Michigan Live (02.08.13)
Michigan State University researchers report that pregnant women treated in emergency rooms (ERs) often do not receive needed care for chlamydia and gonorrhea because laboratory results are not available before the women leave. The study based its conclusions on the records of 735 STD-infected women who were treated in three Grand Rapids hospital ERs. Half of these women received antibiotics for chlamydia or gonorrhea in the ER, but ER physicians prescribed antibiotics for only 20 percent of the 179 pregnant women who had gonorrhea or chlamydia.
Although inexpensive and effective antibiotics are available for these STDs, hospital staff is frequently unable to contact women after they leave the ER and tell them their laboratory results show gonorrhea or chlamydia infection. Medical student Roman Krivochenitser stated that on-the-spot testing would help staff provide immediate treatment for STD-infected pregnant women who come to the ER.
Diagnosing chlamydia and gonorrhea in pregnant women in the ER can be difficult, according to Krivochenitser, because some degree of abdominal discomfort is common during pregnancy. However, a mother’s untreated STD increases the risk of low birth weight, pre-term delivery, and passing the infection along to the baby. Women with untreated STDs also rarely develop pelvic inflammatory disease.
CDC currently restricts antibiotic prescriptions to prevent the growth of drug-resistant bacteria. The Michigan study recommends more research on rapid testing for chlamydia and gonorrhea, improved contact and follow-up with ER patients, and permission for physicians to treat pregnant women with antibiotics based on a clinical assessment.
The full report, “Underrecognition of Cervical Neisseria Gonorrhoeae and Chlamydia Trachomatis Infections in Pregnant Patients in the ED,” was published in The American Journal of Emergency Medicine (2013; doi:10.1016/j.ajem.2012.11.017).