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Chlamydia While Pregnant: Complications And Treatment

Chlamydia during pregnancy
Medically reviewed by Dr. Samra

Overview

Sexually transmitted diseases can be contracted at any time, but are especially dangerous during pregnancy. Check out everything you need to know about chlamydia during pregnancy. 

Often called the silent disease, chlamydia often presents with no symptoms.

In fact, about 75% of women and 50% of men will not experience any indications that they have a sexually transmitted disease.

This can be especially dangerous for pregnant women. Chlamydia during pregnancy can be fatal for an unborn baby yet is easily treatable.

What is Chlamydia?

Chlamydia is a sexually transmitted infection that is caused by the spread of the bacteria chlamydia trachomatis. This type of bacteria can be present in the vaginal fluid and sperm. It likes to live in the mucous membranes.

It is commonly found in the cervix of women and the urethra in men but can also affect the anus, throat and eyes.

Transmission of Chlamydia

Chlamydia is a sexually transmitted disease. It commonly spreads through sexual acts involving the mouth, penis, vagina and anus.

There is a potential risk to both mother and her unborn baby. Therefore, doctors screen most pregnant women for STDs at one of their first prenatal appointments.

If you have sex with an infected partner during your pregnancy, there is a possibility of exposure to STDs, including chlamydia. Therefore, testing may be required.  Quick treatment is the best protection for passing chlamydia onto your baby.

Symptoms of Chlamydia in Women

While chlamydia is often asymptomatic, about one-quarter of women will experience some symptoms such as:

  • Painful or burning sensation during urination
  • Fever
  • Nausea
  • Pain in the lower back and abdomen
  • Pain during intercourse
  • Bleeding between periods

It is also possible for both men and women to develop Reiter syndrome. Reiter syndrome can cause arthritis, painful urination and redness and inflammation in the eyes.

Related: Everything That You Need To Know About Chlamydia In Men.

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Risk to Mother Prior to Becoming Pregnant

Studies indicate that chlamydia can lead to the following conditions:

  • Pelvic inflammatory disease (40%), 
  • Infertility (20%),
  • Tubal pregnancies (9%),
  • Chronic pelvic pain (18%).

The presence of two or more of the following factors puts a woman at risk of contracting a chlamydial infection:

  • Being unmarried
  • Age less than 20 years old
  • Having other sexually transmitted diseases
  • Having multiple sexual partners in the past 3 months
  • The partner has nongonococcal urethritis
  • Nongonococcal mucopurulent endocervicitis
  • Abacterial pyuria
  • History of unprotected sex within the past 3 months
  • Low socioeconomic status
  • African American or Hispanic race/ethnicity

Chlamydia can cause serious damage to the female reproductive system regardless of whether a woman is pregnant. If left untreated, chlamydia bacteria can migrate in the body from the vagina into the uterus, fallopian tubes and ovaries. As the bacteria travels, so does the infection and inflammation. This can cause scarring in the reproductive organs.

Untreated Chlamydia can lead to pelvic inflammatory disease (PID). PID can cause scar tissue to form in the fallopian tubes as well as chronic pelvic pain. This scar tissue can make it difficult for a fertilized egg to travel through the fallopian tubes and implant in the uterine lining. This can lead to fertility issues or ectopic pregnancy.

As many as 500 000 PID cases in the United States are due to chlamydia infection. Of these cases, 100,000 women become infertile.

Additionally, women infected with chlamydia have a three- to five-fold increased risk of acquiring the human immunodeficiency virus (HIV) if exposed.

Chlamydia During Pregnancy

Can Chlamydia Cause a Miscarriage?

Sexually transmitted diseases, such as chlamydia are serious illnesses. Chlamydia can cause serious harm to both men and women, but with pregnancy, another life is also at risk. When present during pregnancy chlamydia can cause miscarriage and preterm birth.

Chlamydia can cause damage to the fallopian tubes which can increase the chance of having an ectopic pregnancy. An ectopic pregnancy is one where the fertilized egg attaches itself outside of the uterus. This type of pregnancy ends in termination and if left untreated can even be fatal. Unfortunately, these pregnancies are unable to survive to term or be relocated into the uterus.

Physicians recommend screening for chlamydia in early pregnancy, preferably on a woman’s first prenatal visit. The recommendations strongly suggest screening for chlamydia in pregnancy’s third trimester to prevent any complications during the perinatal period or in the newborn.

Risk to Baby

Pregnant women who do not treat their chlamydia put their unborn babies at risk. Chlamydia during pregnancy increases the risk of prematurely ruptured membranes, low birth weight, stillbirth and miscarriage.

Chlamydia can also be passed onto the baby at birth. The infection is spread from an infected mother to her baby in about 50 % of vaginal births. It can also be spread during cesarean sections but at a much lower rate. Intrauterine and transplacental infections are possible. If fetal membranes rupture, it can cause direct inoculation of the neonate’s nasopharynx and lungs. Amniotic fluid is an excellent medium for chlamydial growth and may lead to amnionitis, premature rupture of membranes, stillbirth, premature delivery, and low birth weight. 

Once the newborn is infected, conjunctivitis occurs in newborns of untreated mothers, and pneumonia occurs in these newborns. Chlamydia can lead to other respiratory illnesses, such as otitis media, bronchiolitis, rhinitis, pharyngitis, and infant gastroenteritis. Chlamydial conjunctivitis usually affects both eyes and progresses from a watery to a discharge that becomes purulent, followed by swelling of the eyelids and redness of the conjunctiva. Signs of conjunctivitis usually do not appear until the newborn is 2 to 3 weeks old. Therefore, a culture of discharge should be taken for diagnosis. If the infection is left untreated, conjunctivitis may last a few weeks to several months. Early detection and treatment are necessary to avoid corneal scarring and impaired vision. 

On entering the conjunctiva, the organism can spread through the lacrimal ducts to the nasopharynx and end up in the lungs. Several exposed infants will develop pneumonia. Symptoms may not develop until 6 weeks after birth. Signs of pneumonia gradually worsen, and the newborn develops a cough, nasal obstruction and nasal discharge, vomiting, and cyanosis. Occasional wheezing or rales may be present. Newborns with chlamydia infections of the lower respiratory tract have a higher chance of chronic symptoms and impaired lung function longer than do infants with uncomplicated viral infections. Therefore, it is essential to screen the mother whenever a newborn is diagnosed with a chlamydial infection.

Chlamydial conjunctivitis and pneumonia are usually easily treated but if left untreated could result in a more serious illness even death. Infants with a history of CT pneumonia have a greater chance of asthma and reactive airways disease.

While the symptoms typically appear about 1 to 3 weeks after exposure, pneumonia may develop several months after birth.

Diagnosis of Chlamydia in Women

A doctor usually carries out early pregnancy screening for Chlamydia. Chlamydia can be transmitted through any unprotected act of oral, vaginal or anal sex. Any risky behaviour should warrant another screening.

A chlamydia screening is a combination of two tests. The first is a simple urinalysis to determine if chlamydia trachomatis is present in the urine.

Secondly, a physician will swab the cervix to test for the bacteria. He may also swab the anal region during your routine pap smear.

Usually, only one test is necessary. Either a urine specimen or a cervical swab. The sensitivity and specificity of the cervical swab are slightly higher than for urine sample but for most clinical situations one test is sufficient

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Treatment of Chlamydia

A doctor should evaluate each pregnancy on an individual basis. Although, treatment for chlamydia is safe during pregnancy.

Some antibiotics used in treating chlamydia are unsafe to take during pregnancy. However, safer options are available.

Inexpensive antibiotics to treat chlamydia are equally effective. According to research, these are safe for pregnant and breastfeeding women.

In rare cases, these may cause side effects such as vomiting, nausea and diarrhoea.

If you have tested positive for chlamydia while pregnant, there are multiple treatment options but taking treatment is essential to cure the infection. 

Since doxycycline and ofloxacin are contraindicated during pregnancy, Chlamydia treatment in pregnancy includes the followings regimens: 

Azithromycin, 1 g orally given as a single dose 

                         OR

Amoxicillin 500 mg orally, three times a day for 7 to 10 days is used as an alternative for those who cannot take azithromycin.

When an infant is affected with chlamydial pneumonia or conjunctivitis they are usually treated with should be treated with oral medications. Topical treatment for the eye infection is ineffective and unnecessary.

Pregnant women should be retested for Chlamydia 3 weeks after completion of treatment. Anyone you have had sexual contact within the last 60 days should get treatment. This includes oral, anal and penetrative sex.

Treating all partners is an important step in preventing the spread of the disease since it often has no symptoms.

It is best to avoid sexual contact for seven days after you complete a full round of antibiotics.

It is still possible to get chlamydia while receiving treatment. Do not stop taking the antibiotics even if you are no longer experiencing any symptoms. You should retest after three months of completing the treatment.

When to Consult a Doctor

Starting the treatment at the right time can help prevent any serious risks or complications. If you are currently pregnant or planning a pregnancy, our doctors at Your Doctors Online can help you with your medical concerns.

FAQs on Chlamydia During Pregnancy Answered by Your Doctors Online

What is the clap?

Gonorrhoea is a common sexually transmitted disease (STD). It is also known as “the clap” or “drip.”

Can chlamydia cause miscarriage in early pregnancy?

Untreated chlamydial infections increase the chances of complications during pregnancy. Chlamydia causes an increased risk of miscarriage, preterm birth, premature rupture of membranes and low birth weight.

Can chlamydia affect pregnancy?

Yes, chlamydia during pregnancy can lead to several problems. Infections in pregnancy increase the risk of premature labour and birth and the baby being born with low birth weight.

How long after treating chlamydia can you get pregnant?

Make sure that you complete the course of antibiotics if you are diagnosed with chlamydia. It is essential to avoid intercourse until the treatment is finished or at least for a week following that. Repeating the test 3 months after treatment is of utmost importance as well.

Can you get pregnant if you have chlamydia?

Even if you have chlamydia, you can get pregnant. However, untreated infections may lead to pelvic inflammatory disease (PID), which may cause scarring, and blockage in your reproductive organs, particularly your fallopian tubes contributing to infertility. It also increases the chances of ectopic pregnancy and developing chronic pelvic pain.

Can having chlamydia while being pregnant harm your baby?

If chlamydia is left untreated during your pregnancy, there is a chance it can be passed on to your unborn baby. Your baby can develop conjunctivitis or pneumonia.

Can you be born with chlamydia?

If a woman has a chlamydial infection when giving birth, there is a possibility that the infection will be passed on to the newborn during delivery. Such babies can develop an eye infection (conjunctivitis) or pneumonia(lung infection) and usually require antibiotics for treatment.

What happens to babies born with chlamydia?

Babies born with chlamydia can develop conjunctivitis or pneumonia. Chlamydia can lead to other respiratory illnesses, such as otitis media, bronchiolitis, rhinitis, pharyngitis, and infant gastroenteritis. Testing, prevention and treatment are required to prevent complications. 

If you have chlamydia, can you still get pregnant?

Untreated infections can contribute to infertility and increase the chances of ectopic pregnancy. If the condition is left untreated may cause pelvic inflammatory disease (PID) that can cause scarring of the fallopian tubes, increasing the risk of future ectopic pregnancy (implantation of the egg outside of the uterus). If the scarring blocks the tube, the fertilized egg can’t reach the uterus contributing to infertility.

Can chlamydia be treated during pregnancy?

Chlamydia can be cured by taking antibiotics that are safe to take during pregnancy. Commonly prescribed include azithromycin or amoxicillin. However, the treatment protocol can vary according to the condition and symptoms of the patient.

Can you take antibiotics while pregnant?

Some antibiotics are considered safe to take during pregnancy. However, Hower treatment depends on the condition, and it is wise to consult a doctor before starting any treatment. To cure infections, it is essential to take antibiotics as advised.

Doctors Treating this Issue
dr asim cheema

Dr. Asim Cheema

Internal Medicine

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