Treatment of chlamydial infections of the cervix during pregnancy.

Chlamydia trachomatis infections in pregnancy are associated with a high rate of transmission to the newborn and may be associated with poor obstetrical outcome including low birth weight, premature delivery, stillbirth and neonatal death. This prospective study of 99 chlamydia infected women assessed the clinical efficacy of treating chlamydial infections diagnosed at the initial obstetrical visit. Twelve women had concomitant gonococcal and/or urinary tract infections. Seven day regimens of erythromycin 1 gm per day and erythromycin 2 gm per day appear to be equally effective (95.1% and 92.3% respectively) in the treatment of chlamydial infections in pregnancy. Successive therapy did not vary with gestational age when treated. Four of 91 erythromycin treated women discontinued therapy due to gastrointestinal distress. Eight women received sulfisoxazole 4 gm per day and all responded to therapy. Additional controlled studies are needed to determine the most efficacious treatment for chlamydial infections in pregnancy.