History Of Salpingitis Research Articles

INFECTIONS ASSOCIATED WITH OBSTETRIC AND GYNECOLOGICAL SURGERIES AS A CAUSE OF FEMALE INFERTILITY IN UKRAINE.

The aim: To assess the role of surgical site infections types associated with obstetric and gynecological surgeries as a cause of infertility among women reproductive age in Ukraine. Materials and methods: We conducted a retrospective multicentre cohort study was based on reproductive health surveillance data among women reproductive age from 2019 to 2021. Definitions of infertility were used from the WHO and surgical site infections were used CDC/ NHSN. Results: Among all the 3,825 of infertility women in this study, the prevalence of surgical site infection (SSI) was 67.9%. The prevalence of SSI among primary infertility group and secondary infertility group women was 67.5% and 71.4%, respectively. There were differences among SSI type associated with infertility, primary infertility and secondary infertility. In logistic multivariate regression analyses, infertility was associated history of induced abortion (p < 0.001), history of obstetric and gynecological surgeries (p < 0.001), Salpingitis (p < 0.001), Oophoritis (p < 0.001), Endometritis (p < 0.001), Adnexa utery (p=0.009), and Pelvic abscess or cellulitis (p=0.043). The main factors associated with primary infertility were history of Salpingitis (33.6%) and Oophoritis (28.2%) after gynecological surgery. A factors associated with secondary infertility were history of Endometritis (27.2%), Pelvic abscess or cellulitis (11.2%), Salpingitis (10.1%), Adnexa utery (9.4%), Oophoritis (4.8%), and Chorioamnionitis (3.9%). Conclusions: One of the main causes of infertility in women of reproductive age in Ukraine are SSIs after obstetric and gynecological surgeries, and induced abortion. This applies to both primary and secondary infertility group women's in this cohort study.

Sexually Transmitted Diseases as Major Causes of Ectopic Pregnancy

Objective To evaluate the current impact of sexually transmitted diseases (STDs) and their consequences on the occurrence of ectopic pregnancy (EP). Design Case-control study. Setting Fifteen maternity hospitals in the Rhone-Alpes region, France. Subjects Six hundred twenty-four women with EP diagnosed from October 1988 to December 1991 and 1,247 controls who delivered liveborn children during the same period. Main Outcome Measures Information on risk factors included behavioral, clinical, and serological indicators of STDs and other known risk factors of EP. Results Logistic regression identified several indicators of STDs as strong and independent risk factors for EP: previously treated STD without history of salpingitis; history of probable pelvic inflammatory disease (PID) and, especially, history of confirmed PID; previous STDs of the sexual partner; and Chlamydia trachomatis seropositivity. The adjusted attributable fractions of EP for previous symptomatic STDs, symptomatic STDs of the sexual partner, and C . trachomatis seropositivity were 20%, 3.5%, and 25.2%, respectively, giving a total of 43% of EP cases attributable to infectious factors. Conclusions Our findings and previous epidemiological and biological evidence suggest that STD is a major cause of EP. The evidence is particularly strong in the case of C . trachomatis infection. An effective way of dramatically reducing the EP rate would be to prevent STD through education programs sensitizing young women to the complications of STD and public health measures promoting the use of protective methods such as condoms.

Sexually transmitted diseases as major causes of ectopic pregnancy: results from a large case-control study in France

To evaluate the current impact of sexually transmitted diseases (STDs) and their consequences on the occurrence of ectopic pregnancy (EP). Case-control study. Fifteen maternity hospitals in the Rhône-Alpes region, France. Six hundred twenty-four women with EP diagnosed from October 1988 to December 1991 and 1,247 controls who delivered liveborn children during the same period. Information on risk factors included behavioral, clinical, and serological indicators of STDs and other known risk factors of EP. Logistic regression identified several indicators of STDs as strong and independent risk factors for EP: previously treated STD without history of salpingitis; history of probably pelvic inflammatory disease (PID) and, especially, history of confirmed PID; previous STDs of the sexual partner; and Chlamydia trachomatis seropositivity. The adjusted attributable fractions of EP for previous symptomatic STDs, symptomatic STDs of the sexual partner, and C. trachomatis seropositivity were 20%, 3.5%, and 25.2%, respectively, giving a total of 43% of EP cases attributable to infectious factors. Our findings and previous epidemiological and biological evidence suggest that STD is a major cause of EP. The evidence is particularly strong in the case of C. trachomatis infection. An effective way of dramatically reducing the EP rate would be to prevent STD through education programs sensitizing young women to the complications of STD and public health measures promoting the use of protective methods such as condoms.

Risk Factors in Ectopic Pregnancy Results of A Population‐Based Case‐Control Study

In a population-based case-control study, possible risk factors for ectopic pregnancy were compared in 119 patients with ectopic pregnancy and in 119 age-matched controls with intra-uterine pregnancy from each of the following categories: deliveries, spontaneous abortions and induced abortions. The following factors were found significantly more often in cases of ectopic pregnancy: a history of earlier ectopic pregnancy, a history of salpingitis, a history of earlier operation on the Fallopian tubes, a history of infertility, and a pregnancy that had occurred in spite of an intra-uterine contraceptive device. A history of appendectomy was also found significantly more often among the cases. There was no significant correlation between ectopic pregnancy and a history of no earlier pregnancy, earlier deliveries, earlier spontaneous or induced abortions or a history of other gynecological operations and increased risk of ectopic pregnancy. One or more of the risk factors were found in 76.5% of cases and 23% of controls.

Tubal infertility and silent chlamydial salpingitis.

Antibodies to Chlamydia trachomatis (serum IgG antibodies with a titre of at least 32) were detected in 141 (86.0%) of 164 infertile women with tubal infertility (TF group) and in 20 (28.6%) in 70 infertile women with normal tubes (NTF group). The difference was highly significant (P less than 0.001), as was the difference in geometric mean titre of antibody-positive cases, 181 and 87, respectively. Pregnant, age-matched women were used as controls. Significantly fewer of these women (P less than 0.001) had antibodies, when compared with the TF group, 60 (36.6%) of 164, but not when the comparison was made with the NTF group, 31 (44.3%) of 70. There was a history of salpingitis in 64 (39.0%) of the 164 infertile women with damaged tubes. Neither the frequency nor the geometric mean titre of chlamydial antibodies differed between tubal factor infertility patients with and without a history of salpingitis. Previous chlamydial infection, reflected by serological markers, is strongly associated with tubal damage leading to tubal infertility. A large proportion of these cases run a silent course, since a majority of the antibody-positive patients with tubal infertility have never had salpingitis.

Importance of chlamydial antibodies in acute salpingitis in central Africa.

Of 35 women with acute salpingitis on laparoscopy, 86% had chlamydial antibodies at a titre of 1/16 or higher and 49% at a titre of 1/512 or higher. Geometric mean titres of chlamydial antibodies correlated significantly with a laparoscopic observation of chronic salpingitis (p less than 0.001), with a history of infertility (p less than 0.05), and with severe inflammation (p less than 0.10), but not with a history of salpingitis or a positive cervical culture for Chlamydia trachomatis. In the subgroup of infertile women, the geometric mean titre of antibodies to chlamydiae correlated significantly with the presence of chronic salpingitis (p less than 0.005). These data indicate that chlamydial infections play a major part in salpingitis and infertility in central Africa. In this area, which is known as the "infertility belt", programmes to control chlamydial infections should be implemented.

Ectopic pregnancy and antibodies to Chlamydia trachomatis

Ectopic pregnancy is one of the most serious sequelae to acute salpingitis. Chlamydia trachomatis seems to be the most common etiologic agent of acute salpingitis. In the present study, we tested whether women with ectopic pregnancy had serologic evidence of a current or past chlamydial infection. Sixty-five percent of the women with ectopic pregnancy had IgG serum antibodies to C. trachomatis, and 21% of women pregnant in utero had such antibodies. Eleven percent of women with infertile husbands, 42% of women with cervicitis, and 69% of women with salpingitis had IgG serum antibodies to C. trachomatis. In women with ectopic pregnancy, there was a correlation between the occurrence of IgG antibodies and a history of salpingitis or gross evidence of a previous tubal inflammation. We conclude that previous chlamydial salpingitis may be a major etiologic factor leading to ectopic pregnancy.

Urogenital involvements and rheumatic disorders in females. An interview study

To study dependence between urogenital involvements and musculoskeletal complaints in females, 311 randomly selected women aged 15 to 54 were interviewed. In the analysis of these dependences musculoskeletal complaints were considered as a whole per person. A history of salpingitis, gonorrhoea, urinary tract infection (UTI) and Trichomonas vaginalis was revealed as constituting a relative risk factor of 4.4, 3.9, 3.1 and 4.5 respectively in connection with inflammatory rheumatic disease or suspicion of it, with or without dorsal pains of unknown cause. Anamnestic cervicitis was disclosed as constituting a relative risk factor of 1.9 in connection with joint pains in the extremities and 1.8 in connection with dorsalgia of unknown cause, but not a statistically significant relative risk of inflammatory rheumatic diseases or suspicion of them. Salpingitis is proposed as a diagnostic criterion for female Reiter's syndrome. In epidemiologic work the importance of considering the medical history of musculoskeletal complaints as a whole per person is emphasized.

Salpingitis and cervicitis in uro-arthritis.

To compare anamnestic cervicitis and salpingitis as a relative risk for uro-arthritis the medical history of 60 consecutive females with uro-arthritis was compared with that of 311 interviewed controls. Salpingitis was revealed to be a relative risk factor of 3.2 as compared to cervicitis 1.4 in connection with uro-arthritis. HLA-B27 was tested in the 60 patients and in an additional 7 females with uro-arthritis, all of whom had a history of salpingitis. HLA-B27 was positive in 42% (28/67). There were no significant differences between those with or without cervicitis or salpingitis or both. Salpingitis could thus as justifiably be accepted as a diagnostic criterion for RS as cervicitis. These findings and clinical observations, including comprehensive histories of the patients concerned, serve as a basis for our hypothesis of rheumatic salpingitis. Further prospective and co-operative investigations will be needed to confirm or disprove this hypothesis.

Correlation between Serum Antichlamydial Antibodies and Tubal Factor as a Cause of Infertility

Although salpingitis frequently produces tubal damage and infertility, many women with tubal factor as a cause of their infertility do not have a clinical history of salpingitis. In order to investigate whether or not some such cases might be due to subclinical chlamydial infections, we measured antichlamydial antibodies in the serum of 172 women consecutively undergoing evaluation for infertility. Only 16 (9.3%) had a prior history of salpingitis. Sixty-one (35%) had antichlamydial antibodies (S+), and of these 75% had tubal factor as a sole or contributing cause of their infertility, versus 28% of the seronegative (S–) women (x 2 = 34, P Subclinical infections with Chlamydia trachomatis may be a major cause of tubal infertility in the United States, and chlamydial serologic studies may be useful in identifying that subset of infertile women likely to have tubal factor.

Ectopic pregnancy: a five-year experience.

In the five-year period 1974 to 1978, there were 23,256 deliveries and 204 ectopic pregnancies at Fairfax Hospital. Forty-six patients (22.5%) had had previous pelvic surgery, including 14 salpingectomies for previous ectopic pregnancies. Only 27 patients (13.2%) had a history of salpingitis, but chronic salpingitis was evident in 91 patients (44.6%). Twenty-one patients (10.3%) had an IUD in situ at the time of diagnosis. Presenting symptoms included abdominal pain (95.1%), amenorrhea (73.7%), and abnormal uterine bleeding (63.7%). Abdominal pain (91.2%) and adnexal tenderness (94.6%) were the common pelvic findings. The correct diagnosis was made on admission in 77.5% of cases. Culdocenteses and pregnancy tests were positive in 82.4% and 81.2% of patients, respectively. Unilateral salpingectomy was the primary operative procedure in 78% of patients. Postoperative morbidity was limited almost exclusively to nonspecific fever (41.2%) and urinary tract infection (9.3%).

Better diagnosis could aid battle against pelvic inflammatory disease

This document presented the highlights of a 3 day conference on PID (pelvic inflammatory disease) recently held at the Center for Disease Control in Atlanta Georgia. In the U.S. each year physicians treat 212000 patients for salpingitis PID patients spend a total of 1 1/2 million days in the hospital and 900 women die from PID. 20% of all women who have had salpingitis subsequently become infertile. Women with a history of salpingitis have a 6 to 10 times greater risk of having an ectopic pregnancy than women without a history of salpingitis. PID is also a serious problem in most developing countries. For example in Gabon an estimated 1/3 of all women are infertile as a result of PID. In the past attention was directed primarily toward treating salpingitis caused by Neisseria gonorrhoeae; yet in a large proportion of cases other pathogens are involved. In Sweden a recent study demonstrated that Chlamydia trachomatis was involved in 60% of the investigated cases of salpingitis and Mycoplasma hominis was involved in 10-15% of the cases. In the U.S. only 50% of the cervical cultures from symptomatic women are gonorrhea positive and attention is now being directed toward uncovering the nongonococcal causes of PID. Salpingitis is difficult to diagnosis since cervical cultures do not always reveal the presence of pathogens in the pelvic andexa and lower abdominal pain is not always experienced by the patient. Lars Westrom of Sweden advocates the use of laparoscopy to diagnose salpingitis. This technique permits the physician to visually examine the pelvic organs and to obtain cultures from infected tissue and peritoneal exudate. In the U.S. many physicians hestitate to use laparoscopy for this purpose due to the risks associated with the use of this technique. Appropriate drug regimens for treating salpingitis were also discussed.