Answers To Case 52 Chlamydial Cervicitis and HIV in Pregnancy

Summary: An 18-year-old G1 PO at 22 weeks' gestation has a positive Chlamydia DNA assay of the endocervix. She denies lower abdominal pain and is afebrile. Her abdomen is nontender and gravid. The gonorrhea culture is negative, and the HIV ELISA test is positive.

^ Next step in therapy: Oral erythromycin, azithromycin, or amoxicillin.

^ Next diagnostic step for HIV: Either western blot confirmation or polymerase chain reaction (PCR) confirmation.

^ Optimal treatment of HIV infection in pregnancy: Assessment of stage of HIV infection, initiation of highly active antiretroviral therapy (HAART), offer elective cesarean delivery, oral zidovudine (ZDV) to the neonate.

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