Chlamydia and Mycoplasma Testing During Pregnancy

Pregnancy and Chlamydia, Mycoplasma

Doctor: Hello! I am quite confused about the issues regarding Chlamydia and Mycoplasma.
I come from mainland China, and when preparing for pregnancy, hospitals there place great importance on preconception screenings, which include tests for Chlamydia and Mycoplasma.
Later, when I consulted doctors in Taiwan, they all said that these two tests are not routinely performed in Taiwan because of concerns.
I went to a testing facility and had a blood test done, which resulted in a positive for Chlamydia, but my husband and I have no discomfort at all.
(The testing facility did not even offer Mycoplasma testing.) My husband and I took antibiotics for a week, and then we did not follow up with any further testing.
I am currently 7 months pregnant, and I have recently been reading various pregnancy encyclopedias (written by Japanese authors), which emphasize the importance of these tests.
Similar to the mainland, they state that Chlamydia needs to be treated before delivery, typically with two weeks of antibiotics, followed by a retest to confirm eradication.
However, my obstetrician said that no further testing is necessary, stating that if Chlamydia is present, it would only cause early miscarriage, but I was never tested for this in the early stages! I apologize for the lengthy explanation, but my confusing questions are:
1.
Can a week of antibiotics truly cure Chlamydia? (Both my husband and I took the medication simultaneously, and we did not have intercourse during that time.
We have not engaged in unprotected sex and have no other sexual partners.) We took Clarithromycin for 5 days, followed by 3 days of Erythromycin, as we obtained the medications from different clinics.
Could the use of different antibiotics weaken the effectiveness of the treatment?
2.
Since I did not test for Mycoplasma, if it were also positive, would the antibiotics taken be effective? Can we guarantee eradication in just one week?
3.
If I still test positive, could it currently affect the fetus (intrauterine infection)? If I have a cesarean section, would that mitigate any issues? After the baby is born, could the newborn be infected, for example, through shared bathrooms or cross-contamination of clothing?
4.
Should I undergo these two tests again before trying for a second child? (It seems that many hospitals do not offer these tests.)

anna, 30~39 year old female. Ask Date: 2011/07/14

Dr. Chen Changfu reply Obstetrics and Gynecology

The testing and culture of Chlamydia and Mycoplasma are time-consuming and not easy.
A positive serological test only indicates a past infection and does not confirm an active infection or the severity of the disease.
In Taiwan, prenatal screening for these infections is not included as a routine benefit under the National Health Insurance; however, hospitals are unlikely to refuse a request for serological testing if it is self-paid.
Mycoplasma infections predominantly occur in children aged 3 to 6 years, and erythromycin treatment is effective, with little association to maternal or intrauterine infections.
Chlamydia infections may lead to infertility in women due to pelvic inflammatory disease.
In pregnant women, genital Chlamydia infections can potentially cause severe conjunctivitis or blindness in newborns.
However, in Taiwan, it is mandated that all newborns receive erythromycin eye ointment immediately after birth to effectively prevent and treat Chlamydia conjunctivitis.
There is no need for a cesarean section solely based on a positive serological test result.
Obstetricians and gynecologists consider the possibility of various infections in pregnant women, but the medical approaches may differ.

Reply Date: 2011/07/14

More Info

Understanding Chlamydia and Mycoplasma Testing During Pregnancy
Chlamydia and Mycoplasma are two sexually transmitted infections (STIs) that can have implications for pregnancy and fetal health. Your concerns about these infections, especially given your positive test for Chlamydia and the lack of testing for Mycoplasma, are valid and warrant a thorough understanding.

1. Effectiveness of One Week of Antibiotics: The treatment regimen you followed, which included a combination of clarithromycin and erythromycin, is generally effective for treating Chlamydia. The standard treatment for Chlamydia is a single dose of azithromycin or a week-long course of doxycycline. While your treatment may have been effective, the key to ensuring that the infection is cured is follow-up testing. It is advisable to have a test of cure, typically done about three weeks after completing treatment, to confirm that the infection has been eradicated. The concern about using different antibiotics is valid; while they may target different bacteria, it is essential to follow a prescribed regimen to ensure full effectiveness.

2. Mycoplasma Testing and Treatment: Mycoplasma genitalium is another STI that can cause reproductive health issues, but it is less commonly tested for in many regions, including Taiwan. If you were treated for Chlamydia, it is unclear whether that treatment would effectively address a Mycoplasma infection, as the two are different pathogens. If you suspect you might have Mycoplasma, it would be prudent to discuss this with your healthcare provider, as they may recommend specific testing and treatment.

3. Impact on Fetal Health: If Chlamydia is left untreated during pregnancy, it can lead to complications such as preterm labor, low birth weight, and neonatal infections. However, since you have undergone treatment, the risk of these complications is significantly reduced. Regarding Mycoplasma, while it is less understood, there is some evidence suggesting it could potentially lead to complications during pregnancy. If you remain positive for either infection, it is crucial to discuss this with your obstetrician, as they can provide guidance on monitoring and management. As for delivery, a cesarean section may reduce the risk of transmitting infections to the baby, but it is not a guaranteed prevention method. The primary concern is ensuring that any active infection is treated before delivery.

4. Future Pregnancies: Before attempting to conceive again, it would be wise to have a thorough check-up, including testing for both Chlamydia and Mycoplasma. Even if your current healthcare provider does not routinely test for these infections, you can advocate for yourself by requesting these tests, especially if you have a history of positive results. Understanding your STI status can help ensure a healthier pregnancy in the future.

In conclusion, while your treatment for Chlamydia is a positive step, follow-up testing is essential to confirm that the infection has been cleared. Discussing your concerns about Mycoplasma with your healthcare provider is also crucial, as it may require specific attention. Maintaining open communication with your obstetrician about your health and any potential risks to your baby is vital for ensuring a healthy pregnancy and delivery.

Similar Q&A

Chlamydia Infection and Pregnancy: What You Need to Know

Hello, Dr. Wei. I apologize for the intrusion and appreciate your understanding. I would like to ask the following questions: 1. I want to become pregnant, but I have previously been infected with Chlamydia, and it has recurred after treatment. What should I do? Does this mean I...

Dr. Wei Fumao reply Obstetrics and Gynecology
1.3. Find a medical center to test for infections and receive treatment (which can be done through blood tests or cervical cultures). 2. Late pregnancy infections have a significant impact on newborns, increasing the risk of premature rupture of membranes, preterm birth, and maki...

Understanding Chlamydia and Gonorrhea Testing During Pregnancy

My wife is pregnant and went to the hospital for a gynecological examination, specifically for C. trachomatis/N. gonorrhoeae PCR using urine samples. However, shouldn't it be done using secretions? The report shows negative results. Is that normal? If gonorrhea is left untre...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, discharge is more accurate; gonorrhea can primarily lead to infertility. Wishing you good health.

Understanding Chlamydia Antibody Positivity in Virgin Women

I am a virgin and have never engaged in sexual intercourse, but I am puzzled as to why I tested positive for antibodies against Chlamydia. I sincerely request your assistance in clarifying this matter. Thank you.

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, the questioner: Chlamydia is primarily transmitted through sexual contact or vertically during childbirth. How is Chlamydia transmitted? Chlamydia is transmitted through direct human contact, with the vast majority of cases occurring through sexual intercourse. Infections ...

How to Test for Chlamydia: Symptoms, Risks, and Testing Options

Recently, I have noticed that my discharge has a yellow-green color. Could this be a sign of a chlamydia infection? If I have been using condoms consistently during sexual intercourse, is there still a possibility of being infected? How can I check for an infection? Is it possibl...

Dr. Lin Wenbin reply Obstetrics and Gynecology
The examination for Chlamydia can be conducted by collecting secretions from the vagina or urethra using immunoassay methods. Alternatively, a blood test can be performed to check for IgG or IgM antibodies in the serum (the former indicates a past infection, while the latter indi...