity in pregnant women is observed infrequently. It is accompanied by increased pain in the lower abdomen, dysmenorrhea. Vaginal discharge becomes more abundant, acquire a mucopurulent or bloody character. Even less often, gonorrheal salpingo-oophoritis develops, accompanied by intense abdominal pain, fever up to 39-40 ° C, tachycardia, and a decrease in blood pressure. The causative agent causes purulent inflammation of the ovaries and fallopian tubes, which is fraught with the development of infertility. Without timely treatment, gonococcal infection causes sepsis with multiple organ damage.
Gonococcal proctitis (inflammation of the rectum) is asymptomatic. Less commonly, a woman complains of discomfort, pain during bowel movements, itching and discharge from the anus. With gonococcal pharyngitis, sore throat, long-term unsuitable cough attract attention.
The course of gonorrhea during pregnancy can be without vivid clinical symptoms. In addition, even obvious signs of infection are not always considered manifestations of STDs: often the discharge in a pregnant woman is associated with candidiasis (thrush), and pain during urination is associated with cystitis.
Effects of infection on pregnancy and childbirth
How are pregnancy and gonorrhea related? What is the effect of infection on the fetus and the negative consequences for the body of the expectant mother and child? And how can you prevent potential health problems?
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Gonorrhea, what kind of disease, its symptoms and treatment
Gonorrhea during pregnancy can be dangerous: it's a fact. How the disease will affect the work of the reproductive system of a woman and the intrauterine development of the child depends, first of all, on the period of limitation of the infection.
How is gonorrhea in expectant mothers
There are no pronounced differences between the course of gonorrhea in pregnant and non-pregnant women: usually the disease develops according to the classical scenario. Expectant mothers are more likely to face asymptomatic and erased forms of infection, which are dangerous for both the woman and the child. In addition, due to the functional restructuring of vaginal cells during pregnancy, the risk of developing gonorrheal vaginitis is higher. It is accompanied by burning, itching, profuse mucopurulent or purulent discharge from the genital tract.
Note! Gonorrhea in women can be complicated by infertility: often pregnancy does not occur at all.
How does the infection affect the baby
A future mother who has experienced gonorrhea should know that the infection does not cause congenital malformations and abnormalities in the development of the child. However, infection while carrying a baby can negatively affect the fetus and the course of pregnancy.
The penetration of infectious agents into a woman's body in the first half of pregnancy is often accompanied by inflammation of the walls of the uterus. Gonococcal endometritis is one of the reasons for spontaneous abortion (miscarriage) in the first 8-10 weeks of pregnancy: the fetus cannot implant into the loose edematous endometrium and is rejected by the uterus, disrupting the woman's reproductive system. When infected in the first trimester, it is also possible to form a frozen pregnancy, which requires timely diagnosis and treatment.
Infection of a pregnant woman in the second or third trimesters of pregnancy also has its negative consequences. Usually gonococci cannot penetrate into the uterine cavity due to the protective action of the hematoplacental barrier and fetal membranes. However, with reduced immunity of the mother, the fetus is exposed to intrauterine infection with the development of chorioamnionitis or gonococcal sepsis of the newborn. These pathologies are accompanied by a sharp and, as a rule, sudden increase in body temperature of a pregnant woman, tachycardia.
In addition, gonococcus can cause fetoplacental insufficiency, in which the fetus lacks oxygen and nutrients, gaining weight poorly.
But usually the infection of a baby from a sick mother occurs precisely during childbirth. Moreover, most often it is accompanied by the development of gonoblenorrhea (inflammatory lesions of the eyes). In girls, concomitant gonorrhea of \u200b\u200bthe genitals is possible. Blennorrhea (literal translation from Greek - the expiration of mucus) - purulent inflammation of the conjunctiva (mucous layer of the eyeball). Called by gonococcal flora. May lead to blindness.
The first signs of the disease become noticeable 2-3 days after childbirth. The eyelids of the child swell strongly, and after 48-72 hours, abundant discharge of pus from both eyes begins. A severe course of infection is accompanied by damage to the cornea with the formation of a leucorrhoea - a white fibrous spot that prevents light from reaching the retina.
Note! In the postpartum period, women suffering from gonorrhea often develop severe inflammatory lesions of the uterus.
Diagnosis of gonococcal infection
According to medical documentation, a study on gonorrhea is carried out:
- women with manifestations of urethritis, cervicitis, adnexitis;
- ladies who confirm unprotected sexual contact with a patient with gonorrhea;
- any person with a comprehensive diagnosis of STIs;
- pregnant women during registration;
- women preparing to terminate a pregnancy;
- newborns with signs of purulent conjunctivitis (if gonorrhea is detected, parents are subject to mandatory examination).
In the diagnosis of the disease, an important place is given to complaints of a pregnant woman (in the topic of conversation, the doctor draws attention to a change in the nature of vaginal discharge, pain during urination, abdominal pain), gynecological examination (mucosal hyperemia around the urethra, cervical erosion, purulent discharge from the cervical canal ).
Developing gonorrhea during pregnancy is one of the most serious and dangerous diseases that threatens the life of the child and the health of the mother. In the absence of appropriate treatment, a tripper can provoke labor activity early, create conditions for premature discharge of amniotic fluid, or significantly affect the baby's health.
Why is gonorrhea dangerous in pregnant women?
The causative agent of this disease is gonococcus. Its activity provokes disturbances in the bladder, pharynx and rectum. Most often, women who suffer from gonorrhea have previously had inflammation of the fallopian tubes, ovaries or uterus. Over time, an infiltrate begins to form in the affected internal organ, which is then replaced by connective tissue.
A woman in position should be regularly tested and be observed by a doctor throughout the entire period of gestation. If you follow these requirements, then gonorrhea can be detected in the early stages. The sooner a disease is discovered, the less likely it is to develop a negative effect on the child or mother.
An untreated violation can lead to:
- poor functioning of internal organs;
- late miscarriage;
- infection of amniotic fluid;
- the occurrence of placental insufficiency;
- infection of the child.
How dangerous gonorrhea turns out to be directly depends on when the infection occurred.
If this happened even before fertilization, then most likely gonorrhea will acquire a latent form, and then become a chronic disorder. Chronic gonorrhea is more difficult to treat and it is dangerous because the fetus can become fixed outside the uterus.
Causes of gonorrhea
Most often, women become infected with gonorrhea as a result of sexual contact. There is also a risk of gonococcal infection through the household route. This can happen when personal hygiene is violated, that is, using someone else's underwear, washcloth or towel will be enough to get such a violation.
Symptoms of gonorrhea do not appear immediately. The incubation period ranges from 3 days to several weeks. With the development of the chronic form of the disease, other disorders are also observed, such as proctitis, cervitis, salpingo-oophoritis, etc.
Symptoms of gonorrhea in pregnant women
Gonorrhea during pregnancy has practically no distinguishing features. In the overwhelming majority of cases, the symptoms begin to manifest themselves sharply, since the influence is also exerted on the baby.
The situation is aggravated by the fact that against the background of the development of concomitant diseases, a woman may not pay attention to their cause, especially if you do not consult a doctor during this period. The acute course of the disorder is accompanied by a high body temperature and other signs of intoxication.
With a recurrent course, all symptoms can be blurred, which greatly complicates the identification of the disease.
There are no significant differences in gonorrhea during pregnancy. The only complication that can occur against the background of reduced immunity is the emergence of several infectious agents at once. This will cause the following symptoms:
- Burning or aching pain when urinating.
- Discomfort in the vagina, itching may occur. This is due to the fact that the microflora in the body is disturbed.
- Discharge from the genitals. They will have a thick consistency and white color.
- Lack of pleasure during sex. On the contrary, this process will be unpleasant for a woman.
- Unpleasant sensations in the area where the rectum is located.
In the photo on the right, you can see how the process of infection of the baby occurs with the development of gonorrhea.
If you notice at least one of the signs listed, then you should immediately seek help from a doctor and conduct additional research to confirm the diagnosis.
Treatment for gonorrhea during pregnancy
Before proceeding to the appointment of medications, the doctor will necessarily conduct a diagnosis, during which he will assess the current condition of the patient.
It is mandatory to conduct a survey regarding sexual relations and the time of possible infection. In addition, a smear is taken on the flora and gonorrhea, during the pregnancy of a woman, the doctor determines his norm on his own. The level largely depends on what stage of development the baby is and whether the expectant mother has concomitant diseases. A swab is taken from the rectum, cervix and pharynx. If leukocytes are found in the smear, then the previously established diagnosis is confirmed. In addition, blood, urine and mucous membranes are analyzed.
When a disease is detected, patients are prescribed a course of antibiotics.
The most popular of these is ceftriaxone. A single dose of the drug in the form of an injection is recommended, the dosage should not exceed 250 mg.
Often, treatment of gonorrhea during pregnancy is carried out taking into account chlamydia and other disorders that managed to develop simultaneously with gonococci. In this case, a course of erythromycin is prescribed, in duration it should not exceed 10 days. This drug is taken orally every 8 hours, but the doctor may prescribe a different dosage regimen.
Also required are immunomodulators and medications that help maintain the normal state of the placenta.
Drug-free treatment
- exclude all sexual contacts;
- follow the medication regimen to notice the effect of therapy;
- observed by a doctor to monitor the dynamics of recovery;
- adhere to proper nutrition and exclude the consumption of spicy, salty, smoked and fatty foods.
How well the therapy helps and the main remedy for treatment is assessed based on the test results. A woman is considered healthy if, 3 months after therapy, gonococci were not found.
Consequences of gonorrhea for pregnant women
The most negative consequence that can occur in a pregnant woman is a miscarriage.
The high probability of negative consequences increases with infection in the first trimester of pregnancy. However, properly selected therapy and medical supervision help to avoid this in 75% of cases.
If it is possible to avoid premature birth, then the baby can become infected with a gonorrhea while passing through the birth canal. In this case, doctors decide to have a cesarean section to prevent negative consequences.
During the period of gestation, gonococci negatively affect the condition of the baby, and problems with its stabilization may arise. In pregnant women, against the background of the disease, immunity deteriorates, which makes it vulnerable to other pathologies. Pathogens in this situation quickly enter the bloodstream and begin to rapidly spread throughout the body.
Health problems can be affected by arthritis, pharyngitis, and racing-related miningitis.
The effects of gonorrhea on the fetus
Infection of a baby with gonorrhea can occur during pregnancy or during childbirth. If an infection enters the uterus at an early stage of fetal development, serious defects may appear. However, even a successful course of the first trimester of pregnancy does not guarantee that health problems of the child will not arise later.
At about 4 months of pregnancy, the risk of infection in the membranes increases. This in turn will provoke chorioamnionitis. With this violation, inflammation of the membranes that envelop the baby occurs.
Complications of gonorrhea can cause placental insufficiency or hypoxia in the baby. At the final stage of pregnancy, there is a risk of developing polyhydramnios. Amniotic fluid at the same time exceeds the norm and the child cannot develop normally in such conditions. After 30 weeks of gestation, there is a risk of premature discharge of water, which will inevitably lead to infection of the baby.
Childbirth in gonorrhea
An infection transferred during gestation is not an indication for a cesarean section. If complications have been avoided, and also the baby feels normal, then childbirth takes place naturally. Doctors insist on surgery only with infection of the fetus and early discharge of water.
Caesarean is done even if the pathology was detected immediately before childbirth. In this case, it will not be possible to avoid infection of the baby, and it is simply impossible to quickly cure the gonorrhea. Symptoms of intoxication of the body will complicate the birth process and can provoke negative consequences in the form of injuries to the baby.
Doctor Komarovsky, in one of his programs, focused the attention of women that it becomes necessary to carry out a caesarean if there is evidence. Many people think that surgery is much worse than a natural birth, but it often helps prevent health problems for the baby and mother.
Regardless of whether the violation in the mother was completely cured or not, in the postpartum period the condition of the baby should be especially carefully monitored by doctors. A woman who has given birth also needs to be tested periodically to make sure that there is no chronic gonorrhea.
When a woman is in an interesting position, her health is important not only for her, but also for her unborn child. Many pathologies can adversely affect the formation of the fetus, so it is important to prevent them, and if the disease is there, then urgently take measures to cure it. Such serious pathologies include gonorrhea during pregnancy. What is this disease, how can you get infected with it? Is it possible to completely recover? What are the consequences for the baby?
What is gonorrhea
Once in the human body, gonococci begin to develop rapidly, provoking the disease
This pathology is one of the most serious, which pose a great danger to a developing baby. Bacteria lead to the development of a pathological process that captures simultaneously all the organs of the reproductive and excretory system of a woman. Therefore, if gonorrhea develops during pregnancy, the consequences for the child can be disastrous if urgent measures are not taken.
Important! Gonorrhea is insidious in that it can develop for a long time in the body, affecting more and more organs, but without showing symptoms.
How to suspect a disease
Pregnancy and gonorrhea are two incompatible concepts, therefore, if it so happened that the woman could not protect herself from this pathology, then it is necessary to start treatment as soon as possible.
Very often, if an infection is already present, the woman does not suspect it, because there are no obvious signs of the disease. Sometimes gonorrhea in pregnant women and not only in them is similar in its manifestations to urological pathologies, so women try to cope with symptoms on their own. There may be complaints about:
- some discomfort while urinating.
- There is more vaginal discharge, but future mothers may associate this with their condition.
- The discharge can have a rather unpleasant odor.
- Often a headache, but this symptom is not associated with the presence of a serious infection in the body.
- There is a burning sensation and itching of the genitals, the symptom resembles a thrush, so it does not make women seriously think and visit a doctor.
- Soreness and discomfort during intimacy.
- The temperature may rise.
The appearance of discomfort during urination by women can be confused with symptoms of cystitis, but this can be a sign of a dangerous disease. The development of gonorrhea often provokes severe headaches, and expectant mothers do not associate them with a dangerous pathology.
Need to know. All these symptoms can be observed in the acute phase of the disease, and it lasts only about 2 weeks. Then the symptoms begin to subside, the woman thinks that the disease has passed and medical consultation is not needed.
This is the whole danger of the situation: the infection flourishes further and increases the risk of serious complications that will affect not only the woman, but also her unborn baby.
Possible complications of gonorrhea
After the acute form passes, if therapy is not started, the disease becomes chronic. This usually occurs 2 months after infection. At this time, gonorrhea does not show symptoms during pregnancy, but the danger increases. Chronic gonorrhea is fraught with the following complications:
- Abortion, and this can happen at any time.
- Premature birth.
- Miscarriage early.
- The development of placental insufficiency, which negatively affects the condition of the child.
- The chronic form can provoke developmental pathologies in the fetus.
If there are all the prerequisites for terminating pregnancy, then there is a possibility that a pathological microorganism develops in the body
Need to know. The lack of an appropriate treatment for gonorrhea can end in failure for a woman. She may never become a mother again.If a woman is sick, then during childbirth there is a high risk of contracting a baby. And this can lead to the following consequences:
- Development of sepsis.
- Infectious diseases of the joints.
- Dermatological problems.
- Frequent conjunctivitis, especially immediately after birth.
- Meningitis is the most serious complication that can lead to death.
After birth, babies infected with gonorrhea suffer from conjunctivitis
Diagnosis of the disease
A diagnosis can only be made according to the results of the study, so a pregnant woman is simply obliged to regularly pass all the necessary tests, and even better to do this before pregnancy. If a doctor suspects gonorrhea, he will direct him to the following studies:
- Vaginal swab for gonococci.
- Since a smear for gonorrhea during pregnancy is only 60% accurate, therefore, a study of vaginal secretions is mandatory.
- A PCR study allows you to detect the causative agent of gonorrhea in almost 100% of cases, since the method is based on the determination of gonococcal DNA.
- An ELISA test is based on a blood test and allows you to accurately determine the pathology.
First of all, the doctor will take a smear, but he will not give complete information, so other tests are necessarily prescribed.
Modern research methods make it possible to determine the pathogen, quite often other pathogens are found along with gonococcus, for example, provoking chlamydia and trichomonellosis.
Treatment of gonorrhea in pregnant women
Important! If we compare the risk of developing complications from the disease and taking medications during pregnancy, then from gonorrhea it is much more serious. That is why, even while carrying a baby, treatment is mandatory.
If a pregnant woman is diagnosed with gonorrhea, treatment involves several directions:
- Taking medications that strengthen the woman's immune system.
- The course of antibiotic therapy. It should be at least 2 weeks.
- The recovery period, accompanied by the intake of vitamin preparations.
- Partner treatment to eliminate the risk of reinfection.
Given that the pathogen is a bacterial organism, antibiotics are prescribed to the woman. The safest for her are:
- Flemoxin.
- Benzylpenicillin.
- Ceftriaxone.
- Cephalexin.
- Erythromycin.
After undergoing a course of treatment, a woman must be prescribed vitamins and minerals to support the body and strengthen the immune system.
Any antibiotics while carrying a baby should be prescribed only by a doctor, self-medication is unacceptable. Treatment of a pregnant woman suffering from gonorrhea is most often carried out in a hospital, in the infectious ward, in order to exclude the risk of infection of households. Every pregnant woman should be aware of the seriousness of the situation, so in no case should you interrupt therapy without the knowledge of a doctor.
Is it possible to avoid infection
A woman, planning a pregnancy, must undergo a full examination to identify the presence of chronic pathologies, cure them, and only then think about having a baby. Quite often, during such examinations, sexually transmitted diseases are found, which the woman does not even suspect. If gonorrhea is treated in a timely manner, the risk for a woman and her child is reduced many times, it is possible to become pregnant and give birth to a healthy baby.
- Avoid accidental relationships that can end in disastrous health.
- During intimacy with a man, even with a husband, it is necessary to use high-quality condoms while carrying a baby.
- Timely take all the tests that the doctor recommends.
- Observe the hygiene of the body and personal space.
When planning a pregnancy, and especially during the period of carrying a baby, a woman should be very careful about her health.