Clinical Significance of Identification of Chlamydia Trachomatis by Polymerase Chain Reaction in Pregnant Women with Preterm Labor and Preterm Premature Rupture of Membrane

Hwangbo, H J; Ahn, J H; Jang, T K; Park, Y K; Lee, D J; Lee, S H

Abstract

Subclinical infection of female genital tract is one of most important cause of preterm labor and preterm premature rupture of membrane (PPROM). To evaluate the relationship between chlamydial infection and preterm labor and PPROM, 52 pregnant women with preterm labor and PPROM who admitted to Department of Obstetrics and Gynecology of Yeungnam University Hospital, were studied for Chlamydia trachomatis (C. trachomatis) infection by using polymerase chain rection from June 1994 to March 1995. Fifty-one pregnant women who showed no evidence of labor or membrane rupture were studied for C. trachomatis as control group. There was no significant difference in clinical characteristics as ge,gravidity, parity, body weight between risk and control group. There was no significant difference in age, gravidity, parity, body weight between chlamydia-infected group and not-infected group. The rate of identification of C. trachomatis in risk group was significantly higher than control group (p<0.01). The rate of presence of clinical symptom as lower abdominal pain was significantly higher in risk group than control group, and 34.1% of women in control group did not show any specific symptom (p<0.05, p<0.01). The rate of presence of clinical symptoms was significantly higher in chlamydia-infected group than not-infected group (p<0.05). Women with preterm labor and PPROM had significantly shorter duration of pregnancy than women with preterm labor alone (p<0.05). C-reactive protein was elevated, though not significant, in chlamydia-infected group. Gram negative bacilli was found with higher rate in women with preterm labor or PPROM than control group. All of the pregnant women who infected with chlamydia, were cured by doxycycline or erythromycin. We conclude that routine screening and treatment for chlamydia in pregnant women would be expected to decrease maternal and fetal morbidity and improve maternal and fetal well-being.