1.         All patients should be screened at the New OB exam.

 

2.         All patients should be screened by 36 weeks gestation.  (State Guidelines)

 

3.         Sexual contact with possibly infected partner or suspicious cervical discharge (mucopurulent) noted during speculum exam

 

 

If the patient has a positive culture and is otherwise asymptomatic the following treatment options may be used: Check for penicillin allergy

Cefixime 400 mg orally in a single dose,
                          OR

 Ceftriaxone 125 mg IM in a single dose

Alternative Regimen:   Spectinomycin 2 g in a single, IM dose. Spectinomycin is expensive and must be injected; however, it has been effective in published clinical trials, curing 98.2% of uncomplicated urogenital and anorectal gonococcal infections. 

 

If the patient has symptoms of disseminated GC (fever, low abdominal pain) she should be referred for evaluation.

 

Follow-up After Treatment:

 

 

 

 

 

 

Prepared in conjunction with the

Division of Maternal-Fetal Medicine

Duke University Medical Center

 

                                                                        _____________________  __________

1/16/07                                                 Director                                    Date

 

 

 

1.         Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2006. MMWR 2006:55(No. RR-42-47)

 

 

 

 

The Clinical Care Guidelines Development Committee of the Perinatal Improvement Board of Duke University Health System has developed a series of multi-disciplinary protocols to offer guidance to health care providers who are caring for pregnant women with high risk conditions.

 

These protocols are designed to assist health care providers in the management of a variety of problems that occur in pregnancy and the time of delivery. They should not be interpreted as standard of care, but instead represent only general guidelines for the care of pregnant women with high risk conditions.  We recognize that services offered by individual providers depend not only on their training, experience and institutional resources, but on the medical facts and circumstances of the specific care situation.

The protocols remain the intellectual property of the Duke University Health System.  They cannot be reproduced in whole or part without the expressed permission of the Health System.

 

These protocols are reviewed by the Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine, the Department of Pediatrics Division of Neonatology and the Department of Anesthesiology Division of Women’s Anesthesia.  Please contact Andra H. James (andra.james@duke.edu), Chair, Clinical Care Guidelines Development Committee of the Perinatal Improvement Board with ideas for additional protocols.