Chlamydia in pregnancy Flashcards
Define chlamydia
Obligate intracellular parasite, very common in young adults, causing inflammation of the cervix or urethra
Chlamydia screening age
15-24
Sexual history signs
Multiple partners
Unprotected sex
Other history of STI
Symptoms of chlamydia
Cervicitis:
IMB
PCB
Dyspareunia
Purulent PV discharge
Pelvic pain
Urethritis:
Dysuria
Investigations - how do these differ in people with penises/vaginas?
First line - Nucleic acid amplification test
In men - first void urine catch or urethral swab
In women - vulvovaginal swab or first catch urine
Second line - Culture and sensitivity
What would you see on direct microscopy?
Non-gonococcal urethritis evidenced by neutrophil presence without other organisms.
Medical management of chlamydia if not pregnant
Doxycycline 100mg, BD, 7 days
Send to GUM clinic (see other flashcard)
Only if they refuse, treat in primary care
Medical management of chlamydia if pregnant or breastfeeding or allergic to penicillin
AZITHROMYCIN
Doxycycline contraindications
Pregnancy/breastfeeding
Doxy = foxy = baby belly biten = not good
Social management of chlamydia
Avoid sex completely until treatment is complete - avoid up to after 7 days if on azithro
Contact tracing up to 6 months
Recommend STI screen - send to GUM clinic
Follow up again and rescreen if pregnant
Repeat testing is offered to who and when?
Young people under the age of 25, offered 3-6m after
Anyone above 25 who you think might be at high risk of re-infection
When is test of cure recommended?
In pregnancy
In poor compliance to medication
Where symptoms persist
Complications of Chlamydia
PID, ectopic pregnancy, infertilty
Reactive arthritis - urethritis, conjunctivitis, and arthritis
Fitz-Hugh-Curtis syndrome (perihepatitis)
Pregnancy - PROM, preterm labour, post partum endometritis
