[Chlamydia trachomatis infection and bacterial analysis in pregnant women in II and III trimester of pregnancy].
Chlamydia trachomatis (CT) infection during pregnancy might be the reason of an increased risk of preterm delivery and premature rupture of membranes. CT could also be responsible for the presence of intrauterine growth restriction, chorionamnionitis and post partum endometritis. It is the most common sexually transmitted disease. The infection may be the reason for PID and consequently even sterility. CT infection could be asymptomatic and the most frequently seen symptom is cervicitis in Pap smears.


OBJECTIVE
The main aim of the study was to estimate the frequency of CT infection in pregnant women, the presence of inflammatory symptoms in Pap-smears, abnormal bacterial status of the vagina and the risk of preterm delivery.


METHODS
The study was conducted between the years 2005 and 2007 on hospitalized women in The Clinic of High Risk Pregnancy. The first group consisted of 200 pregnant women in II trimester and the second of 200 pregnant women in III trimester of pregnancy. In case of each patient the indication for hospitalization was as increased risk of preterm delivery. The Pap-smears, bacterial smear and immunochromatographic test for CT were done on the first day of the treatment from the border line of the cervical epithelium. The immunochromatographic method, despite its low specificity, lower than PCR (polymerase chain reaction), is useful because of low costs, simplicity of the method and ease of the diagnosis. In case of positive immunochromatographic Ct test, PCR CT analysis should be conducted to make sure the diagnosis is correct. The Pap-smear result suggesting inflammatory process of dysplastic changes was the reason for local antibacterial treatment after which a control smear was done. Bacterial analysis done from external ostium showed patogenic and cohabitants bacteria and resistance to antibiotics. The written consent for the study was obtained.


RESULTS
In the group of pregnant women there were no pathological-alert bacteria smears. In the second group the alert bacteria was found in 3 cases (1.5). In 32% of the first group in 27% of cases inflammatory changes in Pap-smears were found. No positive result of CT was found in either of the groups. The symptoms of preterm delivery were found in 78% members of the first group and in 84% cases of the second group. Preterm delivery occurred in 4 cases in the first group (2%) and 6 cases in the second group (3%).


CONCLUSIONS
1. In analyzed groups of pregnant women the CT infection was excluded. 2. The inflammatory symptoms on uterine cervix were not connected with CT infection.
Karowicz-Bilińiska
Agata
A
Klinika Patologii Ciaźy I Katedry Ginekologii i Połoznictwa Uniwersytetu Medycznego w Lodzi. agakar@interia.pl
Kuś
Ewa
E
Kazimiera
Wojciech
W
Maścidło
Aleksandra
A
Brzozowski
Michał
M
Niedźwiecka
Beata
B
Kowalska-Koprek
Urszula
U
D000328:Adult; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000382:microbiology*; D065006:Papanicolaou Test; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies; D014626:Vaginal Smears / Q000706:statistics & numerical data; D016387:Women's Health