Continued increase in gonorrhea – KNOV

May 7, 2024

The National Coordination of Infectious Disease Control (LCI) informs about the continued increase in gonorrhea. Since mid-2022, there has been an increasing incidence of N. gonorrhoeae infections. The increase among highly educated heterosexual young people under the age of 25 with Dutch origins is particularly striking. An increase can also be seen in Europe. What does this mean for you as a midwife?

Advice

The RIVM asks healthcare providers, including midwives, to be alert regarding gonorrhea infections. The RIVM advises that women and heterosexual men should be tested for gonorrhea in an accessible manner.

Conditions that can be caused by gonorrhea

Before, during and after pregnancy

• Gonorrhea is often asymptomatic in women. However, an infection can lead to Pelvic Inflammatory Disease (PID) and, in the longer term, to reduced fertility, for example.

• Gonorrhea is transmittable from mother to child during pregnancy and especially during birth (The STD consultation | NHG Guidelines). During pregnancy, a gonorrhea infection can result in septic abortion, chorioamnionitis, premature rupture of membranes and premature birth.

• Postpartum, a woman is at risk of postpartum endometritis based on a N. gonorrhoeae infection. During labor, the child can become infected and develop gonorrhea conjunctivitis. Be alert for signs of an eye infection, because untreated gonorrhea conjucitvitis can lead to blindness (Gonorrhea and pregnancy | RIVM).
  

Birth control

During a contraceptive consultation, STD testing is performed if there are complaints consistent with an STD or pelvic inflammatory disease (PID) and if there is an increased risk of an STD. Even if a woman asks about this herself, you perform an STD test. In the absence of complaints, STD testing can take place in the same consultation in which the IUD is placed. If there is an STD, treatment with the IUD can take place in situ. If there are indications of the existence of an STD or PID: only insert the IUD after treatment, unless it concerns emergency contraception (Contraception | NHG Guidelines).

For treatment of an STD, refer the client to the GP. For pregnant women, a control test is performed 4-6 weeks after starting medication.