• Acad Emerg Med · Aug 2002

    Comparative Study

    Cervical infections in emergency department patients with vaginal bleeding.

    • Lance Hoffman, O John Ma, Gary Gaddis, and Robert A Schwab.
    • Department of Emergency Medicine, Truman Medical Center, UMKC School of Medicine, Kansas City, MO, USA. lhoffman@unmc.edu
    • Acad Emerg Med. 2002 Aug 1; 9 (8): 781-5.

    UnlabelledTo the best of the authors' knowledge, no previous study has compared the prevalences of Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (NG) cervical infection among pregnant and non-pregnant patients presenting to the emergency department (ED) with vaginal bleeding.ObjectivesTo determine the prevalence of these infections in a simultaneously assembled cohort, and to determine whether pregnancy is associated with altered rates of CT or NG cervical infection among patients with vaginal bleeding.MethodsThis was a prospective, seven-month, cross-sectional study of a convenience sample of patients (aged > or = 15 years) who presented to an urban, teaching ED with the chief complaint of vaginal bleeding. A urine pregnancy test was administered to each patient. Cervical swab specimens were analyzed for CT or NG via polymerase chain reaction technology (DNA probe). The hospital laboratory's baseline 18% rate of positive tests was used for sample size planning. Chisquare analysis and Fisher's exact test, where appropriate, were used to compare pregnant and non-pregnant patient groups.ResultsCervical infection rates did not differ between pregnant and non-pregnant patients. Testing for CT showed that 13 of 114 (11%) of the pregnant patients were positive, while 11 of 147 (8%) non-pregnant patients tested positive (chi(2) = 0.759, p = 0.384). Testing for NG revealed that seven of 114 (6%) pregnant patients tested positive, while 16 of 147 (11%) non-pregnant patients tested positive (chi(2) = 1.256, p = 0.262). Combined testing showed that 18 of 114 (16%) of the pregnant patients and 25 of 147 (17%) of the non-pregnant patients harbored a cervical infection with one or both pathogens (chi(2) = 0.009, p = 0.925).ConclusionsThe prevalence of CT or NG cervical infection in pregnant patients presenting to the ED with vaginal bleeding is 16%. Pregnant and non-pregnant patients with vaginal bleeding are at similar risks for having CT or NG cervical infection. Cervical swab specimens should be obtained in all patients with vaginal bleeding.

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