1.               All patients should be screened at the New OB Exam and at 35-37 wks per Health Department protocols.

2.               Screen patients with suspicious vaginal discharge or it their partner has been treated for nongonococcal urethritis, even if patient is asymptomatic

 

1.       Azithromycin 1 gm  po  x  1 dose for patient and her partner.

 

2.       Alternative: Erythromycin 500 mg  QID  x  7 days or 250 mg  QID  x 10 days.

 

3.       Advise patient to return if symptoms persist.

 

4.       Test of cure should occur within 2-3 months of treatment and again at 36 weeks per state guidelines as appropriate.  If the 2-3 month test falls at 36 week, no further testing would be recommended.

 

5.       Refer patient for Hepatitis B vaccination if has not previously received

 

 

 

 

 

 

Prepared in conjunction with the

Division of Maternal-Fetal Medicine

Duke University Medical Center

 

 

 

Director_______________________

 

Date__________________________

 

 

 

1.       McGregor JA, French JI, Richter R, Vuchetich M, Bachus V, Seo K, Hillier S, Judson FN, McFee J, Schoonmaker J, Todd JK. Cervicovaginal microflora and pregnancy outcome: results of a double-blind, placebo-controlled trial of erythromycin treatment. Am J Obstet Gynecol, 1990; 163:1580-1591.

 

2.               Weber JT, Johnson RE. New treatments for Chlamydia trachomatis genital infection. Clinical Infectious Diseases. 20 Suppl 1:S66-71, 1995 Apr.

 

3.       Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2006. MMWR 2006:55(No. RR-20)

 

 

 

The Clinical Care Guidelines Development Committee of the Perinatal Improvement Board of Duke University Health System has developed a series of multi-disciplinary protocols to offer guidance to health care providers who are caring for pregnant women with high risk conditions.

 

These protocols are designed to assist health care providers in the management of a variety of problems that occur in pregnancy and the time of delivery. They should not be interpreted as standard of care, but instead represent only general guidelines for the care of pregnant women with high risk conditions.  We recognize that services offered by individual providers depend not only on their training, experience and institutional resources, but on the medical facts and circumstances of the specific care situation.

The protocols remain the intellectual property of the Duke University Health System.  They cannot be reproduced in whole or part without the expressed permission of the Health System.

 

These protocols are reviewed by the Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine, the Department of Pediatrics Division of Neonatology and the Department of Anesthesiology Division of Women’s Anesthesia.  Please contact Andra H. James (andra.james@duke.edu), Chair, Clinical Care Guidelines Development Committee of the Perinatal Improvement Board with ideas for additional protocols.