Management of genital chlamydial infections at termination of pregnancy services in England and Wales: where are we now?
OBJECTIVE: To determine the range of policies and practices related to the management of genital chlamydial infection employed at termination of pregnancy services in England and Wales. DESIGN: Cross-sectional descriptive study. SETTING: England and Wales. POPULATION: Termination of pregnancy providers. METHODS: Survey questionnaire administered to termination of pregnancy providers. MAIN OUTCOME MEASURES: Policies and practices for the management of genital chlamydial infection in women seeking termination of pregnancy with comparison to the national guidelines of the chief medical officer (CMO) and the Royal College of Obstetricians and Gynaecologists (RCOG). RESULTS: One hundred and thirty-eight (48%) practices responded to the survey, with representation across England and Wales. Policies for screening and/or treatment of chlamydial infection existed for 70% of providers. We found three practice patterns for the management of genital chlamydial infection among termination of pregnancy attenders: 70% of providers tested their own attenders prior to termination and treated if necessary; about 25% of providers administered prophylaxis without testing; and a small number of providers (< 5%) neither tested nor treated attenders. CONCLUSION: These patterns may be the result of differences in the CMO and RCOG guidelines. Given the impact of untreated genital chlamydial infection in women attending for termination, consistent recommendations from the CMO and RCOG may encourage uniform practice for the management of chlamydial infection in this vulnerable population.