SAN DIEGO — Repeat screening for lower genital tract infections in pregnant adolescents is reasonable because of high recurrence and persistence rate of infections in this patient population, Andrea Ries Thurman, M.D., reported in a poster session at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.
“Universal screening of adolescents for common genital tract infections will improve their obstetric outcomes,” said Dr. Thurman of the department of ob.gyn. at Medical University of South Carolina, Charleston. “They're a different population than pregnant adults in their risk of problems, particularly in their risk of lower genital tract infections.”
In an ongoing study, pregnant adolescents were screened for bacterial vaginosis (BV), yeast vaginitis, trichomoniasis, gonorrhea, and chlamydia at their intake obstetric visit and at their 35- to 37-week visit. A Gram stain of the vaginal secretions was obtained upon admission to labor and delivery.
Dr. Thurman reported on complete data available for 69 patients at the intake obstetric visit and 31 patients at the 35- to 37-week visit. At the intake visit, 33% of patients had BV, 15% had chlamydia, 13% had yeast vaginitis, 4% had gonorrhea, and 4% had trichomoniasis.
At the 35- to 37-week visit, 19% of patients had chlamydia, 16% had BV, 13% had yeast vaginitis, 3% had trichomoniasis, and no patients had gonorrhea.
Of the lower genital tract infections identified at the 35- to 37-week visit, the following were new diagnoses: 100% of the trichomoniasis cases, 80% of the BV cases, 75% of the yeast infections, and 50% of the chlamydia cases. The rest were recurrent infections from the intake visit, despite receiving treatment.
Gram stains were obtained from 94 pregnant teens on admission for labor and delivery. Investigators observed that Nugent scores for vaginal flora did not differ between mothers who delivered preterm and those who delivered at term. They also found that screening for BV at 35–37 weeks does not appear to be predictive of BV at admission for labor.
