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Chapter 9 : Gonorrhea

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Abstract:

The purpose of this chapter is (i) to review the pathophysiology of gonorrhea during pregnancy, (ii) to summarize epidemiologic data regarding gonorrhea among pregnant women, and (iii) to discuss the manifestations of maternal and infant infections, with special emphasis on principles of prevention and management. is a sexually transmitted bacterium which infects columnar and transitional epithelium of the genitourinary tract, including the urethra, endocervix, and anal canal, and the conjunctivae and pharynx. The majority of pregnant women with gonorrhea are asymptomatic; the proportion of symptomatic patients among pregnant women with gonorrhea has been reported to be as low as 1.2%. Pregnant women who are diagnosed with uncomplicated gonococcal infections or who are the sexual partners of men with gonorrhea should be treated with ceftriaxone (125 mg intramuscularly) in a single dose or with cefixime (400 mg orally) in a single dose. Due to the higher risk of pharyngeal gonorrhea in pregnant women, it may be preferable to treat them with ceftriaxone, since the efficacy of cefixime for treating pharyngeal gonorrhea has not been established. The problem of low utilization of prenatal care in populations with a high prevalence of gonorrhea must be promptly addressed, and strategies to reach high-risk women for diagnosis and treatment outside the context of prenatal care require exploration. Urine screening for sexually transmitted pathogens in facilities attended by underserved high-risk pregnant women is a promising alternative.

Citation: Morse S, Beck-Sagué C. 1999. Gonorrhea, p 151-174. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch9
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References

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1. Alexander, E. R.,, and H. R. Harrison. 1983. Role of Chlamydia trachomatis in perinatal infection. Rev. Infect. Dis. 5: 713 719.
2. Alger, L. A.,, J. C. Lovchik,, J. R. Hebel,, L. R. Blackmon,, and M. C. Crenshaw. 1988. The association of Chlamydia trachomatis, Neisseria gonorrhoeae, and group B streptococci with preterm rupture of the membranes and pregnancy outcome. Am. J. Obstet. Gynecol. 159: 397 404.
3. Amstey, M. S.,, and K. T. Steadman. 1976. Asymptomatic gonorrhea and pregnancy. J. Am. Vener. Dis. Assoc. 1: 14 16.
4. Armstrong, J. H.,, F. Zacarias,, and M. F. Rein. 1976. Ophthalmia neonatorum: a chart review. Pediatrics 57: 884 892.
5. Behets, F. M. T.,, J. Desormeaux,, D. Joseph,, M. Adrien,, G. Coicou,, G. Dallabetta,, H. A. Hamilton,, S. Moeng,, H. Davis,, M. S. Cohen,, and R. Boulos. 1995. Control of sexually transmitted disease in Haiti: results and implications of a baseline study among pregnant women living in Cité Soleil shantytowns. J. Infect. Dis. 172: 764 771.
6. Bessen, D.,, and E. C. Gotschlich. 1986. Interactions of gonococci with HeLa cells: attachment and role of protein II. Infect. Immun. 54: 154 160.
7. Beutler, B.,, and A. Cerami. 1986. Cachectin and tumor necrosis factor as two sides of the same biological coin. Nature 320: 584 588.
8. Blackwell, A. L.,, P. D. Thomas,, K. Wareham,, and S. J. Emery. 1993. Health gains from screening for infection of the lower genital tract in women attending for termination of pregnancy. Lancet 342: 206 210.
9. Blanchard, A. C.,, J. G. Pastorek,, and T. Weeks. 1987. Pelvic inflammatory disease during pregnancy. South. Med. J. 80: 1363 1365.
10. Bradford, W. L.,, and H. W. Kelley. 1933. Gonococcal meningitis in a newborn infant with review of the literature. Am. J. Dis. Child. 46: 543 549.
11. Brunham, R. C.,, and J. E. Embree,. 1992. Sexually transmitted diseases: current and future dimensions of the problem in the Third World, p. 35 58. In A. Germain et al. (ed.), Reproductive Tract Infections. Plenum Press, New York, N.Y.
12. Burkman, R. T.,, J. A. Tonascia,, M. F. Atienza,, and T. M. King. 1976. Untreated endocervical gonorrhea and endometritis following elective abortion. Am. J. Obstet. Gynecol. 126: 648 651.
13. Cacciapuoti, A. F.,, W. S. Wegner,, and S. A. Morse. 1979. Phospholipid metabolism in Neisseria gonorrhoeae: phospholipid hydrolysis in nongrowing cells. Lipids 14: 718 726.
14. Campos-Outcalt, D.,, and K. Ryan. 1995. Prevalence of sexually transmitted diseases in Mexican-American pregnant women by country of birth and length of time in the United States. Sex. Transm. Dis. 22: 78 82.
15. Casey, M. L.,, and P. C. MacDonald. 1988. Biomolecular processes in the initiation of parturition: decidual activation. Clin. Obstet. Gynecol. 31: 533 552.
16. Centers for Disease Control. 1983. Neonatal gonococcal ophthalmia—California. Morbid. Mortal. Weekly Rep. 39: 518519.
17. Centers for Disease Control and Prevention. 1991. Premarital sexual experience among adolescent women—United States, 1970-1988. Morbid. Mortal. Weekly Rep. 39: 929932.
18. Centers for Disease Control and Prevention. 1993. Recommendations for the prevention and management of Chlamydia trachomatis infections, 1993. Morbid. Mortal. Weekly Rep. 42: 2829.
19. Centers for Disease Control and Prevention. 1994. Increasing incidence of low birthweight—United States, 1981-1991. Morbid. Mortal. Weekly Rep. 43: 335339.
20. C enters for Disease Control and Prevention. 1995. Fluoroquinolone resistance in Neisseria gonorrhoeae—Colorado and Washington. Morbid. Mortal. Weekly Rep. 44: 250253.
21. Centers for Disease Control and Prevention. 1996. Division of STD Prevention: Sexually Transmitted Disease Surveillance, 1995. U.S. Department of Health and Human Services, Public Health Service. Centers for Disease Control and Prevention, Atlanta, Ga.
22. Centers for Disease Control and Prevention. 1997. Division of STD Prevention: Sexually Transmitted Disease Surveillance, 1996. U.S. Department of Health and Human Services, Public Health Service. Centers for Disease Control and Prevention, Atlanta, Ga.
23. Centers for Disease Control and Prevention. 1998a. F luoroquinolone-resistant Neisseria gonorrheae, San Diego, California, 1997. Morbid. Mortal. Weekly Rep. 47: 405408.
24. Centers for Disease Control and Prevention. 1998b. Sexually transmitted diseases treatment guidelines. Morbid. Mortal. Weekly Rep. 47: 5970.
25. Charles, A. G., S. Cohen, M. B. Kass, and R. Richman. 1970. Asymptomatic gonorrhea in prenatal patients. Am. J. Obstet. Gynecol. 108: 595598.
26. Chen, C.-Y. 1988. Membrane proteolipids and iron-regulated proteins of Neisseria gonorrhoeae. Ph.D. thesis. Oregon Health Sciences University, Portland.
27. Chow, W. H.,, J. R. Daling,, W. Cates, Jr.,, and R. S. Greenberg. 1987. Epidemiology of ectopic pregnancy. Epidemiol. Rev. 9: 70 93.
28. Christmas, J. T.,, G. D. Wendel,, R. E. Bawdon,, R. Farris,, G. Cartwright,, and B. B. Little. 1989. Concomitant infection with Neisseria gonorrhoeae and Chlamydia trachomatis in pregnancy. Obstet. Gynecol. 74: 295 298.
29. Corman, L. C.,, M. E. Levison,, R. Knight,, E. R. Carington,, and D. Kaye. 1974. The high frequency of pharyngeal gonococcal infection in a prenatal clinic population. JAMA 230: 568 570.
30. Coulaud, J. P. 1991. Epidemiologie et prevention de la transmission neonatale des gonocoques et de Chlamydia. Bull. Soc. Pathol. Exp. 84: 597 602.
31. D’Auria, A.,, L. Tan,, M. Kreitzer,, and V. Galdi. 1975. Gonococcal scalp wound infection. Morbid. Mortal. Weekly Rep. 24: 115 116.
32. Dekker, N. P.,, C. J. Lammel,, R. E. Mandrell,, and G. F. Brooks. 1990. Opa (protein II) influences gonococcal organization in colonies, surface appearance, size and attachment to human fallopian tube tissues. Microb. Pathog. 9: 19 31.
33. Desenclos, J. C. A.,, D. Garrity,, M. Scaggs,, and J. E. Wroten. 1992. Gonococcal infection of the newborn in Florida, 1984-1989. Sex. Transm. Dis. 19: 105 110.
34. Donders, G. G.,, J. Desmyter,, D. H. De Wet,, and F. A. Van Assche. 1993. The association of gonorrhoea and syphilis with premature birth and low birthweight. Genitourin. Med. 69: 98 101.
35. Donders, G. G.,, V. vanGerven,, H. G. de Wet,, A. M. van Straten,, and F. de Boer. 1996. Rapid antigen tests for Neisseria gonorrhoeae and Chlamydia trachomatis are not accurate for screening women with disturbed vaginal lactobacillary flora. Scand. J. Infect. Dis. 28: 559 562.
36. Doraiswamy, B.,, M. R. Hammerschlag,, G. F. Pringle,, and L. du Bouchet. 1983. Ophthalmia neonatorum caused by β-lactamase-producing Neisseria gonorrhoeae. JAMA 250: 790 791.
37. Elliott, B.,, R. C. Brunham,, M. Laga,, P. Piot,, J. O. Ndinya-Achola,, G. Maitha,, M. Cheang,, and F. A. Plummer. 1990. Maternal gonococcal infection as a preventable risk factor for low birth weight. J. Infect. Dis. 161: 531 536.
38. Frau, L. M.,, and E. R. Alexander. 1985. Public health implications of sexually transmitted diseases in pediatric practice. Pediatr. Infect. Dis. 4: 453 467.
39. Frost, E.,, F. Yvert,, J. Zue Ndong,, and B. Ivanoff. 1987. Ophthalmia neonatorum in a semi-rural African community. Trans. R. Soc. Trop. Med. Hyg. 81: 378 380.
40. Garner, J. S. 1996. Guideline for isolation precautions in hospitals. Infect. Control Hosp. Epidemiol. 17: 53 80.
41. Gery, I.,, R. K. Gershon,, and B. H. Waksman. 1972. Potentiation of cultured mouse thymocyte responses by factors released by peritoneal leucocytes. J. Exp. Med. 136: 128 142.
42. Glaser, S.,, B. Boxerbaum,, and J. H. Kennell. 1966. Gonococcal arthritis in the newborn: report of a case and review of the literature. Am. J. Dis. Child. 112: 185 188.
43. Goh, T. H.,, Y. F. Ngeow,, and S. K. Teoh. 1981. Screening for gonorrhea in a prenatal clinic in southeast Asia. J. Am. Vener. Dis. Assoc. 8: 67 69.
44. Gorwitz, R. J.,, A. K. Nakashima,, J. S. Moran,, and J. S. Knapp. 1993. Sentinel surveillance for antimicrobial resistance in Neisseria gonorrhoeae—United States, 1988–1991. CDC surveillance summary SS-3, August 13, 1993. Morbid. Mortal. Weekly Rep. 42: 29 39.
45. Graber, W. J., III, J. P. Sanford, and M. Ziff. 1968. Sex incidence of gonococcal arthritis. Arthritis Rheum. 11: 569 578.
46. Gregg, C. R.,, M. A. Melly,, C. G. Hellerquist,, J. G. Coniglio,, and Z. A. McGee. 1981. Toxic activity of purified lipopolysaccharide of Neisseria gonorrhoeae for human fallopian tube mucosa. J. Infect. Dis. 143: 432 439.
47. Hagblom, P.,, E. Segal,, E. Billyard,, and M. So. 1985. Intragenic recombination leads to pilus antigenic variation in Neisseria gonorrhoeae. Nature 315: 156 158.
48. Handsfield, H. H.,, W. A. Hodson,, and K. K. Holmes. 1973. Neonatal gonococcal infection: orogastric contamination with Neisseria gonorrhoeae. JAMA 225: 697 701.
49. Harkness, A. H. 1948. The pathology of gonorrhoea. Br. J. Vener. Dis. 24: 137 147.
50. Heckels, J. E.,, B. Blackett,, J. S. Everson,, and M. E. Ward. 1976. The influence of surface charge on the attachment of Neisseria gonorrhoeae to human cells. J. Gen. Microbiol. 96: 359 364.
51. Holmes, K. K.,, G. W. Counts,, and H. N. Beaty. 1971. Disseminated gonococcal infection. Ann. Intern. Med. 74: 979 993.
52. Israel, K. S.,, K. B. Rissing,, and G. R. Brooks. 1975. Neonatal and childhood gonococcal infections. Clin. Obstet. Gynecol. 18: 142 151.
53. Joesoef, M. R.,, H. Sumampouw,, M. Linnan,, S. Schmid,, A. Idajadi,, and M. E. St. Louis. 1996. Douching and sexually transmitted diseases in pregnant women in Surabaya, Indonesia. Am. J. Obstet. Gynecol. 174: 115 119.
54. Jones, D. E. D.,, R. G. Brame,, and C. P. Jones. 1976. Gonorrhea in obstetric patients. J. Am. Vener. Dis. Assoc. 2: 30 32.
55. Kamwendo, F.,, L. Forslin,, L. Bodin,, and D. Danielsson. 1996. Decreasing incidence of gonorrhea- and chlamydia-associated acute pelvic inflammatory disease. A 25-year study from an urban area of central Sweden. Sex. Transm. Dis. 23: 384 391.
56. Keiser, H.,, F. L. Ruben,, E. Wolinsky,, and I. Kushner. 1968. Clinical forms of gonococcal arthritis. N. Engl. J. Med. 279: 234 240.
57. Kiviat, N. B.,, J. A. Paavonen,, P. Wolner-Hanssen,, C. W. Critchlow,, W. E. Stamm,, J. Douglas,, D. A. Eschenbach,, L. A. Corey,, and K. K. Holmes. 1990. Histopathology of endocervical infection caused by Chlamydia trachomatis, herpes simplex virus, Trichomonas vaginalis, and Neisseria gonorrhoeae. Hum. Pathol. 21: 831 837.
58. Kupsch, E. M.,, B. Knepper,, T. Kuroki,, I. Heuer,, and T. F. Meyer. 1993. Variable opacity (Opa) outer membrane proteins account for the cell tropisms displayed by Neisseria gonorrhoeae for human leukocytes and epithelial cells. EMBO J. 12: 641 650.
59. Laga, M.,, F. A. Plummer,, H. Nzanza,, W. Namaara,, R. C. Brunham,, J. O. Ndinya-Achola,, G. Naitha,, A. R. Ronald,, L. J. D. D’Costa,, V. B. Bhullar,, J. K. Mati,, L. Fransen,, M. Cheang,, and P. Piot. 1986. Epidemiology of ophthalmia neonatorum in Kenya. Lancet : ii1145 1148.
60. Laga, M.,, F. Plummer,, P. Piot,, P. Datta,, W. Namaara,, J. O. Ndinya-Achola,, H. Nzanza,, G. Maitha,, A. R. Ronald,, H. O. Pamba,, and R. C. Brunham. 1988. Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum: a comparison of silver nitrate and tetracycline. N. Engl. J. Med. 318: 653 657.
61. Laga, M.,, A. Meheus,, and P. Piot. 1989. Epidemiology and control of gonococcal ophthalmia neonatorum. Bull. W. H. O. 67: 471 478.
62. Limberger, R. J.,, R. Biega,, A. Evancoe,, L. McCarthy,, L. Slivienski,, and M. Kirkwood. 1992. Evaluation of culture and the Gen-Probe PACE 2 assay for detection of Neisseria gonorrhoeae and Chlamydia trachomatis in endocervical specimens transported to a state health laboratory. J. Clin. Microbiol. 30: 1162 1166.
63. Lind, I. 1997. Antimicrobial resistance in Neisseria gonorrhoeae. Clin. Infect. Dis. 24(Suppl. 1): 593 597.
64. Mabey, D.,, P. Hanlon,, L. Hanlon,, V. Marsh,, and T. Forsey. 1987. Chlamydial and gonococcal ophthalmia neonatorum in The Gambia. Ann. Trop. Pediatr. 7: 177 180.
65. Makino, J.,, J. P. M. van Putten,, and T. F. Meyer. 1991. Phase variation of the opacity outer membrane protein controls invasion by Neisseria gonorrhoeae into human epithelial cells. EMBO J. 10: 1307 1315.
66. Mayoud, P.,, H. Grosskurth,, J. Changalucha,, J. Todd,, B. West,, R. Gabone,, K. Senkoro,, M. Rusizoka,, M. Laga,, R. Hayes,, and D. Mabey. 1995. Risk assessment and other screening options for gonorrhoea and chlamydial infection in women attending rural Tanzanian antenatal clinics. Bull. W. H. O. 73: 621 630.
67. McGee, Z. A.,, A. P. Johnson,, and D. Taylor-Robinson. 1976. Human fallopian tubes in organ culture: preparation, maintenance, and quantitation of damage by pathogenic microorganisms. Infect. Immun. 13: 608 618.
68. McGee, Z. A.,, A. P. Johnson,, and D. Taylor-Robinson. 1981. Pathogenic mechanisms of Neisseria gonorrhoeae: observations on damage to fallopian tubes in organ culture by gonococci of colony type 1 or type 4. J. Infect. Dis. 143: 413 422.
69. McGee, Z. A.,, G. L. Gorby,, P. B. Wyrick,, R. Hodinka,, and L. H. Hoffman. 1988. Parasite-directed endocytosis. Rev. Infect. Dis. 10: S311 S316.
70. McGee, Z. A.,, C. M. Clemens,, R. L. Jensen,, J. J. Klein,, L. R. Barley,, and G. L. Corby. 1992. Local induction of tumor necrosis factor as a molecular mechanism of mucosal damage by gonococci. Microb. Pathog. 12: 333 341.
71. Melly, M. A.,, Z. A. McGee,, and R. S. Rosenthal. 1984. Ability of monomeric peptidoglycan fragments from Neisseria gonorrhoeae to damage human fallopian tube mucosa. J. Infect. Dis. 149: 378 386.
72. Murphy, G. L.,, T. D. Connell,, D. S. Barritt,, M. Koomey,, and J. G. Cannon. 1989. Phase variation of gonococcal protein II: regulation of gene expression by slippedstrand mispairing of a repetitive DNA sequence. Cell 56: 539 547.
73. Niles, J. H.,, and E. W. Lowe. 1966. Gonococcal arthritis in pregnancy. Med. Ann. D.C. 35: 69 74.
74. Owen, J.,, L. J. Groome,, and J. C. Hauth. 1993. Randomized trial of prophylactic antibiotic therapy after preterm amnion rupture. Am. J. Obstet. Gynecol. 169: 976 981.
75. Paruchuri, D. K.,, H. S. Seifert,, R. S. Ajioka,, K. A. Karisson,, and M. So. 1990. Identification and characterization of a Neisseria gonorrhoeae gene encoding a glycolipid-binding adhesin. Proc. Natl. Acad. Sci. USA 87: 333 337.
76. Plummer, F. A.,, M. Laga,, R. C. Brunham,, P. Piot,, A. R. Ronald,, V. Bhullar,, J. Y. Mati,, J. O. Ndinya-Achola,, M. Cheang,, and H. Nsanze. 1987. Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology and risk factors. J. Infect. Dis. 156: 92 98.
77. Quinn, T. C., 1997. Nucleic acid amplification assays for sexually transmitted diseases, p. 201 232. In H. Lee,, S. Morse,, and Ø. Olsvik (ed.), Nucleic Acid Amplification Technologies: Application to Disease Diagnosis. Eaton Publishing Co., Natick, Mass.
78. Rolfs, R. T.,, E. I. Galaid,, and A. A. Zaidi. 1992. Pelvic inflammatory disease: trends in hospitalizations and office visits, 1979 through 1988. Am. J. Obstet. Gynecol. 156: 983 990.
79. Ross, J. D. 1996. Systemic gonococcal infection. Genitourin. Med. 72: 404 407.
80. Rothenberg, R. 1979. Ophthalmia neonatorum due to Neisseria gonorrhoeae: prevention and treatment. Sex. Transm. Dis. 6: 187 191.
81. Schachter, J.,, M. Grossman,, R. L. Sweet,, J. Holt,, C. Jordan,, and E. Bishop. 1986. Prospective study of perinatal transmission of Chlamydia trachomatis. JAMA 255: 3374 3377.
82. Schulz, K. F.,, W. J. Cates, Jr.,, and P. R. O'Mara. 1987. Pregnancy loss, infant death and suffering: legacy of syphilis and gonorrhoea in Africa. Genitourin. Med. 63: 320 325.
83. Schulz, K. F.,, J. M. Schutte,, and S. M. Berman,. 1992. Maternal health and child survival: opportunities to protect both women and children from the adverse consequences of reproductive tract infections, p. 145 182. In A. Germain,, K. K. Holmes,, P. Piot,, and J. Wasserheit (ed.), Reproductive Tract Infections: Global Impact and Priorities for Women’s Reproductive Health. Plenum Publishing Corp., New York, N.Y.
84. Simon, D.,, and R. F. Rest. 1992. Escherichia coli expressing a Neisseria gonorrhoeae opacity-associated outer membrane protein invade human cervical and endometrial cell lines. Proc. Natl. Acad. Sci. USA 89: 5512 5516.
85. So, M.,, E. Billyard,, C. Deal,, E. Getzoff,, P. Hagblom,, T. F. Meyer,, E. Segal,, and J. Tainer. 1985. Gonococcal pilus: genetics and structure. Curr. Top. Microbiol. Immunol. 118: 13 28.
86. Solberg, D. A.,, J. Butler,, and N. N. Wagner. 1973. Sexual behavior in pregnancy. N. Engl. J. Med. 238: 1098 1108.
87. Stutz, D. R.,, M. R. Spence,, and C. Duangmani. 1976. Oropharyngeal gonorrhea during pregnancy. J. Am. Vener. Dis. Assoc. 3: 65 67.
88. Swanson, J. 1973. Studies of gonococcus infection. IV. Pili: their role in attachment of gonococci to tissue culture cells. J. Exp. Med. 137: 571 589.
89. Taylor, H. A.,, S. A. Bradford,, and S. P. Patterson. 1966. Gonococcal arthritis in pregnancy. Obstet. Gynecol. 27: 776 782.
90. van der Lugt, B.,, A. C. Dogendijk,, and J. R. J. Banffer. 1980. Prevalence of cervical gonorrheae in women with unwanted pregnancies. Br. J. Vener. Dis. 56: 148 150.
91. Van Dyck, E.,, F. Crabbe,, N. Nzila,, J. Bogaerts,, J.-P. Munyabikali,, P. Ghys,, M. Diallo,, and M. Laga. 1997. Increasing resistance of Neisseria gonorrhoeae in West and Central Africa. Consequence on therapy of gonococcal infection. Sex. Transm. Dis. 24: 32 37.
92. Vuyllsteke, B.,, M. Laga,, and M. Alary. 1993. Clinical algorithms for the screening of women for gonococcal and Chlamydial infection: evaluation of pregnant women and prostitutes in Zaire. Clin. Infect. Dis. 17: 82 88.
93. Ward, M. E.,, J. N. Robertson,, P. M. Englefield,, and P. J. Watt,. 1975. Gonococcal infection: invasion of mucosal surfaces of the genital tract, p. 188 199. In D. Schlessinger (ed.), Microbiology—1975. American Society for Microbiology, Washington, D.C.
94. Webster, L. A.,, S. M. Berman,, and J. R. Greenspan. 1993. Surveillance for gonorrhea and primary and secondary syphilis among adolescents—United States, 1981-1991. CDC surveillance summary SS-3, August 13, 1993. Morbid. Mortal. Weekly Rep. 42: 1 12.
95. Weel, J. F. L.,, C. T. P. Hopman,, and J. P. M. van Putten. 1991. In situ expression and localization of Neisseria gonorrhoeae opacity proteins in infected epithelial cells. Apparent role of opa proteins in cellular invasion. J. Exp. Med. 6: 1395 1406.
96. Welgemoed, N. C.,, A. Mahaffey,, and J. Van Den Ende. 1986. Prevalence of Neisseria gonorrhoeae infection in patients attending an antenatal clinic. S. Afr. Med. J. 69: 32 34.
97. Wendel, P. J.,, and G. D. Wendel. 1993. Sexually transmitted diseases in pregnancy. Semin. Perinatol. 17: 443 451.
98. Wilfert, C.,, and L. Gutman,. 1987. Sexually transmitted diseases, p. 595 621. In R. D. Feigin, and J. D. Cherry (ed.), Textbook of Pediatric Infectious Diseases. The W. B. Saunders Co., Philadelphia, Pa.
99. Yip, L.,, P. J. Sweeney,, and B. F. Bock. 1993. Acute suppurative salpingities with concomitant intrauterine pregnancy. Am. J. Emerg. Med. 11: 476 479.
100. Yvert, F.,, E. Frost,, P. Walter,, R. Gass,, and B. Ivanoff. 1985. Prepartal infection of the placenta with Neisseria gonorrhoeae. Genitourin. Med. 61: 103 105.

Tables

Generic image for table
Table 1

Prevalence of infection in selected populations of pregnant women in developing and developed countries, 1970 to 1989

Citation: Morse S, Beck-Sagué C. 1999. Gonorrhea, p 151-174. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch9
Generic image for table
Table 2

Adverse outcomes of pregnancy associated with infection

Citation: Morse S, Beck-Sagué C. 1999. Gonorrhea, p 151-174. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch9
Generic image for table
Table 3

Recommended regimens for perinatal infection

Citation: Morse S, Beck-Sagué C. 1999. Gonorrhea, p 151-174. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch9

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