A Senior Lecturer, Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Dr. Ochuwa Babah, has said that gonorrhea can occur in pregnancy contrary to a general belief that sexually transmitted diseases cannot occur in pregnancy.
According to the maternal health expert, pregnant women with gonorrhea, a sexually transmitted disease should not ignore it, warning that it can cause eye infection in children and other complications in pregnancy if left untreated.
Dr. Babah who is a consultant obstetrician and gynaecologist at the Lagos University Teaching Hospital, Idi-Araba, said pregnant women with gonorrhea who manage to carry the pregnancy for a longer period are also at risk of preterm birth.
Preterm birth, according to the World Health Organisation is the leading cause of under-five mortality globally.
The gynaecologist said, “Gonorrhea infection is one of the sexually transmitted diseases. In the past, there used to be this general belief that sexually transmitted diseases cannot occur during pregnancy.
“But, we now have evidence to show that they do occur in pregnancy.
“Gonorrhea in particular is an infection that can occur in about 0-14.2 per cent of pregnancy. The prevalence varies from place to place depending on behavioural attitude of the people.”
“Gonorrhea is not as common as Chlamydia trachomatis which is another sexually transmitted disease. But it has been found to impact adversely on pregnancy both in women that have HIV and even in women that do not have HIV.
“Commonest of these complications is the occurrence of continuous miscarriage. It starts with vaginal bleeding and some abdominal cramp and before you know it, the bleeding becomes heavy and by the time the woman gets to the hospital, she would be told she lost the pregnancy. This happens at the early stage of the pregnancy.”
The maternal health specialist stated that untreated STIs in pregnancy were associated with adverse outcomes in the neonate such as conjunctivitis, pneumonia, sepsis and infant death.
Giving further insight into the risk of gonorrhea in pregnancy, the gynaecologist said, “It has been found that for those who are able to carry the pregnancy for a longer period, they have a higher risk of preterm birth.
“This infection spreads upward from the vagina towards the cervix and then towards the uterus. It weakens the membrane surrounding the baby. When the weak membrane gets torn, the water drains out. So, the woman can present with what we call premature rupture of the membrane.
“Also, the infection might spread to the uterine lining and cause irritation that will trigger a contraction and the woman will go into early labour. If the infection becomes overwhelming, it can affect the baby to the extent of killing the baby. At the end of the day, the baby dies in the womb.”
She noted that babies that are born alive might develop certain health problems.
“They are likely to develop infection and this infection if it spreads to the brain can cause neonatal meningitis. The baby may have inflammation of the eye,” she explained.
Researchers in a study published in the Journal of American Sexually Transmitted Diseases Association, found that about 50 per cent of untreated maternal gonorrhea infections are transmitted to the neonate during birth, which they say could cause eye and lower respiratory tract infections.
According to them, gonococcal eye infections can result in corneal damage and blindness if left untreated.
Continuing, Dr. Babah stated that Chlamydia trachomatis and gonorrhea have been found to be independently factored for certain complications that can occur in pregnancy.
The senior lecturer stressed that gonorrhea in pregnancy requires proper treatment to achieve a full cure, adding that vaginal discharge is the commonest mode of presentation in women with the infection.
The maternal health expert noted that if diagnosed, gonorrhea can be effectively treated, urging women who have been treated to ensure that their husbands were also treated to avoid re-infection.
She stated that pregnant women are screened for other sexually transmitted diseases during antenatal clinics such as syphilis, HIV, and Hepatitis B.
She, however, noted that gonorrhea is not part of routine screening in the ANC clinics yet.