How is Chlamydia treated during pregnancy?

There is a wide variety of genital tract infections. Some of them are sexually transmitted.  Treatment of these infections is important to prevent complications. Chlamydia is one such infections requiring immediate medical attention. It is also a sexually transmitted disease.  Chlamydia is an obligate intracellular organism. That means that the organism lives in side the cells. The pathogen chooses only the noncilliated columnar, transitional and cuboidalcells to live in. These are the cells found in the upper genital tract and urethra.

Unlike many other sexually transmitted diseases, Chlamydia infection gives rise to few symptoms. The patients will be completely normal until they develop complications. The complications are more when the infections occur during pregnancy. In pregnancy, not only the mother but also the baby can get affected by the infections. Chlamydia infection during pregnancy can lead to preterm birth, preterm prematue rupture of membranes and choriamnionitis. Usually, Chlamydia infection in non-pregnant women can be treated with several antibiotics. These antibiotics include azythromycine, doxycycline, erythromycin, levofloxacin and orfloxacin, some of these antibiotics cannot be used during pregnancy. That is because they can cross the placenta and can give rise to adverse effects in the baby. Therefore, the drug should be chosen carefully.

The antibiotic of choice in pregnancy is tetracycline, usually doxycycline. Out if these two, tetracycline binds to the developing bones and teeth of the fetus during second and third trimester. This results in brown colored teeth and dysplastic bones. Therefore, it should be avoided in the second and third trimesters. Erythromycin 500 mg twice a day for two weeks is the treatment of Chlamydia infection during pregnancy.

Erythromycin is usually a drug with many gastrointestinal side effects. Once ingested, the mother can get nausea and vomiting. As a result, the drug might not get absorbed properly. The pharmacokinetics of the drug during pregnancy can also get altered and the efficacy of the treatment is doubtful. Therefore, pregnant mothers who are treated with erythromycin should be tested later for presence of infection 2 weeks after the completion of antibiotic therapy. For women who cannot tolerate erythromycin, azythromycin as a single 1g dose is given. Scientists have found that Co-amoxyclave have a protective effect against neonatal infection. Therefore, it can also be used to treat Chlamydia infection during pregnancy.

As mentioned earlier, Chlamydia is a sexually transmitted infection. Therefore, not only the pregnant mother, but also her partner should be tested for the presence of infection. If the male partner is also found to have the infection, he should also be treated before resumption of sexual intercourse. If the mother is found to have infected with Chlamydia after delivery, she should be given tetracycline as definitive treatment. Breast feeding can be continued while on treatment.

Sometimes, Chlamydia infection goes unnoticed during pregnancy. In such cases the first presentation could be eye infection of the neonate. This is called ophthalmia neonatarum. If the baby develops ophthalmia neonatarum, it should be treated with tetracycline eye oinements. They should be also given erythromycin syrup for two weeks. This is to reduce the risk of neonatal pneumonia.

As described earlier, treatment of Chlamydia infection is very important to prevent its complications. The treatment of the mother as well as her sexual partner and the baby after birth is very important.