Gonorrhea during pregnancy- The complete guide for the mothers.

The health of women and babies is the topmost priority during pregnancy. However, their well-being sometimes can prove to be a challenge. Especially, if the mother is infected with STDs. One of the common sexually transmitted diseases is Gonorrhea. A woman can be infected with it either before or during pregnancy. In some cases, gonorrhea does not show any symptoms and is hard to detect. So its detection early on is critical. 

What is Gonorrhea?

Commonly known as ‘the clap’ it is a highly contagious sexually transmitted disease. It spreads by having unprotected vaginal, anal, and oral sex with a partner infected with Gonorrhea. Gonorrhea is a bacterial infection that takes 10 days to develop and spread through the body. 

A pregnant woman with gonorrhea is likely to spread the infection to the baby either during pregnancy or at the time of delivery. If left untreated gonorrhea can be very harmful both to the mother and baby. 

Gonorrhea unlike other STDs once treated properly can be fully eradicated. So if you think you have contracted gonorrhea it is better to seek treatment. 

Causes of Gonorrhea 

Gonorrhea is a common STD that is contracted by sexually active individuals. Like many STDs, it mostly happens due to unprotected sex between two individuals. Gonorrhea happens by:

• Having unprotected anal, vaginal, and oral sex

• Having more than one sex partner

• Sharing unwashed sex toys

• Gonorrhea spreads to the baby if the mother is infected at the time of delivery. 

Gonorrhea does not spread by casually touching, kissing, or hugging. It also does not spread by sharing cutleries or utensils. 

Symptoms of Gonorrhea

Gonorrhea infection happens to both men and women. Their symptoms, though largely the same, vary slightly. Gonorrhea symptoms in men: 

• Painful and burning sensation while urinating

• Swollen and tender testicles

• Unusual discharge from the penis

Typically with gonorrhea, there are no physical symptoms. This makes diagnosing gonorrhea hard. Some come to know only when their partner develops the symptoms. Usually, s, symptoms of gonorrhea in women are:

• Unusual vaginal discharge 

• Painful urinating

• Rashes on hands, wrists, elbows, and ankles

• Anal itching

• Irregular bleeding during menstruation 

• Soreness in the anus

• Bleeding from the anus

• Painful bowel movements

• Itchiness, redness of eyes, and discharge from eyes if you touch your eyes after touching your genitals. 

Long-term effects:

If gonorrhea is left untreated it can cause many long-term effects on women. In most cases gonorrhea is undetectable which may cause:

• The infection spreads from the cervix to the upper genital tract and uterus.

• Pelvic Inflammatory disease (PDI). In this, the infection spreads to the Fallopian tubes which leads to:

▪ Infertility

▪ Ectopic pregnancy: In this the fertilized egg implants outside the uterus 

▪ Chronic pelvic pain

• Disseminated gonococcal infection in which the infection spreads to the blood.

• Arthritis in knees, hands, feet, ankles, and wrists with gonococcal organisms invading the body.

The inflammation of the tissues in the brain or spinal cord, inflammation of the lining of the liver, or infection in the heart valve is reported in some rare cases. 

Effects of Gonorrhea during pregnancy.

What happens when the woman contracts gonorrhea before or during pregnancy? There are many harmful effects for women who get infected with gonorrhea. Preterm labor and miscarriages are common among women with gonorrhea. And, it affects the health of both the baby and the mother. There are several harmful effects for both of them.

Mother

• Infection of the amniotic sac and fluid

• The infection may lead to the rupture of membranes (PPROM)

• Gonorrhea makes the mother susceptible to other STDs such as HIV and chlamydia

• Urinary Tract infection (UTI) post-delivery

• Infection in the uterus post-delivery

Baby or Foetus

• It may lead to miscarriage

• It can cause preterm birth

• At the time of delivery, the baby may be underweight

• Gonorrhea mostly affects the eyes of the baby causing infection. It usually happens after 3-4 days after the birth.

• If left untreated it may lead to permanent blindness in the baby

• Blood infection

• Scalp infection

• Upper respiratory infection

If caught early gonorrhea can be cured permanently and the chances of passing the infection to the baby are eradicated. If babies contract the infections there are treatments available to cure them. 

Who is at high risk to get infected by gonorrhea?

Though every woman who has unprotected anal, vaginal, and oral sex are susceptible to contracting gonorrhea, some women are at higher risk to get connected by it. The women who have high chances of getting gonorrhea are:

• Women between the age of 15 to 24

• Women with a new sex partner

• Women having sex with multiple partners.

• Women who have been previously diagnosed with gonorrhea 

• Women who have been infected with another sexually transmitted disease.

Women infected with gonorrhea at the time of delivery can pass the infection to the baby when they come in contact with the vaginal fluids and the bacteria that cause the disease.

Does Gonorrhea go away on its own?

There are no chances of gonorrhea going without any treatment. Gonorrhea cannot be cured naturally or with any home remedies. If detected you should immediately go to your doctor and get treated. 

Gonorrhea if not treated will lead to many long-term harmful effects. Like Pelvic inflammatory disease (PID), higher risk of getting other STDs like HIV, infection in the blood, joint arthritis, and many more.

So it is advisable to seek the help of medical professionals then relying on your own when it comes to gonorrhea. 

What is the treatment of Gonorrhea during pregnancy?

Unlike many sexually transmitted diseases, gonorrhea can be cured permanently. You do not live with it for the rest of your life. However, the problem does not lie in the treatment but rather in detecting the disease. As discussed earlier, usually if an individual has gonorrhea they may not exhibit the signs or symptoms. This results in many cases getting undetected. So women should:

• Get themselves checked regularly to see if they have contracted any sexually transmitted disease.

• Ask their partners to get screened for any potential STDs. 

• If their respective partners show the symptoms they should also get tested irrespective of any symptoms.

When gonorrhea is detected during pregnancy your doctor will treat it according to your case. 

• Experts recommend getting screened for gonorrhea in the early stage of pregnancy. This leads to uncomplicated pregnancy preventing the spread to the baby.

• If possible get retested again during pregnancy to eliminate any risk. Health professionals do recommend it if your partner exhibits any sign of it. 

• When gonorrhea is detected in pregnancy it is treated by administering antibiotics. The antibiotics are either given by injection or orally. These antibiotics are: 

▪ Ceftriaxone- it is given as an injection

▪ Azithromycin (Zithromax)- is given orally.

During pregnancy, gonorrhea can be passed to the babies. If they get infected by this they can also be treated for this.

▪ Antibiotics given to women are also given to babies. Ceftriaxone is safe for both mother and baby. 

▪ At the time of delivery, babies are given eye drops irrespective of vaginal birth or cesarean section. 

▪ As there are high chances of contracting the eye infection babies along with eye drops are also given Erythromycin ophthalmic ointment.

Is it necessary for women to get tested while pregnant?

In the first trimester of the pregnancy, there are many tests an obstetrician performs. Among them, they also test for some common sexually transmitted infections. This testing is done on all women just to be on the safe side. 

In America, CDC has made it compulsory to test for gonorrhea too. So during the prenatal visit, they are also tested for gonorrhea. However, in India, it is not compulsory to get checked for gonorrhea. They do test for HIV and syphilis. 

So if you think you may have contracted the disease you should ask your gynecologist to test you for the same. It is better if it is caught early so then it can be treated and cured. 

Experts do recommend getting tested again after the first prenatal visit. You can be tested between 8-18 weeks. And again in the third trimester, you are screened for gonorrhea. 

How is Gonorrhea diagnosed?

During pregnancy when women go for their first prenatal checkup she is tested for STDs. For gonorrhea, they test many methods, such as:

▪ A culture test is done on Thayer-Martin media. This is the most widely used method to diagnose gonorrhea.

▪ Nucleic Acid Hybridization test of cervical can also detect gonorrhea in women.

▪ A swab of the mouth also detects gonorrhea

▪ A swab of the vagina and rectum is taken and then they are given for testing. If results are positive it means the woman has s gonorrhea. 

What steps to take to prevent Gonorrhea?

Gonorrhea in sexually active individuals are preventable. There are several things you can do to ensure that you do not get the infection. 

▪ Practice safe vaginal and anal sex by using a condom

▪ Use dental dams while practicing oral sex

▪ You should get yourself regularly checked for any infection you may have contracted. Screening helps in the early detection of gonorrhea.

▪ Ask your respective partner to get tested for STDs regularly. If your partner is tested positive then you can take necessary preventive measures.

▪ Limit the number of sexual partners. The chances of getting gonorrhea are less if you have sex with less number of people.

▪ Do not have sex with your partner if they exhibit the symptoms of gonorrhea like painful urination, genital soreness, or rash.

The overview of this is that if you are pregnant and have gonorrhea then you should go to your obstetrician and get treated. If left untreated it can have serious complications in pregnancy which may affect the health of your baby. 

Gonorrhea is curable. The antibiotics are safe for both mother and baby.