History Of Pelvic Inflammatory Disease Research Articles

Factors associated with an unfavorable clinical course in hospitalized patients with pelvic inflammatory disease: a retrospective cohort study of 117 patients from a Japanese academic institution

BackgroundThis study aimed to determine the factors associated with an unfavorable clinical course (emergency surgery and/or prolonged hospitalization) in patients requiring hospitalization owing to pelvic inflammatory disease (PID).MethodsA retrospective study was performed on 117 patients diagnosed with PID who were admitted to our hospital between January 2014 and December 2018. Multivariate regression analysis was conducted to determine the factors associated with emergency surgical intervention, and prolonged hospitalization in a subgroup of successful expectant management (n = 93).ResultsThe average age (mean ± standard deviation) of the patients was 41.2 ± 12.5 years; 16 (13.7%) were postmenopausal; 81 patients (69.2%) complicated with a tubo-ovarian abscess (TOA) of which 59 (72.9%) had an ovarian endometrioma; and 19 patients (16.2%) had a history of various intrauterine manipulations. Emergency surgery was performed in 24 patients (20.5%), and patients with TOA underwent emergency surgery more often than did patients without TOA (25.9% vs. 8.3%, p = 0.03), and TOA was associated with longer length of hospital stay (17.1 days vs. 8.0 days, p = 0.01). Smoking, postmenopausal status, past medical history of PID, and high C-reactive protein (CRP) level at admission were significantly associated with emergency surgery. In patients with successful expectant management, obesity (body mass index ≥ 30) and high WBC and CRP level at admission were significantly associated with prolonged hospitalization.ConclusionsOf the patients requiring hospitalization owing to PID, TOA was associated with both emergency surgery and prolonged hospital stay. Patients with increased inflammatory markers and obesity should be considered to be at a high risk for unfavorable clinical course in the management of PID.

Intrauterine adhesions, peritubal adhesions and tubal occlusion on hysterosalpingography

Pelvic Inflammatory Disease (PID), Dilatation and Curettage (D&C) and other abdominopelvic surgeries are often presumed to cause female infertility. This can occur through adhesions formation that can result in Intrauterine Adhesions (IUA), Peritubal Adhesions (PTA) and Tubal Occlusion (TO). Hysterosalpingography (HSG) can be used to diagnose IUA, PTA, and TO; and the correlations of these findings with the histories of PID, D&C and other abdominopelvic surgeries statistically tested. The available literature shows very few of such correlation tests. The objective of this study was to document HSG diagnosis of IUA, PTA and TO, and test their correlation with histories of previous PID, D&C and abdominopelvic surgeries among women with secondary infertility. This is a prospective descriptive study of 158 subjects, analyzed with SPSS version 21. For correlation test, p≤0.05 is considered significant. There was history of previous PID in 53 subjects (33.5%), D&C in 114 (72.2%), and abdominopelvic surgery in 80 (50.6%). The important findings included: IUA in 20 subjects (12.7%), TO in 53 (33.5%) and PTA in 30 (19.0%). Significant correlation was found between D&C and PTA, but not between PID and IUA, PID and TO, PID and PTA, D&C and IUA, D&C and TO, abdominopelvic surgery and IUA, abdominopelvic surgery and TO, or abdominopelvic surgery and PTA. Tubal occlusion, followed by PTA and by IUA were detected in that order as the possible causes of infertility in our subjects; and these did not correlate well with the history of PID, D&C and other abdominopelvic surgeries.

Retained pregnancy tissue after miscarriage is associated with high rate of chronic endometritis

The objective of this study was to evaluate prevalence of chronic endometritis in a cohort of patients with retained pregnancy tissue (RPT) following miscarriage, with and without a history of recurrent pregnancy loss (RPL). In a cohort of our single academic fertility centre, we evaluated women with unexplained RPL (two or more losses) without evidence of RPT and women undergoing hysteroscopic resection of RPT following miscarriage. Endometrial samples underwent staining with H and E and CD138. A pathologist blinded to patient history recorded the number of plasma cells per 10 high power fields (HPF) and the presence or absence of endometrial stromal changes. Our main outcome measure was to measure the prevalence of chronic endometritis. Endometrial samples from 50 women with RPT following miscarriage and 50 women with unexplained RPL without evidence of RPT were reviewed. The prevalence of chronic endometritis was significantly higher in the RPT cohort (62% versus 30%). A multivariable regression demonstrated significantly higher odds of chronic endometritis in the RPT cohort, aOR 7.3 (95% CI 2.1, 25.5). We conclude that women with RPT following pregnancy loss have a high rate of chronic endometritis, suggesting that RPT is a risk factor for this disorder. Impact Statement What is already known on this subject? Known risk factors for chronic endometritis include a history of pelvic inflammatory disease, intrauterine polyps and fibroids. The aetiology for increased chronic endometritis among women with RPL is unknown. What do the results of this study add? The prevalence of chronic endometritis is significantly higher among women with retained pregnancy tissue (RPT) following miscarriage compared to women with RPL. These data presented suggest that RPT is associated with chronic endometritis among women with a history of miscarriage. What are the implications of these findings for clinical practice and/or further research? We suggest a pathologic evaluation for chronic endometritis be performed on all patients who undergo hysteroscopic resection of RPT following miscarriage. Our findings also suggest that a uterine cavity evaluation with hysteroscopy to evaluate for RPT may be reasonable in women with a history of miscarriage who are found to have chronic endometritis on endometrial biopsy. Further research is needed to determine if resection of retained tissue is sufficient to treat RPOC associated chronic endometritis, or if additional antibiotic treatment is necessary.

Common and Uncommon Imaging Presentations of Ectopic Pregnancy

Ectopic pregnancy most commonly occurs in a fallopian tube (~95%1) (Figure 1). Major risk factors for ectopic pregnancy include a history of pelvic inflammatory disease or previous tubal surgery. Additional risk factors include smoking, assisted reproductive technology, and the use of an intrauterine device.2 Ectopic pregnancies located outside the fallopian tube have a poorer prognosis, as they have more blood supply, grow larger, and have an elevated risk of catastrophic hemorrhage if ruptured. The clinical presentation of pelvic pain, elevated β-human chorionic gonadotropin, and vaginal bleeding is similar, regardless of the location of an ectopic pregnancy; thus, imaging plays a crucial role in directing management. Early diagnosis by imaging has played a key role in reducing maternal mortality and allowing patients to pursue more conservative management options to reduce morbidity and preserve future fertility. However, ruptured ectopic pregnancy still remains the leading cause of maternal death in the first trimester.3 Uncommon locations of ectopic pregnancy often are missed or incorrectly diagnosed at initial imaging, resulting in poor outcomes.

A study on histopathological changes in ectopic tubal gestation

Background: Ectopic pregnancy is a serious cause of maternal morbidity and mortality. Fallopian tube is the most common site. Ectopic pregnancy is often the consequence of chronic salpingitis. The aim of the study was to identify the various histopathological changes in the fallopian tube, which are removed following an ectopic tubal gestation. The prevalence of various risk factors in ectopic tubal pregnancy was also investigated. Methods: This descriptive study included 160 cases of ectopic tubal gestation received in the department during the study period. Slides were studied for various changes like chronic salpingitis, acute salpingitis, salpingitis isthmica nodosa, endometriosis, tuberculosis etc. Patient’s clinical details were obtained from the medical records.Results: The most frequent pathological finding was chronic salpingitis followed by salpingitis isthmica nodosa. It was noted that all cases with a positive history of pelvic inflammatory disease (PID), showed evidence of chronic salpingitis during histopathological examination. Chronic salpingitis was also noted in 45% cases who did not give a history of PID. Among the risk factors, a history of tubal sterilization was the most frequent one.Conclusions: Even though the mortality has reduced, ectopic pregnancy causes significant morbidity and affects the fertility of women. The rise in incidence could be due to increase in prevalence of sexually transmitted diseases, increase in tubal sterilization practices and frequent use of assisted reproduction technology. It is evident from the study that many cases of PIDs are left unidentified.

Unruptured ectopic pregnancy with alive fetus

Advanced tubal EP is uncommon and it can never lead to alive fetus. Diagnosis can be missed easily in the absence of classic symptoms of spotting, abdominal pain and amenorrhea. A woman aged 41, referred complaining of spotting. She had amenorrhea for 2 months.Her medical history was hypertension without any history of pelvic inflammatory disease.

Heterotopic pregnancy

Heterotopic pregnancy is defined as a condition when intrauterine and extra uterine pregnancy occur simultaneously. It is a life-threatening condition that requires immediate and accurate diagnostics and treatment. It is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. We present a case of a 30-year-old secondi gravida with history of one spontaneous abortion and pelvic inflammatory disease, who conceived spontaneously and at her fifth week of amenorrhea, was presented to the emergency department with acute pain in lower abdomen, moderate vaginal bleeding and weakness. Laboratory tests and transvaginal ultrasonography revealed the diagnosis of heterotopic pregnancy.

Effect and Role of miR-196b in Ectopic Pregnancy.

Ectopic pregnancy (EP) is associated with significant morbidity and mortality, but the molecular mechanism of this condition is still unclear. miR-196b, a hot research direction for the past few years, participates in the occurrence of various diseases but whether it plays a regulatory role in EP is still unclear. This research was set to investigate the expression and potential value of miR-196b in EP. qRT-PCR was utilized to determine the relative expression of miR-196b in peripheral blood of EP patients and to observe the expression changes of miR-196b before and after treatment. Correlation analysis of miR-196b with HCG and progesterone was performed. Logistic regression analysis was applied to independent risk factors affecting EP patients. TargetScan was utilized to predict the downstream target genes of miR-196b, and GO and KEGG analysis was carried out using the R language pack. qRT-PCR showed that miR-196b expression in peripheral blood of EP patients was lower than that of normal people. miR-196b expression in patients after treatment was notably higher than that before treatment. In addition, correlation analysis showed that miR-196b was positively correlated with the expression of HCG, progesterone, and estradiol. Risk factor analysis revealed that abortion history, pelvic inflammatory disease history, lower abdominal surgery history, and miR-196b were independent risk factors for EP, and the AUC of the combined ROC curve was 0.899. GO function enrichment and KEGG signal pathway enrichment found 10 potential functions and 2 potential signal pathways of miR-196b. miR-196b is expressed in EP patients, is differentially expressed according to the change in EP condition, and is expected to become a promising index for clinical diagnosis of EP.

Preliminary hysteroscopic tubal hydrotubation improves fertility outcomes after laparoscopic salpingotomy for tubal ampullary pregnancy

BackgroundSalpingotomy may change the anatomical structure and patency of the fallopian tube, which may affect the fallopian function. This study is to investigate the clinical efficacy of preliminary hysteroscopic tubal hydrotubation (HTH) after laparoscopic salpingotomy for tubal ampullary pregnancy.MethodsA retrospective study was carried out, 140 women underwent laparoscopic salpingotomy for ampullary pregnancy from March 2013 to March 2017. Some patients received HTH in the 1st month and hysterosalpingography (HSG) in the 3rd month after salpingotomy (HTH group; n = 95), and some patients only received HSG in the 3rd month after salpingotomy (control group; n = 45). Clinical data, tubal patency and fertility outcome were evaluated after follow-up of 15 months.ResultsThe tubal patency rate of the operated side was significantly higher in the HTH group than that in the control group (89.47% vs 68.89%, P < 0.05). The intrauterine pregnancy (IUP) rate was significantly higher in the HTH group (76.47% vs 51.11%, P < 0.05), and the recurrent ectopic pregnancy rate in the operated side was significantly lower in the HTH group than in the control group (9.41% vs 22.22%, P < 0.05). Logistic regression analysis showed that the positive factor for IUP was HTH (OR = 3.109, 95% CI 1.439–6.714, P = 0.004), while the negative factors were history of pelvic inflammatory disease (PID) (OR = 0.167, 95% CI 0.074–0.377, P < 0.001) and history of tubal infertility (OR = 0.286, 95% CI 0.113–0.723, P < 0.05).ConclusionPreliminary HTH after laparoscopic salpingotomy for ampullary pregnancy could improve reproductive function and lead to a better fertility outcome. Patients without history of PID or tubal infertility may be the most suitable ones for HTH after salpingotomy.

High Prediagnosis Inflammation-Related Risk Score Associated with Decreased Ovarian Cancer Survival.

There is suggestive evidence that inflammation is related to ovarian cancer survival. However, more research is needed to identify inflammation-related factors that are associated with ovarian cancer survival and to determine their combined effects. This analysis used pooled data on 8,147 women with invasive epithelial ovarian cancer from the Ovarian Cancer Association Consortium. The prediagnosis inflammation-related exposures of interest included alcohol use; aspirin use; other nonsteroidal anti-inflammatory drug use; body mass index; environmental tobacco smoke exposure; history of pelvic inflammatory disease, polycystic ovarian syndrome, and endometriosis; menopausal hormone therapy use; physical inactivity; smoking status; and talc use. Using Cox proportional hazards models, the relationship between each exposure and survival was assessed in 50% of the data. A weighted inflammation-related risk score (IRRS) was developed, and its association with survival was assessed using Cox proportional hazards models in the remaining 50% of the data. There was a statistically significant trend of increasing risk of death per quartile of the IRRS [HR = 1.09; 95% confidence interval (CI), 1.03-1.14]. Women in the upper quartile of the IRRS had a 31% higher death rate compared with the lowest quartile (95% CI, 1.11-1.54). A higher prediagnosis IRRS was associated with an increased mortality risk after an ovarian cancer diagnosis. Further investigation is warranted to evaluate whether postdiagnosis exposures are also associated with survival. Given that pre- and postdiagnosis exposures are often correlated and many are modifiable, our study results can ultimately motivate the development of behavioral recommendations to enhance survival among patients with ovarian cancer.

Common Complications after Immediate Postpartem Intrauterine Contraceptive Device Insertion

Introduction: Low contraceptive rates in poor nations are caused by numerous causes including a lack of information about contraceptives, the inability to get family planning methods, and cultural and geographic constraints on women's movement in these countries. If the birth takes place at a health care institution, women with limited access to medical care have a unique chance to address their contraception needs. Objective:To determine the frequency of common complications in immediate postpartum intrauterine contraceptive device insertion. Material and Methods: This study was conducted at Gynae and Obs department, QaziHussain Ahmed Medical Complex, Noshehra. This was a cross sectional descriptive study in which consecutive non probability sampling technique was used. Duration of the study was 6 months from 21st August 2020 to 20th February 2021,in which a total of 292 patients were studied. All multigravida females undergoing Normal Vaginal delivery and who gave consent for Immediate IUCD insertion were included, while patients with known history of pelvic inflammatory disease or sexually transmitted infection, patients having cavity distorting uterine fibroids, known uterine or cervical malignancy as seen through medical records and women with bleeding disorders as detected from past medical records were excluded.Data wascollected on a pre-designed proforma and analyzed by the SPSS version 20. Results: In this study mean age was 27 years with standard deviation ±1.26. Two hundred and four patients had delivery of placenta and IUCD insertion in 1-5 hours and 88 patients had delivery of placenta and IUCD insertion in 5-10 hours. Regarding complications 44 patients had expulsion in which partial expulsion was found in 9 patients and complete expulsion was found in 35 patients, uterine perforation was found in 6 patients while pelvic inflammatory disease was found in 29 patients. Conclusion: Despite the fact that IUCD's verbal approval was low, its real insertion was even less so. The only time these women have to learn about contraceptive options is during childbirth, when they are in direct touch with medical workers. That's why some people think family planning can help increase the uptake of contraceptives among women who otherwise wouldn't seek them out on their own. Keywords:Common complications, Immediate postpartum, Intrauterine contraceptive device insertion.

Diagnostic laparoscopy and oophorectomy for ovarian vein thrombosis in a patient with COVID-19: a surgical case report and literature review

Ovarian vein thrombosis (OVT) is a rare condition most frequently associated with pelvic inflammatory disease (PID), malignancy or the immediate postpartum period. This case study reports on a 56-year-old woman who developed OVT 11 days after a positive COVID-19 diagnosis. Imaging including abdominal/pelvic computed tomography, transvaginal Doppler ultrasound and transabdominal pelvic ultrasound failed to definitively diagnose the thrombotic etiology of the patient’s presentation. Ultimately, laparoscopic visualization and subsequent oophorectomy were necessary for diagnostic and therapeutic purposes. The patient did not have underlying malignancy, recent surgical history, history of PID or any history of previous thromboembolic events. Therefore, this report contributes further evidence to the growing knowledge of systemic manifestations associated with COVID-19 that may require surgical intervention.

The Burden of and Trends in Pelvic Inflammatory Disease in the United States, 2006-2016.

Pelvic inflammatory disease (PID) is an infection of the upper genital tract that has important reproductive consequences to women. We describe the burden of and trends in PID among reproductive-aged women in the United States during 2006-2016. We used data from 2 nationally representative probability surveys collecting self-reported PID history (National Health and Nutrition Examination Survey, National Survey of Family Growth); 5 datasets containing International Classification of Diseases, Ninth/Tenth Revision codes indicating diagnosed PID (Healthcare Utilization Project; National Hospital Ambulatory Medical Care Survey, emergency department component; National Ambulatory Medical Care Survey; National Disease Therapeutic Index; MarketScan); and data from a network of sexually transmitted infection (STI) clinics (Sexually Transmitted Disease Surveillance Network). Trends during 2006-2016 were estimated overall, by age group and, if available, race/ethnicity, region, and prior STIs. An estimated 2 million reproductive-aged women self-reported a history of PID. Three of 4 nationally representative data sources showed overall declines in a self-reported PID history, and PID emergency department and physician office visits, with small increases observed in nearly all data sources starting around 2015. The burden of PID in the United States is high. Despite declines in burden over time, there is evidence of an increase in recent years.

Association of pelvic inflammatory disease (PID) with ovarian cancer: a nationwide population-based retrospective cohort study from Taiwan

BackgroundPelvic inflammatory disease (PID) is an important health issue for women. Infection and inflammation play an important role in carcinogenesis and PID has been reported to be associated with ovarian cancer in some small scale studies.AimWe sought to determine whether PID is associated with an elevated risk of ovarian cancer in Asian women.MethodsUsing data from Taiwan’s National Health Insurance Research Database (NHIRD), our retrospective cohort study included women diagnosed with PID (cases) between the years of 2000 till 2012. Each case was matched with two women without PID (controls) by age and the year of first entry into the database. Both study cohorts were followed-up until the first event of ovarian cancer, withdrawal from the NHI program, death, or the end of the study period (December 31, 2012). Cox proportional hazards regression models were used to estimate crude and adjusted hazard ratios (HRs and aHRs) with their corresponding 95% confidence intervals (95% CIs) for the association of PID and ovarian cancer risk, with and without adjusting for potential confounders.ResultsDuring an approximate 10 years of follow-up, cases were significantly more likely than controls to develop ovarian cancer (incidence rates of 0.27 and 0.16 per 1,000 person-years, respectively; P < 0.001). Women with a history of PID had a 1.49-fold elevated risk for ovarian cancer (aHR, 1.49; 95% CI, 1.21–1.84; P < 0.001).ConclusionOur study evidence supports the contention that PID increases the risk of developing ovarian cancer among Taiwanese women. Gynecologists should undertake careful assessments and closely follow patients with PID, who are at long-term risk of developing ovarian cancer. Our findings need further verification in other international cohorts.

Predictive Analytic Model for Diagnosis of Ectopic Pregnancy.

Objective: Ectopic pregnancy (EP) is a serious condition. Delayed diagnosis could lead to life-threatening outcomes. The study aimed to develop a diagnostic predictive model for EP to approach suspected cases with prompt intervention before the rupture occurred.Methods: A retrospective cross-sectional study enrolled 347 pregnant women presenting first-trimester complications (abdominal pain or vaginal bleeding) with diagnosis suspected of pregnancy of unknown location, who were eligible and underwent chart review. The data including clinical risk factors, signs and symptoms, serum human chorionic gonadotropin (hCG), and ultrasound findings were analyzed. The statistical predictive score was developed by performing logistic regression analysis. The testing data of 30 patients were performed to test the validation of predictive scoring.Results: From a total of 22 factors, logistic regression method–derived scoring model was based on five potent factors (history of pelvic inflammatory disease, current use of emergency pills, cervical motion tenderness, serum hCG ≥1,000 mIU/ml, and ultrasound finding of adnexal mass) using a cutoff score ≥3. This predictive index score was able to determine ectopic pregnancy with an accuracy of 77.8% [95% confidence interval (CI) = 73.1–82.1], specificity of 91.0% (95% CI = 62.1–72.0), sensitivity of 67.0% (95% CI = 88.0–94.0), and area under the curve of 0.906 (95% CI = 0.875–0.937). In the validation group, no patient with negative result of this score had an EP.Conclusion: Statistical predictive score was derived with high accuracy and applicable performance for EP diagnosis. This score could be used to support clinical decision making in routine practice for management of EP.

A Retrospective Study of Clinical Encounters for Pelvic Inflammatory Disease: Missed Opportunities to Screen for Syphilis and HIV?

Missed screening opportunities may contribute to the rising rates of sexually transmitted and blood borne infections (STBBIs) in Manitoba. This study sought to determine the proportion of women who are screened for syphilis and human immunodeficiency virus (HIV) when admitted with pelvic inflammatory disease (PID). We performed a retrospective analysis of all inpatient admissions for PID over 3 discrete years (fiscal years 2007, 2012, 2017) at a single tertiary care centre. Data extracted from medical records included STBBI screening performed, clinical signs at presentation, and history of PID or STBBI. To improve the accuracy of our estimates, we complemented the records data with population data from Manitoba. We evaluated predictive factors influencing any or concurrent STBBI screening using bivariate analysis for significance (P < 0.05). One hundred and five admissions met inclusion criteria. Syphilis and HIV screening was ordered concurrently with chlamydia and gonorrhoea screening in 6 (6%) of encounters and was ordered at any point during admission for PID in 28 (27%). A history of substance abuse (odds ratio [OR] 4.94 [95% CI 1.62-15.05] for syphilis screening and OR 6.94 [95% CI 2.38-20.23] for HIV screening) and a positive gonorrhea result while admitted (OR 3.40 [95% CI 1.06-10.88] for syphilis screening) were strongly associated with receiving any screening. Reporting multiple sexual partners was also strongly associated with receiving any STBBI screening while admitted (OR 19.44 [95% CI 2.01-187.92] and OR 15.00 [95% CI 1.58-142.70] for syphilis and HIV screening, respectively). A minority of patients were screened for syphilis and HIV while admitted for PID. This study highlights a missed opportunity to screen for STBBI among sexually active women.

Incidence and clinical profile of ectopic pregnancies in a tertiary hospital; A two-year Retrospective study

Introduction: Ectopic pregnancy is an emergency and a life-threatening condition which is an important cause of major maternal morbidity and mortality. This study was designed to determine incidence, common identified risk factors, clinical presentations, management, morbidity and mortality due to ectopic pregnancy at the national referral hospital in Thimphu, Bhutan. Methods: This was a retrospective study of all cases of ectopic pregnancies for a period of two years from 1st January 2018 to 31st December 2019. Socio-demographic characteristics, risk factors, clinical presentations, investigations and mode of treatments were extracted. Simple descriptive statistics such as frequencies, percentages, mean and range were utilised. Results: There were 9603 pregnant women admitted for delivery, out of which 122 were ectopic pregnancies. The incidence of ectopic pregnancy was 12.7/1000 pregnancies. Majority of them were in the age group of 21-30 years and 32.69% of the affected were nulliparous. While Pelvic inflammatory disease was seen in 41.35%, 20.19% were unmarried. Abdominal pain, amenorrhea, and vaginal bleeding were the most common symptoms. Among the ectopic pregnancies, 99.5% were diagnosed with ultrasound. A total of 94.23% had undergone surgical intervention, of which only 1% had laparoscopic surgery. No maternal mortality had occurred. Conclusions: Women with past history of pelvic inflammatory disease, previous miscarriage, unmarried, and nulliparous presenting with history of amenorrhea, abdominal pain, vaginal bleeding should be a high index of suspicion for ectopic pregnancy. Timely diagnosis and intervention in the form of surgical or medical management will reduced the morbidity and mortality due to ectopic pregnancy.

Pelvik inflamatuar hastalık ve kontrasepsiyon : Üçüncü basamak merkezde kesitsel bir çalişma

Aim: The purpose of our study in the light of this information; to investigate the relationship between the contraceptive methods used in the patient population treated for pelvic inflammatory disease (PID) in a tertiary center with clinical and laboratory features and clinical outcome of PID.&#x0D; Material and Method: This is a cross-sectional study using the anamnesis, examination findings, microbiological and pathological evaluation results of vaginal and cytological samples recorded in the hospital database of 974 patients treated with a diagnosis of PID in a tertiary center between 2017 and 2019.&#x0D; Results: Copper-Intrauterine Device (Cu-IUD) was the most commonly used contraceptive method in women with a history of PID. When the cervicovaginal culture results are evaluated; E.coli positivity was more frequent in patients using CU-IUD and Levonorgesterone IUD (LNG-IUD) (

Распространенность и факторы риска развития инфекции мочевыводящих путей у женщин репродуктивного возраста

to study the prevalence and identify risk factors for development of urinary tract infections (UTI) among women of reproductive age in Tashkent. a cross-sectional epidemiological study of the prevalence and risk factors of UTI in women was performed. The case-control study was conducted according to the nest-typological method. A total of 1028 women were examined, of which 654 were of reproductive age. To evaluate the impact of various risk factors on the development of UTI, social-economic status, medical and obstetric history and complaints were analyzed. The prevalence of UTI in women of reproductive age was 8.71%. The causative agent of UTI in 99% of cases was E. coli, and S. aureus was isolated only in 1% of cases. The most significant risk factors for UTI were vaginal discharge (odds ratio (OR) 2.32, 95% confidence interval (CI) 1.16-4.64), a history of pelvic inflammatory diseases (OS 1.99, 95 % CI 1.01-3.91), as well as the use of daily pads (OS 1.92, 95% CI 1.03-3.57). Vaginal discharge, a history of pelvic inflammatory diseases and the use of pads are significant risk factors for the development of UTI in women of reproductive age.

The course of pregnancy and the outcomes of labor in the combination of oligoamnion with a flattened shape of the fetal bladder

Aim. To study pregnancy and the outcomes of labor in women with oligohydramnios and flattened fetal bladder. Materials and Methods . We retrospectively analysed childbirth histories of 100 women admitted to Belyaev Kemerovo Regional Clinical Hospital either diagnosed with oligohydramnios combined with a flattened fetal bladder or having normal pregnancy course (n = 50 per group). Results. Patients with oligohydramnios and a flattened fetal bladder more frequently had past medical history of pelvic inflammatory disease (60% versus 30% in healthy women, p = 0.001) as well as dilation and curettage (32% versus 10% in healthy women, p = 0.003). Such patients had higher rate of a urinary tract infections during pregnancy (26.0% versus 4.0% in healthy women, p = 0.001). Childbirth in this patient group was more frequently complicated by a discoordinated labor (40.0% versus 0% in healthy women, p = 0.001). Pathology examination of the placenta confirmed the high frequency of chronic inflammatory process and chorioamnionitis in patients with oligohydramnios and a flattened fetal bladder. Conclusion. Patients with oligohydramnios and a flattened fetal bladder are a risk group of urinary tract infections during pregnancy and chorioamnionitis.