Neisseria gonorrhoeae screening in pregnancy.

All patients undergoing prenatal care at the U.S Naval Hospital in Yokosuka, Japan, have a gonorrhea culture performed at their intake visit. The objective of this study was to determine the prevalence of Neisseria gonorrhoeae in this military population and to propose an effective antenatal screening strategy based on the data. A retrospective 10-month review of patient data was performed. In addition, the guidelines for antenatal N. gonorrhoeae screening by the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, and the World Health Organization were reviewed. During the study period, none of the screened patients (N = 518) had a gonococcal infection. The screening program at this facility will be modified based on the low-risk nature of the pregnant population. Specifically, high-risk patients will be screened selectively in the third trimester.

Myonecrosis of the rectus muscle after a Cherney incision.

BACKGROUND: The original description of the Cherney incision includes bilateral ligation of the inferior epigastric vessels to increase incision width [1]. However, in patients with compromised abdominal wall vasculature, ligation may lead to healing complications. CASE: Our patient experienced necrosis of the right rectus muscle after undergoing pelvic surgery via a Cherney incision. During the procedure, attempts were made to retain both inferior epigastric arteries, but the right was transected and ligated. Sepsis developed and myofascitis was diagnosed. The interesting radiographic findings of myofascitis are also presented. CONCLUSION: The vasculature of our patient's abdominal wall may have been compromised after four previous transverse abdominal incisions, and the ligation of the right inferior epigastric vessel may have contributed to postoperative complications.