Last updated: March 9, 2020
Kate Killoran M.D.
Obstetrics & Gynecology
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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 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 dangerous and even fatal for an unborn baby, yet is easily treated.
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.
While it may be commonly found in the cervix of women and the urethra in men it can also affect the anus, throat and eyes.
How is it Spread?
Chlamydia is a sexually transmitted disease that commonly spread through sexual acts involving the mouth, penis, vagina and anus.
Because of the potential risk to both mother and her unborn baby, most pregnant women are screened for STDs at one of their first prenatal appointments.
However, it is possible to be exposed to STDs, including chlamydia, if you have sex with an infected partner during your pregnancy.
If there is a chance you may have been exposed it is important to get tested again by your healthcare provider. A 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
- Pain in 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.
Check out symptoms of Chlamydia in men here.
Risk to Mother Prior to Becoming Pregnant
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.
Can Chlamydia Cause a Miscarriage?
Sexually transmitted diseases, such as chlamydia are a serious illness. 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.
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 misscarriage.
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.
If Chlamydia is spread to a newborn during birth it can lead to conjunctivitis. Conjunctivitis is an eye inflammation with redness, swelling and discharge. This can also be accompanied by pneumonia. Symptoms of pneumonia can include a cough and rapid breathing.
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.
How is it Diagnosed in Women?
Chlamydia is usually screened for early in a pregnancy. However, it can be spread through any unprotected act of oral, vaginal or anal sex. Any risky behavior should warrant another screening.
A chlamydia screening is a combination of two tests. The first is a simple urinalysis to determine is chlamydia trachomatis is present in the urine.
Secondly, a physician will swab the cervix to test for the bacteria. This swab is often performed during your routine pap smear. If it is believed the anus may be affected, that area may also be swabbed.
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
For information on how Chlamydia is diagnosed in men, click here.
How is it Treated?
While each pregnancy needs to be evaluated on an individual basis, treatment for chlamydia is safe during pregnancy. Some antibiotics used to treat chlamydia should not be used in pregnancy but there are others that are safe to use.
Often Chlamydia is treated with common inexpensive antibiotics which research suggests are safe for pregnant and breastfeeding women.
In rare cases these may cause side effects such as vomiting, nausea and diarrhea.
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.
Is it advised that anyone you have had sexual contact with in the last 60 days also receive a 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 also recommended 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. It is recommended to get retested three months after you complete your treatment.
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About Kate Killoran M.D.
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