Effectiveness of Repeated Gonorrhea Cultures in the Third Trimester

OBJECTIVE With the high cost of health care today, the universal prophylactic measures recommended, and the availability of effective treatment should infection occur, the practice of routinely repeating the endocervical gonorrhea (GC) culture in the third trimester of pregnancy may be unwarranted. METHODS To test this hypothesis, we reviewed charts from patients who had received routine prenatal care during a 2-year period at the Lafayette and Opelousas parish health units. Those charts, which had documented results of both the initial and repeat GC cultures, were then used for retrospective review. The results ofthe initial GC culture were compared with that taken in the third trimester. Other data recorded included age, gravidity, race, and history of gonorrhea, syphilis, or multiple sexual partners. RESULTS Two hundred fifty charts were available for extraction; 130 of these had documentation of both GC cultures. Of the 130 cultures obtained during the initial prenatal visit, only 6 (4.6%) were positive. Of the repeat cultures taken during the third trimester, none were positive. Thirteen patients (10.0%) had a documented history of GC infection; none of them had positive cultures during the study period. CONCLUSIONS Screening for GC during pregnancy is important and appropriate. This is commonly accomplished by taking a GC culture during the initial prenatal visit. Based upon the present study, we found that repeating this culture in the third trimester, even in a relatively high-risk population, seems unnecessary, whether the initial culture is negative or not.