Endocervical Chlamydia Trachomatis Infection in Pregnancy: Direct Test and Clinico‐Sociodemographic Survey of Pregnant Patients at the Port Moresby General Hospital Antenatal Clinic to Determine Prevalence and Risk Markers

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Abstract
EDITORIAL COMMENT: Chlamydia trachomatis causes symptomatic and asymptomatic infections which in pregnant women have been linked to chorioamnionitis, premature rupture of the membranes and premature labour (A). Chlamydial infection is easily treated (by erythromycin) but recognition requires screening. This study has shown that this means screening the entire population, since clinical methods are unable to identify a high risk group. Screening for C. trachomatis is reported to be cost‐effective when the prevalence of the infection exceeds 6% (B), as it did in the present study, and in studies reported in this journal from Saudi Arabia (1987; 27:126 ‐ antenatal incidence 12.6%) and Fiji (1987; 27: 213 ‐ antenatal incidence 38–50%). The standard antenatal investigations recommended in Australia do not include testing for C trachomatis. Readers are referred to the recently available compendium produced by the Royal Australian College of Obstetricians and Gynaecologists which includes a section on routine screening in pregnancy and lists those investigations generally accepted as necessary and also those frequently done in certain groups of patients.A. The Chlamydia Challenge. Am J Obstet Gynecol 1991; 164: 6: 2: 1776–1796.B. Nettleman MD, Bell TA. Cost‐effectiveness of prenatal testing for Chlamydial trachomatis. Am J Obstet Gynecol 1991; 164: 5: 1: 1289–1294.Summary The prevalence of endocervical C. trachomatis infection in 181 consecutive antenatal clinic patients at the first attendance and who had not received antibiotic therapy in the previous 4 weeks, was 17.7%. The direct fluorescent antibody test was used for diagnosis. There was no significant clinical or sociodemographic factor which distinguished patients who tested positive from those who tested negative.