• Gonorrhoea has been shown to be associated with preterm rupture of membranes, preterm birth and low birth weight. There may be a greater rate of complications the earlier in pregnancy the infection occurs.
  • Newborns may acquire gonococcal infection during delivery. The perinatal transmission rate is about 30 to 40 percent in women with cervical infection. Intrauterine infection also can occur after rupture of the membranes.
  • In the newborn, the eye is the most frequent site of gonococcal infection and is typically characterized by a purulent conjunctivitis with a profuse exudate and swelling of the eyelids. Without treatment, the infection can extend leading to ulceration, scarring, and visual impairment.
  • Other localized gonococcal infections include infections of other mucosal surfaces (pharynx, vagina, urethra, and anus) and scalp abscess.
  • In newborns, systemic gonococcal infection (eg, septic arthritis, sepsis, and/or meningitis) is rare and is usually a complication of localised infection.
  • Gonorrhoea increases the risk of post partum infection which can be severe.
  • Cefixime and ceftriaxone are probably safe in pregnancy.
  • Do not use quinolones (for example ciprofloxacin) in pregnancy.
  • For penicillin allergic clients, consult senior colleague for advice.
  • Test of cure should be offered 3 weeks after treatment.
  • A repeat test at 36 weeks gestation is recommended to exclude re-infection.

 

Editorial Information

Last reviewed: 31/01/2024

Next review date: 31/01/2026

Author(s): West of Scotland Managed Clinical Network for Sexual Health Clinical Guidelines Group .

Version: 6.1

Approved By: West of Scotland Managed Clinical Network in Sexual Health