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Mon February 11, 2013
Study: Pregnant women often untreated for sexually transmitted infections
Many pregnant women who visit emergency rooms may not be getting treatment for sexually transmitted infections.
A Michigan State University study finds a small number of the pregnant women tested at three West Michigan hospitals got the medication they needed.
That's because it takes about 48 hours to get the test results for chlamydia and gonorrhea and the women often can't be reached after they leave the emergency room.
"A lot of patients leave false phone numbers, or the number is disconnected, or they don't pick up," explains MSU medical student Roman Krivochenitser, who conducted the study.
Krivochenitser looked at the anonymous records of 735 women who visited emergency rooms at Spectrum Health, Saint Mary's Health Care and Helen DeVos Children's Hospital in Grand Rapids from 2008 through 2010. Of the 179 who were pregnant, only 20 percent were treated on-site for chlamydia or gonorrhea.
"They may not have a family physician, he says. "They may not have any other opportunity to get treatment except for this one time that they have presented to the hospital."
Krivochenitser says pregnant women who come to an emergency room with pelvic or abdominal pain are automatically tested for sexually transmitted diseases. However, antibiotics aren't prescribed until tests confirm an STI because some of the complaints were vague.
"They don't come in with cookie-cutter symptoms, and abdominal pain can be caused by so many things," he says. "We have to be very careful about prescribing medications to pregnant women because you don't want to overmedicate and cause problems. "
The Centers for Disease Control cautions against overuse of antibiotics because of the growth of drug-resistant organisms that are harder to treat.
"It's a game of weighing the risks and benefits of prophylactic treatment, or trying to wait for the definitive test, and treating when we know the exact organism and exact susceptibility to antibiotics," Krivochenitser says. "But in the cases where the patients presented with a vaginal discharge and the doctors had a strong suspicion for an STI, they treated."
Krivochenitser says pregnant women with an STI who don't get treated can run into complications.
"You have risks of pre-term labor, of intrauterine growth restrictions, and you can even pass the STI to the infant," he says.
Women also risk future infertility.
According to the Michigan Department of Community Health, about 66,000 Michiganders were diagnosed with gonorrhea or chlamydia in 2011.