Prenatal Screening for Chlamydia Confusion...

[CaliAtenza]

So I was just revewing OBGYN in Uworld and I'm a bit confused on the guidelines for Chlamydia screening in pregnancy. I consulted UpToDate and it says that the CDC and the ACOG recommend screening for Chlamydia in all pregnant patients, regardless of risk factors. But then the next sentence states that the USPSTF recommends screening in those who are 24 years of age or younger and older women who are at increased risk. Which guidelines should we follow? Which one will the Step 2 take into account?

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[Phloston]

I looked at UpToDate as well. The USMLE won't put debatable stuff like that on the exam. As far as I can recall, all pregnant women are screened for HepB, HIV, syphilis and chlamydia.

If I had to answer the question on my real deal though, I'd say yeah, test for chlamydia.

What the USMLE will assess though is that you do test for chlamydia in any sexually active person, even if <21 (although you wouldn't Pap smear <21). I may have even had that on my exam.

 

[Apoplexy__]

What the USMLE will assess though is that you do test for chlamydia in any sexually active person, even if <21 (although you wouldn't Pap smear <21). I may have even had that on my exam.

Yeah, what was this from? I know I read this somewhere but can't find it for the life of me now. All I see is chlamydia screening <25 yrs in sexually active patients or >25 yrs with sexual risk factors.

 

[CaliAtenza]

I looked at UpToDate as well. The USMLE won't put debatable stuff like that on the exam. As far as I can recall, all pregnant women are screened for HepB, HIV, syphilis and chlamydia.

If I had to answer the question on my real deal though, I'd say yeah, test for chlamydia.

What the USMLE will assess though is that you do test for chlamydia in any sexually active person, even if <21 (although you wouldn't Pap smear <21). I may have even had that on my exam.

Ah okay, thanks Phloston, that works for me . I'm surprised UpToDate would put 2 things in there.

 

[Phloston]

Yeah, what was this from? I know I read this somewhere but can't find it for the life of me now. All I see is chlamydia screening <25 yrs in sexually active patients or >25 yrs with sexual risk factors.

From UpToDate:

"We recommend screening all sexually active young women (age ≤25 years) for genital chlamydia infection

We suggest screening all pregnant women for genital chlamydia, regardless of age, and screening nonpregnant women 25 years and older who are at increased risk for infection (HIV infection, prior chlamydial infection or other sexually transmitted disease, new or multiple sex partners)"

 

[Phloston]

Ah okay, thanks Phloston, that works for me . I'm surprised UpToDate would put 2 things in there.

As per above post. I've quoted UpToDate.

 

[CaliAtenza]

As per above post. I've quoted UpToDate.

It also says this though:

"The Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend chlamydia screening for all pregnant women at the first prenatal visit. The US Preventive Services Task Force (USPSTF) recommends limiting screening to women who are ≤24 years of age and older women who are at increased risk for infection (eg, new or more than one sexual partner, history of sexually transmitted diseases, illicit drug use).The National Screening Committee in the United Kingdom also does not recommend routinely screening all pregnant women."

That's why I was initially confused. CDC and ACOG want you to screen all women, regardless of risk factors, just like how we do for Hep B, HIV, and Syphilis. But the next sentence is contradictory.

 

[Phloston]

I just looked at the summary/recommendations for Chlamydia Screening. They put a lot of detail into the main textual body.

 

[reverieinvictus]

It also says this though:

"The Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend chlamydia screening for all pregnant women at the first prenatal visit. The US Preventive Services Task Force (USPSTF) recommends limiting screening to women who are ≤24 years of age and older women who are at increased risk for infection (eg, new or more than one sexual partner, history of sexually transmitted diseases, illicit drug use).The National Screening Committee in the United Kingdom also does not recommend routinely screening all pregnant women."

I've noticed that for screening and certain management protocols, UTD will list what each organization recommends, but at some point in the topic they'll give their own recommendation which is usually what ends up in the summary.