Cervicitis as a Clinical Indicator of Gonococcal and Chlamydial Infections in Pregnancy

OBJECTIVE We undertook the present study to attempt to apply clinical indicators predictive of cervical infection in nongravid populations with either Neisseria gonorrhoeae or Chlamydia trachomatis to our pregnant population and to determine the significance of the clinical diagnosis of "cervicitis." METHODS A retrospective chart review of all pregnant women with a final diagnosis of cervicitis who were seen in the Medical College of Virginia obstetrical emergency room was performed during the period of September 1991 to December 1992. RESULTS Given the diagnosis of cervicitis in our emergency department, we found that the clinical examination predicted cervical infection with N. gonorrhoeae or C. trachomatis in only 20% of the pregnant women. Gravidas with chlamydial infections were younger (20.1 +/- 3.7 years) compared with gravidas not infected (23.2 +/- 5.4 years) (P < 0.0001). They were also more likely to have a diagnosis of lower urinary-tract infection [relative risk (RR) 2.89, 95% confidence interval (CI) 1.42-5.85]. CONCLUSIONS The clinical indicators of cervical infection with C. trachomatis and N. gonorrhoeae were unreliable.