Genital infection and termination of pregnancy: Are patients still at risk?

Objectives. To identify the treatment patterns and early complication rates in women identified with a genital infection prior to a termination of pre gnancy (TOP) and to re-assess our earlier work on contact attendance and tr eatment. The aim was to refine current prophylactic measures to provide the most efficient and effective way of reducing post-termination complication s. Method. Six-month retrospective analysis of all women with genital Chlamydi a trachomatis ol Neisseria gonorrhoeae identified prior to TOP. Data on the timing of positive results and treatment iii relation to the TOP were reco rded. Clinical signs of pelvic infection and the success of contact tracing and treatment were noted. Results. Forty women were identified with infection, 31 (78%) proceeded to TOP; only five were treated adequately in the peri-TOP period. Twenty-six ( 84%) of the women undergoing TOP attended the genitourinary medicine (GUM) department after the TOP and received antimicrobial therapy where necessary . In total, four women (10%) were untreated. Approximately two thirds of re sults were reported prior to, or on the day of, the TOP. The majority of TO Ps (71%) were carried out at 5 days or less from the initial assessment. Cl inical signs of post-TOP pelvic inflammation developed in seven (28%) women with chlamydial infection. Contact tracing was successful in 24 (69%) of t he 35 women who attended the GUM department. Conclusion. The debate about the best option for the most effective managem ent of women undergoing TOP continues. The options with respect to C. trach omatis include universal prophylaxis, screening and treating as necessary, or a 'belt and braces' approach of screening all and treating all. Fundamen tal is the continuation of active contact tracing and GUM remains integral to this.