title: Evaluation of endocervical, first-void urine and self-administered vulval swabs for the detection of Chlamydia trachomatis in a miscarriage population.
abstract: OBJECTIVE
  To compare, in parallel, different approaches of opportunistically screening women with bleeding in early pregnancy for Chlamydia trachomatis.
  
  
  METHODS
  Prospective observational [corrected] study.
  
  
  METHODS
  Early pregnancy assessment unit, University hospital, Scotland, UK.
  
  
  METHODS
  Over 200 consecutive women admitted to an early pregnancy assessment unit were recruited. All had a positive pregnancy test, a history of vaginal bleeding and were less than 24 weeks of gestation. Women with recent antibiotic use, heavy vaginal bleeding and cervical shock excluded.
  
  
  METHODS
  Each women provided two or more of the following specimens: a self-administered vulval swab, first-void urine and/or endocervical swab. Following screening, each completed a semi-structured questionnaire assessing the acceptability of each method undertaken.
  
  
  METHODS
  Subjective rating of the screening methods; prevalence; method performance, including proportion requiring repeat testing.
  
  
  RESULTS
  The majority accepted screening, with moderate prevalence rates (95% CI) 3.9% (2.0-7.4%) identified. All positive women were less than 30 years of age. Parallel screening exposed the potential of reduced test performance with urine. Non-invasive sampling was more acceptable, but more likely to require repeat testing.
  
  
  CONCLUSIONS
  Both acceptability and the effect of bleeding on test performance need further assessment before a particular specimen can be recommended for screening this population of women for C. trachomatis.
authors.affiliation: Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, UK.
authors.forename: S
authors.initials: S
authors.lastname: Logan
authors.forename: J
authors.initials: J
authors.lastname: Browne
authors.forename: H
authors.initials: H
authors.lastname: McKenzie
authors.forename: A
authors.initials: A
authors.lastname: Templeton
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharya
mesh_terms: D000022:Abortion, Spontaneous / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000652:urine*; D012648:Self Care / Q000379:methods; D013048:Specimen Handling / Q000379:methods; D014844:Vulva / Q000382:microbiology*