Pelvic examination findings and Chlamydia trachomatis infection in asymptomatic young women screened with a nucleic acid amplification test.

Sexually transmitted diseases, 2007; 34 (6) doi:10.1097/01.olq.0000240344.20665.63

Authors: Geisler William M, Chow Joan M, Schachter Julius, McCormack William M

Affiliation: University of Alabama - Birmingham, United States

Abstract: BACKGROUND: Nucleic acid amplification tests (NAATs) allow chlamydia screening in asymptomatic women who otherwise may not have pelvic examinations. How often these women have examination findings that may prompt empiric therapy is unclear.
OBJECTIVE: The objective of this study was to assess the relationship of chlamydia with pelvic examination findings in asymptomatic women screened by NAAT.
METHODS: The authors conducted a retrospective analysis of clinical data from 577 young asymptomatic women screened by chlamydial transcription-mediated amplification (TMA).
RESULTS: TMA was positive in 68 (11.8%). The most common examination finding was vaginal discharge (5.9%) followed by cervical ectopy (3.6%), endocervical mucopus (2.3%) or easily induced bleeding (2.3%), and cervical motion (1.4%) or adnexal (0.7%) tenderness. On multivariate analysis, only easily induced bleeding or mucopus predicted chlamydia (adjusted odds ratio [AOR] = 4.7; P = 0.010 and AOR = 4.4; P = 0.015, respectively).
CONCLUSIONS: Abnormal pelvic examination findings were infrequent in asymptomatic young women screened by a chlamydial NAAT. However, endocervical bleeding or mucopus, when present, predicted chlamydia.

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