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Chlamydia screening and treatment in patients undergoing evacuation of retained products of conception or vaginal termination of pregnancy: an audit of the Royal College of Obstetricians and Gynaecologists' Guidelines in practice
  1. Nicole Zenner, MD, DFFP, Specialist Registrar in Obstetrics and Gynaecology and
  2. Robin Crawford, MD, FRCOG, Gynaecological Oncologist and Audit Lead
  1. Department of Obstetrics and Gynaecology, Addenbrooke's Hospital, Cambridge, UK
  1. Correspondence to Dr Robin Crawford, Department of Gynaecology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK. E-mail: robin.crawford{at}addenbrookes.nhs.uk

Abstract

Objective To assess compliance with the Royal College of Obstetricians and Gynaecologists Guidelines regarding screening for and treatment of Chlamydia trachomatis before vaginal termination of pregnancy (VTOP) and surgical evacuation of retained products of conception (ERPC).

Methods Case notes of women undergoing VTOP and ERPC in the authors' department were examined for evidence of the presence of C. trachomatis infection and identification of chlamydia risk factors, and for evidence of curative treatment for women with confirmed infection or prophylactic treatment for women at risk.

Results In the VTOP group (n = 30) screening and treatment was carried out satisfactorily, aided by an assessment proforma. In the ERPC group (n = 30) there were weaknesses in the identification and treatment of patients at risk.

Conclusions We conclude that the use of a proforma helps to achieve effective screening. Adequate risk assessment of women undergoing ERPC seems to be difficult to achieve and so universal administration of prophylactic antibiotics might be a safe and efficient option until the National Chlamydia Screening Programme is established in our area.

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