Gonorrhea is a sexually transmitted disease caused by the Gram-negative Neisseria gonorrhoeae (referred to as gonorrhea), which mainly manifests itself as a purulent infection of the genitourinary system. In recent years, the incidence of gonorrhea is the most common sexually transmitted disease in China. It can occur at any age, with the majority being between 20 and 30 years old. N. gonorrhoeae has affinity for columnar epithelium and metastatic epithelium, and it is easy to invade and conceal in female genitourinary tract and cause infection. Etiology The infection is caused by Neisseria gonorrhoeae. Infection is caused by unclean sexual intercourse, contact with infected clothing, towels, bed sheets, bath tubs and other items, and incompletely disinfected examination instruments. Clinical manifestations Gonorrhea infection in pregnant women is not uncommon. Gonorrhea infection at any stage of pregnancy can have an impact on the prognosis of pregnancy. In early pregnancy, gonococcal cervicitis can lead to infectious abortion and post-abortion infection. In late pregnancy, gonorrhea increases the fragility of the fetal membranes and predisposes to premature rupture of the membranes. Premature rupture of membranes may lead to amniotic cavity infection syndrome and stalled labor during delivery. The effect on the fetus is a predisposition to preterm delivery and intrauterine fetal infection. The incidence of preterm delivery in gonorrhea infection is about 17%. Fetal infection predisposes to fetal distress, intrauterine growth retardation, and even stillbirth and stillbirth. Patients often develop puerperal infections after delivery. If the fetus survives vaginal delivery, neonatal gonorrheal conjunctivitis, pneumonia, and even gonorrheal sepsis can occur, leading to a significant increase in perinatal mortality. The incubation period of gonorrhea infection is 1-14 days, so neonatal gonorrhea conjunctivitis mostly develops within 1-2 weeks after birth, and is seen as swelling of both eyelids, red conjunctiva, eyelashes sticking together, purulent discharge when opening the eyes, and pus overflowing under local pressure. If not treated in time, conjunctivitis continues to develop, causing gonorrhea orbital cellulitis, which can also infiltrate the cornea to form corneal ulcers, cloud opacities, and even corneal perforation or develop into iridocyclitis and allogyriculitis, leading to blindness. Examination 1.Smear of secretion from urethral opening, cervical canal, etc. 2.Secretory culture. Diagnosis 1.Take a smear of secretion from urethral orifice, cervical canal and other places for Gram staining, and see multiple Gram-negative diplococci in multinucleated leukocytes, which can make a preliminary diagnosis. 2.Secretion culture is the gold standard method for screening gonorrhea, which can be seen as round, raised moist, smooth, translucent colonies with petal-like edges. The diagnosis can be confirmed by taking a smear of the colonies and seeing typical diplococci. Treatment The principle of treatment is early and thorough treatment. Follow the principle of timely, adequate and regular medication. Pregnant women with gonorrhea are mainly treated with antibiotics. Usually, ceftriaxone sodium is preferred, which is injected intramuscularly once a day, and erythromycin is added, which is taken orally four times a day for 7-10 days as a course of treatment. For those who are allergic to β-lactam antibiotics, switch to daikonomycin, injected intramuscularly once a day, and add erythromycin for 7-10 days as a course of treatment. Quinolones are prohibited during pregnancy. Sexual partners should be treated at the same time. After the course of treatment, the presence of gonorrhea should be rechecked and cured when the cervical smear and gonorrhea culture are negative for 3 consecutive times. If the gonorrhea is still positive after one course of treatment, the infection should be treated as a drug-resistant strain and the drug should be changed in time. Prevention In areas with a high incidence of gonorrhea, pregnant women should be routinely screened for gonorrhea before delivery, preferably by microscopic examination of cervical smear for gonorrhea once in early, mid and late pregnancy, and gonorrhea culture is recommended for early diagnosis and thorough treatment. Newborns delivered by pregnant women with gonorrhea should be given prophylactic medication, penicillin intravenous drip and erythromycin eye ointment applied to both heels. It is important to note that disseminated gonorrhea can occur in newborns, with gonorrheal arthritis, meningitis, and sepsis appearing shortly after birth, which can lead to death if not treated promptly.