Association between Prior Chlamydia trachomatis Infection and Ectopic Pregnancy at a Tertiary Care Hospital in South Western Uganda.

Derrick Paul Mpiima,Henry Lugobe,Abraham Masinda,Hillary Twizerimana,Augustine Ssemujju,George Wasswa Salongo,Olivier Mumbere Mulisya,Joseph Ngonzi

doi:10.1155/2018/4827353

Derrick Paul Mpiima, Henry Lugobe + Show 6 more

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https://doi.org/10.1155/2018/4827353

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Abstract

Background Increase in the number of ectopic pregnancy is attributed to increase in the incidence of pelvic infections. Chlamydia trachomatis is responsible for most of the sexually transmitted bacterial infections. If undetected and untreated, the infection can ascend to the upper genital tract and cause pelvic inflammatory disease (PID) and related sequelae (ectopic pregnancy and tubal factor infertility). Objective To determine the association between prior Chlamydia trachomatis infection and ectopic pregnancy at Mbarara Regional Referral Hospital (MRRH). Methods This was an unmatched case-control study carried out at MRRH involving 25 cases and 76 controls. Serological evidence of prior chlamydial infection was determined by testing for the presence of Chlamydia immunoglobulin G antibodies in their blood. Logistic regression was used to determine the association between prior Chlamydia trachomatis infection and also the factors associated with ectopic pregnancy. The significant level of <0.05 was used. Results. Chlamydia antibodies were found in 60% of patients with ectopic pregnancy and 26.3% of the controls (p=0.002). The presence of Chlamydia antibodies was associated with a fourfold risk of ectopic pregnancy. Conclusion There was a strong association between prior Chlamydia trachomatis infection and ectopic pregnancy.

Highlights

In Uganda, in the last three decades, ectopic pregnancy has assumed epidemic proportion with significant maternal morbidity, mortality, and fetal wastage (Aliya (2010)). e incidence of ectopic pregnancy is directly related to the prevalence of salpingitis
Fallopian tube samples of patients with ectopic pregnancy have been found positive for C. trachomatis deoxyribonucleic acid using the polymerase chain reaction. e frequent association between chlamydial cervicitis and the presence of vaginal clue cells or Gram stain abnormalities indicative of an overgrowth of anaerobic bacteria has led to the speculation that C. trachomatis alters the normal vaginal ecology, thereby setting the stage for a complex polymicrobial upper genital tract infection
Serological evidence of prior chlamydial infection was determined in both groups by examining for the presence of Chlamydia immunoglobulin G antibodies in their blood

Summary

Background

Increase in the number of ectopic pregnancy is attributed to increase in the incidence of pelvic infections. The infection can ascend to the upper genital tract and cause pelvic inflammatory disease (PID) and related sequelae (ectopic pregnancy and tubal factor infertility). To determine the association between prior Chlamydia trachomatis infection and ectopic pregnancy at Mbarara Regional Referral Hospital (MRRH). Serological evidence of prior chlamydial infection was determined by testing for the presence of Chlamydia immunoglobulin G antibodies in their blood. Logistic regression was used to determine the association between prior Chlamydia trachomatis infection and the factors associated with ectopic pregnancy. Chlamydia antibodies were found in 60% of patients with ectopic pregnancy and 26.3% of the controls (p 0.002). E presence of Chlamydia antibodies was associated with a fourfold risk of ectopic pregnancy. Ere was a strong association between prior Chlamydia trachomatis infection and ectopic pregnancy Conclusion. ere was a strong association between prior Chlamydia trachomatis infection and ectopic pregnancy

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