A longitudinal study of pelvic inflammatory disease

Abstract

Objective To study the microbiology and long term prognosis of pelvic inflammatory disease (PID). Design A prospective study of women with laparoscopically confirmed PID. Setting Teaching hospital in central London. Subjects 23 women with PID. Outcome measures Microbiological investigations at the time of diagnosis and at follow up; subsequent fertility and the occurrence of pelvic pain. Results PID diagnosed by laparoscopy was regarded as moderate to severe in 15 cases. Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum or a combination of these micro‐organisms were detected most frequently in the cervix, less often in the endometrium and least in the tubes, C. trachomatis being the micro‐organism found most commonly in the tubes. There was serological evidence of acute chlamydial infection in 13 of 20 cases in which paired sera were available and a serological response to M. hominis in 9 of 12 cases in which it was possible to evaluate the results. On the basis of microbiological and serological results, C. trachomatis appeared to be the most important aetiological agent in 10 cases, N. gonorrhoeae in four cases, M. hominis in three cases and U. urealyticum in none; in five cases, two of these microrganisms appeared to be of equal importance. After 1 to 3 years, 33% of the women were having difficulty conceiving and 56% continued to complain of pelvic pain. Conclusion It is difficult to be certain of the infectious cause of PID in any given case. However, the evidence that N. gonorrhoeae and C. trachomatis are pathogens is very strong. M. hominis may be responsible for a few cases on its own or together with other micro‐organisms.

Risk and Protective Factors in the Origin of Atrial Septal Defect Secundum - National Population-Based Case-Control Study

“…Pelvic inflammatory diseases include the inflammatory conditions of ovary, fallopian tube, pelvic cellular tissue, and peritoneum, frequently associated with endometritis, cervitis and/or vulvovaginitis. Both acute and chronic manifestations of this disease-group are known, however, only acute diseases were evaluated in the study with 3 main symptoms: bilateral adnexal and cervical motion tenderness, cervical discharge and fever; in addition, laboratory tests show elevated count of white blood cell and sedimentation rate (21). A large number of microorganisms have been implicated as the cause of pelvic inflammatory diseases such as Chlamydia trachomatis, Neisseria gonorrhoeae, endogenous anaerobic and aerobic bacteria, genital mycoplasma etc.…”

Possible association between acute pelvic inflammatory disease in pregnant women and congenital abnormalities in their offspring: A population‐based case‐control study

“…The classic presentation of APID (Stacey at al., 1992) covers a wide spectrum and symptoms depend on the sensitivity of patients, therefore we accepted only medically recorded APID in the study. Thus our pregnant women had severe APID, in general with high fever.…”

“…The symptoms of APID are fever, cervical discharge, bilateral adnexal, and cervical motion tenderness with laboratory indication of infection such as elevated count of white blood cells and sedimentation rate (Gjonaess, 1982; Stacey et al, 1992). APID is frequently associated with cervitis and/or vulvovaginitis, therefore pregnant women with these associated conditions were also included in the group of APID.…”

Tubal Damage, Infertility and Tubal Ectopic Pregnancy: Chlamydia trachomatis and Other Microbial Aetiologies

“…Mycoplasma spp. have been isolated from the female upper genital tract and Fallopian tubes (Cohen 2005;Heinonen & Miettinen 1994;Stagey et al 1992). Serological testing of women has confirmed an association between mycoplasmas and cases of PID (Moller et al, 1985)and mycoplasma, PID and ectopic pregnancy (Jurstrand et al, 2007).…”