Researchers conducted this study to identify the treatment patterns and early complication rates in women identified with a genital infection before TOP and re-assess our earlier work on contact attendance and treatment. The aim was to refine current prophylactic measures to provide the most efficient and effective way of reducing post-termination complications.

Forty women were identified with infection, 31 (78%) proceeded to TOP; only five were treated adequately in the peri-TOP period. Twenty-six (84%) of the women undergoing TOP attended the GUM department after the TOP and received antimicrobial therapy where necessary. In total, four women (10%) were untreated. Approximately two-thirds of results were reported before, or on the day of, the TOP. Most TOPs (71%) were carried out at five days or less from the initial assessment—clinical signs of post-TOP pelvic inflammation developed in seven (28%) women with a chlamydial infection. Contact tracing was successful in 24 (69%) of the 35 women who attended the GUM department.

The debate about the best option for the most effective management of women undergoing TOP continues. The possibilities concerning C. trachomatis include universal prophylaxis, screening and treating as necessary, or a ‘belt and braces’ approach of screening all and treating all. Fundamental is the continuation of active contact tracing, and GUM remains integral to this.

Reference: https://srh.bmj.com/content/27/2/81