Antepartum screening for Neisseria gonorrhoeae should be performed early in pregnancy for women with risk factors or symptoms and repeated in the third trimester for women at high risk (see Table 16.1). Rates in pregnancy range from1% to 7%, depending on the population. Diagnosis is made by PCR.
of gonorrhea must be reported to health care officials.
Treatment is with an extended spectrum or 3rd-generation cephalosporin.
Tetracyclines and fluoroquinolones are contraindicated in pregnancy.
Infection above the cervix (i.e., of the uterus, including the fetus, and the fallopian tubes) is rare after the first weeks of pregnancy. At delivery, however, infected mothers may transmit the organism, causing gonococcal ophthalmia in the neonate. All neonates receive routine prophylactic treat-ment with sterile ophthalmic ointment containing eryth-romycin or tetracycline, which is generally effective in preventing neonatal gonorrhea.