In the UK routine infection screening is offered through blood tests which check for HIV, Hepatitis B and Syphilis. However, there are more infections which occur and which are not screened for. So what are these, how do they impact your health and pregnancy and what should you do to reduce any harmful effects?

What is Chlamydia Trachomatis (Chlamydia)?

Chlamydia is a very small parasitic bacterium which is spread through sexual contact. This infection infects the urethra in men. However, it infects the urethra, the cervix and can spread to the reproductive organs in women.

Sex without a condom and unprotected oral sex are the main ways a chlamydia infection can spread and so it is one of the named sexually transmitted infections (STI) which affects those having unprotected sex.
In 2016, Chlamydia was stated as the most common STI in Wales, United Kingdom. Young people in the 15-24 age range were more likely to be affected and females had higher reported infection rates than males.

Why does this matter?

This bacterial infection has no symptoms and can cause women to suffer with:
• pelvic inflammatory disease (PID)
• tubal factor infertility
• ectopic pregnancies (Hoenderboom et al, 2019).

In pregnancy, Chlamydia can contribute to complications including:
• miscarriage
• premature rupture of the membranes
• pre-term labour
• low birthrates
• postpartum endometritis

If the infection is present and left untreated in pregnancy (due to a woman not being aware of having the infection as there are no symptoms), the infection may lead to complications for the baby following mother to child transmission during delivery NICE (2008). These complications include:

• Chlamydial conjunctivitis – bacterial
• Chlamydia trachomatis pneumonia
• Possible long-term complications if not treated

All of these factors should be considered by health professions when you present in pregnancy for your booking appointment. Additional features which may indicate infection during pregnancy include:
• post coital (after sex) or intermenstrual bleeding
• lower abdominal pain (endometritis),
• vaginal discharge suggestive of infection
• dyspareunia, dysuria (urethritis),
• bartholinitis

What Can you do if you think you may have Chlamydia or other STI?

As screening is not routine in the UK (unlike NewZealand and Australia), you can visit your local family planning clinic (FPA) and they will support you by giving you support to obtain a self-taken swab test.
This test is performed by you by using a specific cotton bud like swab which is passed into the entrance of the vagina, you circle the swab for 1 minute and then put the swab in the specific container – also given to you by the practitioner. This swab is then sent away for testing. If the test is positive you will be treated with antibiotics which will reduce and minimize any harm to you, your pregnancy and your baby.

What is the treatment for Chlamydia?

Best practice after a positive test for Chlamydia is antibiotic treatment with sexual abstinence for the entire time of treatment and use of condoms until a positive test that the treatment has worked and is confirmed (Public Health England, 2019).

This should be followed up at 36 weeks to ensure treatment has been successful or that no re-infection has occurred.

Other infections in this series include:
Bacterial Vaginosis (BV)
Cytomegalovirus (CMV),
Hepatitis C
Group B Streptococcus (GBS)
HSV (1)

Typical Chlamydial Swab –

Bacterial Conjuctivitis can be caused by Chlamydial infection

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