P232 Keeping on TOP of BV – an audit of bacterial vaginosis and STI screening in GUM clinic attendees requesting a termination of pregnancy

Abstract

Background/introduction BASHH guidelines currently recommend universal testing for all GUM clinic attendees and all those undergoing termination of pregnancy (TOP). Screening for and treating bacterial vaginosis (BV) is recommended by BASHH in order to reduce the incidence of post TOP endometritis and PID. Aim(s)/objectives To audit whether STI screening, to include testing for BV, is being carried out in patients attending a GUM service requesting TOP referral. Methods Retrospective case note review of 100 consecutive patients seen requesting TOP referral in an Inner London GUM clinic 1/1/15–1/2/15. Results Case notes of 100 were reviewed. Median age was 25yrs (range 16–49 yrs). 21% of patients (n = 21) were of Black ethnicity. 28/50 (56%) reported previous pregnancy and 19/43 (44%) previous TOP. Sexual histories were documented in 53% (n = 53) of cases. 43% (43/100) of patients were documented to be asymptomatic. 38/100 patients had an STI screen and of the remainder 37% were documented to have declined. STI screening included serology testing for HIV/STS in 68% (n = 26) of cases and microscopy for BV/TV in 42% (n = 16). No asymptomatic patients were screened for BV. STI prevalence in those screened was BV 50% (8/16), Chlamydia 8% (3/37), Gonorrhoea 5% (2/37). Discussion/conclusion Adherence to BASHH guidelines was inconsistent particularly in relation to STI screening and BV screening in asymptomatic women seeking TOP. STI prevalence was relatively high in those screened. A designated clinical proforma may improve documentation and testing rates.