Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility

Hillis, Susan D.; Joesoef, Riduan; Marchbanks, Polly A.; Wasserheit, Judith N.; Cates, Willard; Weström, L

doi:10.1016/s0002-9378(11)90790-x

Cited by 256 publications

(122 citation statements)

References 15 publications

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“…In one prospective study of a cohort of 14,322 individuals between the ages of 18 and 26 years, the prevalence of Chlamydia infection was 4.2% [4]. Approximately 30% of women with Chlamydia cervicitis will develop PID if left untreated or if treatment is delayed, and tends to be associated with high rates of subsequent infertility (17.8%) [5][6][7]. N. gonorrhoeae cervicitis is more acutely symptomatic and the long-term sequelae are similar to those caused by Chlamydia cervicitis.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation

Imudia

Detti

Puscheck

et al. 2008

J Assist Reprod Genet

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Purpose To determine the prevalence of positive test for Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) infections, and their corresponding Rubella status when undergoing workup for infertility. Methods Retrospective chart review to determine infection status for UU, MH, CT, and NG as determined by cervical swab, as well as the serum Rubella antibody titer. Results A total of 46 patients of the patients reviewed were positive for UU (20.1%), three patients were positive for MH (1.3%), five patients were positive for CT (2.2%) and one patient was positive for NG (0.4%). Rubella immunity was confirmed in 90.3% of patients. Conclusion Approximately one quarter of women presenting to an infertility clinic seeking to conceive were found to have a positive test for UU, MH, CT or NG infection. Additionally, almost 10% of the patients were Rubella nonimmune at the time of presentation for infertility evaluation.

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Section: Introductionmentioning

confidence: 99%

The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation

Imudia

Detti

Puscheck

et al. 2008

J Assist Reprod Genet

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“…4,5 Early detection and treatment of cervical chlamydial infections can prevent pelvic inflammatory disease 6 and have a strong protective effect against infertility. 7 Eradication of genital chlamydial infections would eliminate an estimated 80% of tubal factor infertility and 50% of tubal pregnancies. 8 The sociodemographic factor most strongly associated with chlamydial infection in women is young age (Ͻ20 years old).…”

mentioning

confidence: 99%

Testing for Chlamydia and Sexual History Taking in Adolescent Females: Results From a Statewide Survey of Colorado Primary Care Providers

et al. 2000

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ABSTRACT. Objectives. Little is known about the practice patterns of primary care providers as they relate to assessing risk of and screening for chlamydial infections, an important cause of preventable reproductive morbidity in young women in the United States. The present cross-sectional study was undertaken to assess levels of chlamydia testing, sexual history taking, and prevention practices by Colorado primary care physicians, nurse practitioners, and physician assistants who provide gynecologic care to adolescent females (13-19 years old).Methods. Between July 1998 and October 1998, an anonymous, self-administered questionnaire was mailed to a 25% random sample (n ‫؍‬ 1265) of Colorado physicians (family practitioners, internal medicine specialists, obstetrician-gynecologists, and pediatricians), nurse practitioners, and physician assistants. Practitioners were identified through professional organization membership, state-licensing bodies, and listings in the yellow pages.Results. After estimating the eligibility rate among nonrespondents, the adjusted response rate was 71.5%. Only 53.8% of providers reported regularly testing sexually active female adolescents for chlamydia; 71.8% of providers regularly took a sexual history. Female providers reported significantly higher levels of regularly taking a sexual history (87.2% vs 60.6% of males), feeling comfortable discussing sex (94.4% vs 77.8%), discussing sexually transmitted disease (STD) prevention (81.5% vs 71.3%), and testing for chlamydia (64.4% vs 38.6%). Among provider types, obstetrician-gynecologists, nurse practitioners, and pediatricians were most likely to report regularly taking a sexual history (90.1%, 88.6%, and 76.0%, respectively). Internal medicine specialists were the least likely to report taking a sexual history (43.9%). Pediatricians and nurse practitioners were the most likely to report testing sexually active adolescent females for chlamydia (74.1% and 70.1%, respectively), whereas physician assistants and internal medicine specialists were the least likely (46.0% and 38.5%, respectively).In multivariate analysis, variables independently associated with regularly taking a sexual history included female provider gender (odds ratio [OR]: 5.5; 95% confidence interval [CI]: 2.9 -10.9), obstetrics/gynecology specialty (OR: 4.0; 95% CI: 1.7-10.3; referent group: family practitioners), and provider comfort level in discussing sex (OR: 4.9; 95% CI: 2.3-11

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“…В ис-следованиях было показано, что чем раньше поставлен диагноз ВЗОМТ и назначена антибактериальная терапия, тем реже развиваются осложнения. Так, если лечение на-чато в течение первых 2 дней после появления симптомов, то частота последующего бесплодия составляет 8,3%, если через 3 дня и более, то 19,7% [6]. Таким образом, в основе успешной борьбы с ВЗОМТ лежат своевременная диагно-стика и ранняя адекватная терапия.…”

Section: большие проблемы малого тазаunclassified

Small pelvic inflammatory diseases: Diagnosis and patient management tactics

Prilepskaya¹

2015

Ross. vestn. akush.-ginekol.

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Инфекции верхних отделов женского репродуктив-ного тракта являются одними из наиболее часто встреча-ющихся инфекционно-воспалительных заболеваний у женщин детородного возраста [1]. В настоящее время для обозначения данной патологии как за рубежом, так и в России широко используется термин «воспалительные за-e-mail: Serge.Sekhine@antibiotic.ru болевания органов малого таза» (ВЗОМТ). К ВЗОМТ от-носятся эндометрит, сальпингит, тубоовариальный аб-сцесс и пельвиоперитонит как по отдельности, так и в со-четании [2]. Также часто встречается словосочетание хро-нические ВЗОМТ, однако оно не совсем корректно, так как ВЗОМТ -это всегда острый процесс с более или ме- Воспалительные заболевания органов малого таза (эндометрит, сальпингит, тубоовариальный абсцесс и пельвиопери-тонит) у женщин детородного возраста являются одним из наиболее часто встречающихся заболеваний. На основании анализа американских и европейских руководств, содержащих рекомендации по ведению больных с воспалительными заболеваниями органов малого таза, а также журнальных научных статей представлены критерии диагностики этих забо-леваний (минимальные, дополнительные, специфические), критерии их амбулаторного или стационарного лечения, прин-ципы лечения таких пациенток. Лечение таких больных должно быть комплексным, но основано на рациональной эмпири-ческой антибактериальной терапии. Основные принципы антимикробной терапии следующие: 1) как можно более раннее начало; 2) назначение антибактериальных препаратов с охватом всего спектра вероятных возбудителей на 10-14 дней; 3) при воспалительных заболеваниях органов малого таза легкой и средней степени тяжести -амбулаторное лечение пероральными препаратами. Лечение больных с тяжелыми формами -только в стационаре с парентеральным примене-нием антибактериальных препаратов, при улучшении состояния через 1-2 сут возможен переход на пероральный прием. Представлена высокая эффективность применения фторхинолона IV поколения -моксифлоксацина при лечении данной группы больных. Авторы информируют об отсутствии конфликта интересов.Ключевые слова: женщины репродуктивного возраста, воспалительные заболевания органов малого таза, критерии диагностики, критерии госпитализации, принципы антибактериальной терапии, моксифлоксацин.Small pelvic inflammatory diseases (endometritis, salpingitis, tubo-ovarian abscess, and pelvioperitonitis) in women of childbearing age are most common. Analysis of U.S. and European guidelines for the management of patients with small pelvic inflammatory diseases and research articles from journals has provided criteria (minimum additional, specific) for the diagnosis of these diseases, those for their out-or inpatient treatment, and principles in the treatment of these patents. The management of these patients should be comprehensive, but based on rational empiric antibiotic therapy. The general principles of antimicrobial therapy should be as follows: 1) as early onset as possible; 2) 10-14-day antibiotic use covering the full spectrum of probable causative agents; 3) outpatient oral antibiotic tr...

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Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility

Cited by 256 publications

References 15 publications

The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation

The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation

Testing for Chlamydia and Sexual History Taking in Adolescent Females: Results From a Statewide Survey of Colorado Primary Care Providers

Small pelvic inflammatory diseases: Diagnosis and patient management tactics

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