Pregnant women in high-risk categories should be tested at the first prenatal visit. Ophthalmic antibiotics should be applied topically to the eyes of all newborns immediately after birth to help prevent ophthalmia neonatorum. About half of the sexual partners of persons with chlamydial infection are also infected with this organism. Infection during pregnancy can produce postpartum endometritis, and the organism is transmitted to the fetus in over half of deliveries.
Neonatal infection can result in ophthalmia neonatorum, nasopharyngeal colonization, and pneumonia.
The most sensitive and specific test for detecting chlamydial infection in asymptomatic persons is direct culture. Fluorescent antibody microscopy has comparable sensitivity and specificity to chlamydial culture, but it is a labor-intensive procedure requiring special laboratory equipment and skilled technicians in order to produce reliable results. Both tests, however, may be useful in areas where culture is not available or too costly. Serologic testing remains primarily a research tool due to difficulties associated with performing the laboratory procedure. There have been few controlled studies examining whether early detection and treatment of asymptomatic persons result in improved outcome.