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The value of a screen and treat policy for Chlamydia trachomatis in women attending for termination of pregnancy
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  1. Tamsin M Groom, MB BS, MRCOG, Specialist Registrar1,
  2. Peter Stewart, BM BcH, FRCOG, Consultant Obstetrician and Gynaecologist1,
  3. Heike Kruger, MB BS, Senior House Officer1 and
  4. Gill Bell, SRN, Health Advisor2
  1. Department of Obstetrics and Gynaecology, Northern General Hospital, Sheffield, UK
  2. Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
  1. Correspondence Mr P Stewart, Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Northern General Hospital NHS Trust, Herries Road, Sheffield, S5 7AU, UK.

Abstract

We aimed to assess the efficacy of a screen and treat policy for sexually transmitted infections in women requesting termination of pregnancy, with particular reference to Chlamydia trachomatis. A retrospective review of 100 consecutive cases of Chlamydia-positive women between December 1995 and February 1998, was performed. The referral rate to genitourinary medicine (GUM), the subsequent management, contact tracing and treatment of partners were assessed.

Ninety-nine women were referred to the GUM department, of whom 72 (71.4%) attended. Eighteen (25%) required further treatment. Seventy-five women identified 89 potentially infected men, of whom 62 (69%) attended for treatment.

Identification of positive cases with referral to GUM enabled tests of cure to be carried out, treatment of those reinfected and re-enforcement of behaviour modification, in addition to successful contact tracing. This policy may confer greater benefit for the patient herself and make a significant impact on the reservoir of infection in the community when compared to a policy of blanket prophylactic antibiotic treatment at the time of termination. The implications for future service provision are discussed.

  • chlamydia trachomatis
  • GUM
  • screen and treat

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