Pregnancy is an important stage in the life of every woman. Sick at this time is unpleasant and dangerous. Many drugs are banned, and viruses and bacteria can adversely affect fetal development. Sexually transmitted diseases represent the most serious threat. For example, gonorrhea during pregnancy. What to do if it did not work to maintain health, and the infection occurred? How to protect the baby inside the womb?
Medical certificate
Gonorrhea is the most famous sexually transmitted disease. The people also use its other name - “gonorrhea”. The infection is among the microbial, and affects with the same frequency of men and women. Some time after infection, it manifests unpleasant symptoms.
Infection occurs through sexual contact without barrier means of contraception with an ill partner. Pathology is particularly dangerous for women in the position of the child inside the womb. Infection with gonorrhea during pregnancy often leads to miscarriage.
The causes of the disease
The only reason for the occurrence of gonorrhea is the penetration into the body of microbes from the genus Cocci Neisseria gonorrhoeae. The favorite place for localization is the epithelium of the genitourinary tract (genital mucosa, urethra, internal organs). In some cases, gonococci affect the rectal region and nasopharynx. Therefore, in terms of infection, both traditional sexual acts and other possible options are equally dangerous.
During pregnancy, the causative agent of the disease can be active in the cervical canal and external uterus. Subsequently, he goes to the body of the uterus, fallopian tubes or to the ovary. Possible damage to the placenta and membranes of the fetus, amniotic fluid. Pregnant infection also occurs due to unprotected intercourse with a sick partner. In rare cases, contact-household infection is observed.
Variants of the course of infection
In many ways, gonorrhea during pregnancy in women is similar to that outside of gestation, but there are a number of typical features. In medical practice, diseases are usually divided into three stages, each of which has a characteristic clinical picture. It:
- fresh infection in acute or subacute form;
- chronic gonorrhea, characterized by lethargic symptoms;
- latent infection without severe manifestations.
Fresh infection is diagnosed if up to 2 months have passed since the infection. In this case, the symptoms of the disease are pronounced and gradually increase over 2 weeks after intimate contact without protection.
For pregnant women, the torpid variety of gonorrhea is especially dangerous. Her symptoms are almost invisible. A woman carries a child and does not go to the doctor for treatment. This leads to the transformation of the ailment into a chronic form, the therapy of which is much more complicated and longer.
The latent variant of the disease during pregnancy is detected extremely rarely. This is due to the lack of a pronounced clinical picture. On the other hand, the process of conception becomes almost impossible. The latent form of gonorrhea is characterized by the formation of adhesions in the fallopian tubes, which is a kind of obstacle to the meeting of the egg and sperm.
Clinical picture
Despite the preventive measures recommended by doctors , gonorrhea during pregnancy is often detected. From the moment of infection to the development of its symptoms usually takes from 5 to 10 days. After this period, the following symptoms may occur:
- increased uncharacteristic vaginal discharge;
- cutting pain during urination;
- discomfort in the lower abdomen.
The disease can provoke inflammation of the vaginal glands - bartholinitis. It is characterized by the appearance of a painful formation with a diameter of about 5 cm. At the same time, the woman's health condition worsens, signs of intoxication develop.
The penetration of pathogenic microflora into the uterine cavity in pregnant women is rare. In such a case, the clinical picture is accompanied by increased pain in the abdomen. Vaginal discharge becomes abundant, may have streaks of blood or impurities of pus. Even less often, gonococci cause purulent inflammation of the ovaries and fallopian tubes, which is dangerous for the development of infertility.
In some cases, the disease proceeds without a pronounced clinical picture. Sometimes signs of infection are not even considered a manifestation of STDs. For example, doctors explain abundant discharge with candidiasis, and pain during urination - cystitis.
Diagnostic Methods
Diagnosis of the disease begins with a survey of a woman. Particular attention is paid to pregnant complaints, gynecological examination data and medical history. It is not possible to make an exact diagnosis solely on the basis of the clinical picture. Therefore, without fail, a woman is assigned a number of tests.
First of all, the analysis of a smear taken from the surface of the mucous membranes and neck for gonorrhea is carried out. During pregnancy, this study does not pose a threat to the fetus and the well-being of the woman herself. It is absolutely painless. The resulting material is stained and examined under a microscope. Normally, pathogenic microflora should not be. Its identification indicates the presence of infection.
Also scraping is sown on nutrient media to determine the growth of a specific pathogen and its sensitivity to antibiotics. This approach allows you to choose the most effective and safe treatment that matches the given gestation period.
A swab for gonorrhea during pregnancy is not the only way to identify an ailment. Another informative diagnostic method is PCR. It implies a reaction with biological fluids to determine the DNA of the pathogen. However, with the help of such a study, the presence or absence of gonococci can be detected. Their analysis cannot confirm their number, form of infection.
Antibiotic treatment
When, during pregnancy, the decoding of a smear for gonorrhea shows a positive result, treatment is immediately prescribed to the woman. Usually it begins immediately at the appointment with a gynecologist. Hospitalization may be required only with severe intoxication or a threat to the development of the fetus. In this case, therapy is carried out not only for the underlying disease, but also for concomitant complications.
The basis of treatment is antibacterial agents. Used drugs from the group of cephalosporins ("Cefixime", "Ceftriaxone"). The drug is administered intramuscularly once. In case of an allergic reaction to cephalosporins, they are replaced with "Erythromycin" or other drugs from the macrolide group.
A single course of therapy is enough to completely defeat the ailment. Repeated administration of antibiotics is sometimes required. At the same time, another drug is already selected for which the pathogenic flora has not developed resistance.
Other treatments
With a combination of gonorrhea with other ailments of the genital area, local preparations are mandatory.
To reduce secretions and relieve itching in the first trimester, antiseptic agents are recommended (Hexicon, Fluomizin). The treatment of gonorrhea during pregnancy in the second trimester is supplemented by more powerful drugs (Terzhinan, Macmirror). They come in the form of candles. They relieve inflammation and eliminate unpleasant symptoms of the infection process. The duration of local treatment is no more than 10 days.
If complications occur against a background of gonorrhea, a pregnant woman is hospitalized in a hospital. In case of a threat of miscarriage, the main therapy is supplemented with means to reduce the tone of the uterus. Placental insufficiency is stopped by drugs that normalize blood flow in the uterus and the umbilical cord of the fetus.
Features of childbirth in gonorrhea
Gonorrhea suffered during pregnancy in women is not an essential reason for the appointment of a caesarean section. As a rule, childbirth takes place naturally if there is no other indication for surgery. An obstetrician may advise cesarean if the fetus is in a serious condition due to infection or premature discharge of amniotic fluid.
The question of surgery arises when the “debut” of gonorrhea occurs at the time of delivery. The fetus, passing through the birth canal, can get an infection. In addition, with severe intoxication, the process of the baby being born often ends unsuccessfully. In this case, the method of delivery depends on the general health of the woman and the intensity of the clinical signs of the disease.
The consequences of gonorrhea for a woman
The consequences of gonorrhea during pregnancy for women can vary significantly and depend on the gestational age. In the first trimester, the infection often leads to the formation of endometritis and salpingo-oophoritis, which is dangerous due to fetal freezing, miscarriage and gross malformations.
At a later date, the probability of infection of the membranes, uterus and appendages is high. Such pathologies lead to premature birth or stillbirth. In addition, after gonorrhea, pregnancy is difficult in the future. With inflammation of the fallopian tubes, commissures form in them, preventing the full fertilization of the egg.
The effects of gonorrhea on the fetus
In the early stages, infection in the uterus can cause miscarriage or the development of serious fetal malformations. Even a successful pregnancy does not guarantee the absence of problems in the later stages of gestation.
In the second half of pregnancy, the infection can penetrate the membranes and cause chorionamnionitis. Quite often, the disease leads to placental insufficiency, followed by hypoxia of the child. In the third trimester, the development of polyhydramnios is not ruled out.
The consequences for a child of gonorrhea during pregnancy after 30 weeks are often expressed by the outflow of amniotic fluid. A similar situation can provoke infection of the baby, birth earlier than expected. All premature babies are necessarily transferred to a specialized department, where they are provided with the necessary assistance.
Reviews
What gonorrhea looks like in women in the photo can be found in any medical guide. This disease inspires fear of all the fair sex. If infection cannot be avoided, antibiotic therapy will be required.
According to reviews, many expectant mothers are afraid of antibiotic therapy. In their opinion, such medications can harm the fetus or provoke anomalies in its development. In fact, many antibiotics are allowed during pregnancy. Cephalosporins and macrolides have successfully passed clinical trials, where their effectiveness and safety for the baby in the womb were proved. However, only a doctor can choose a medication and its dosage. Therefore, self-medication is unacceptable. Even worse is to ignore the symptoms and not go to the doctor. In this case, the pregnancy may result in a miscarriage.
Prevention Methods
Any disease is easier to prevent than to treat it. For the prevention of gonorrhea, it is enough to observe elementary rules:
- Avoid accidental and unprotected sex;
- timely treatment of infectious diseases;
- monitor personal hygiene;
- take care of immunity, eating properly and taking vitamin complexes.
Gonorrhea during pregnancy can pose a significant danger to both the woman herself and the baby inside the womb. The main difficulty is that the disease is not easy to diagnose without an appropriate examination, and treatment does not always give a positive result after one course. Therefore, every woman needs to take care of the prevention of the disease, by following fairly simple rules.