Prevalence Of Pelvic Inflammatory Disease Research Articles

Association between heavy metal exposures and the prevalence of pelvic inflammatory disease: a cross-sectional study from the National Health and Nutrition Examination Survey 2013-2018.

Pelvic inflammatory disease (PID) is a common medical condition in women. However, the correlation between exposure to heavy metals, including cadmium (Cd), lead (Pb), manganese (Mn), mercury (Hg), and selenium (Se), and PID, is unclear. Using a large sample size from the National Health and Nutrition Examination Survey, these relationships were studied and verified. PID diagnosis was acquired through a self-reported questionnaire (2013-2018). Heavy metal exposure (Cd, Pb, Mn, Hg, and Se) was measured using mass spectrometry of blood samples. Covariate data were obtained through questionnaires and physical tests. Individuals with complete covariate data were included in the study. The relationship between heavy metal exposure (Cd, Pb, Mn, Hg, and Se) and PID was demonstrated using logistic regression analysis, weighted quantile sum (WQS) regression analysis, and restricted cubic splines (RCS). Overall, 2743 participants were included. Of these, 183 were diagnosed with PID. Through weighted univariate and multivariate regression analyses, the heavy metals of Cd and Pb were positively correlated with the prevalence of PID. However, no significant relationship was observed in the heavy metals of Mn, Hg, and Se. The joint effect of heavy metals further confirmed the important role of Cd and Pb in WQS analysis. After visualizing the RCS, significant curved and linear relationships were observed for Cd and Pb, respectively. Most subgroup analyses confirmed these results. In conclusion, exposure to Cd was nonlinearly correlated with the risk of PID, whereas exposure to Pb showed a linear relationship. Our findings increase the awareness of the environmental effects of exposure to heavy metals in PID. However, further studies are needed to elucidate the causality and underlying mechanisms between heavy metal exposure and the prevalence of PID.

Scope of Homoeopathy in Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infectious and inflammatory ailment of the upper female genital tract, which includes the uterus, fallopian tubes, and associated pelvic tissues. In India, the prevalence of pelvic inflammatory disease ranges between 1 and 2%. N gonorrhoeae and C trachomatis are the organisms most usually isolated in instances of acute PID. Homoeopathic treatments are beneficial in the treatment of both acute and chronic pelvic inflammatory illness, as well as in preventing additional complications. Keywords: Pelvic inflammatory disease, PID, Homoeopathy

Risk of cardiometabolic outcomes among women with a history of pelvic inflammatory disease: a retrospective matched cohort study from the UK

IntroductionTo describe the incidence and prevalence of pelvic inflammatory disease (PID) and to estimate the risk of cardiometabolic outcomes among women with PID compared to women without PID.MethodsA UK retrospective matched cohort study using data from The Health Improvement Network. To assess cardiometabolic risk, women (aged ≥ 16 years) with PID were compared to matched controls without PID. Annual prevalence and incidence of PID (1998–2017) were estimated among women aged 16–50 years using annual cross-sectional and cohort analyses, respectively. Adjusted hazard ratios (aHR) and 95% CI for cardiometabolic outcomes were estimated using Cox proportional hazards models. The primary outcome was composite cardiovascular disease (CVD) and its subtypes, including ischaemic heart disease (IHD), heart failure (HF) and cerebrovascular disease. Secondary outcomes were hypertension, and type 2 diabetes mellitus (T2DM).ResultsAmong the 715 recorded composite CVD events, the crude incidence rate per 1000 person-years was 1.5 among women with history of PID compared to 1.3 in matched controls. Compared to women without PID (N = 73,769), the aHRs for cardiometabolic outcomes among women with PID (N = 19,804) were: composite CVD 1.10 (95% CI 0.93–1.30); IHD 1.19 (95% CI 0.93–1.53); cerebrovascular disease 1.13 (95% CI 0.90–1.43); HF 0.92 (95% CI 0.62–1.35) hypertension 1.10 (95% CI 1.01–1.20); and T2DM 1.25 (95% CI 1.09–1.43). The prevalence (per 10,000 population) of PID was 396.5 in 1998 and 237 in 2017. The incidence (per 10,000 person-years) of PID was 32.4 in 1998 and 7.9 in 2017.ConclusionThere was no excess risk of composite CVD or its subtypes among women with history of PID compared to matched controls. Findings from our study suggest that history of PID was associated with an increased risk of hypertension and type 2 diabetes mellitus, two major risk factors for CVD. Additional studies are required to support these findings.

Социально-гигиенические и клинико-микробиологические особенности формирования нарушений репродуктивного здоровья девочек-подростков

Studies show that inflammatory diseases of the small pelvis and inflammatory diseases of the external genital organs are risk factors for the formation of reproductive health disorders in adolescent girls, the reason for seeking advice and treatment in outpatient and inpatient medical organizations. It is generally believed that pelvic inflammatory disease, as a consequence of the activity of a polymicrobial infection, usually occurs in sexually active women and is rare in young women and adolescent girls who are not sexually active. However, worldwide the prevalence of pelvic inflammatory disease remains quite high among children and adolescent girls of prepubertal and sexually inactive age. In contrast, inflammatory gynecological diseases of the external genital organs are considered a common pathology in girls of early and prepubertal age, however, studies show that they are common among adolescent girls due to the high prevalence of risk factors. Early diagnosis and treatment of pelvic inflammatory disease (PID) in adolescent girls is essential to ensure fertility and reproductive health in this population.

Studies on the Prevalence and Etiology of Pelvic Inflammatory Disease Among Women Attending Primary Health Centers in Sokoto Metropolis

Pelvic Inflammatory Disease (PID) is an inflammation of the uterus, fallopian tube, and ovaries as it progresses to scar leading to infertility and other reproductive problems. This research work was conducted to determine the etiology, antibiogram and prevalence of pelvic inflammatory disease among women attending Public Health Centres in Sokoto metropolis. The main objective of the study is to isolate the pathogens and determine the antibiotics sensitivity pattern and prevalence age of the Disease among the patients diagnosed with PID. 155 PID patients that were sorted by age and month were diagnosed within the year 2020. Laboratory assay on the etiology and antibiogram were carried out. From the total (155) patients diagnosed with PID in this study, thirty-three (33) were within the age of 15-20, forty-one (41) were between the ages of 21-25 and fifty-five (55) were between the age ranges of 26-30. The least (26) were between ages of 36 and 40. The highest prevalence age (35.5%) in this study were observed to fall between the ages of 26-30 then followed by forty-one patients (26.5%) prevalence that were between the ages of 21-25. The least in occurrence were 26 patients (8.4%) that were between the age range of 36 and 40. Similarly, the results obtained from this study revealed that there were 77 (49.67%) recorded in the first quarter of the year 2020. This was then followed by 48 (30.97%) patients in the last quarter. The least occurrence of PID patients 30 (19.35%) were diagnosed in the second quarter of the same year. The pathogens consistently identified to be associated with the disease were Neisseria gonorrhea and ciprofloxacin was the most sensitive on antibiogram. The factors responsible were poor personal hygiene, environmental pollution and unsanitary conditions of the toilets. It is recommended that patients should regularly visit health facilities for routine diagnosis of PID and ciprofloxacin and Broad spectrum antibiotics were the most efficacious for use in this study in the treatment of Pelvic inflammatory Disease.

A comparative study on the effects of various factors to the prevalence of pelvic inflammatory disease in North central Nigeria

Pelvic inflammatory disease is a gynaecological disease that affects the upper genital organs of reproductive age females. It is a disease associated with clinical sequalae such as tubal blockage, oophoritis and cervicitis which are said to result to high rate of disease (such as female infertility) and deaths among the females. This study therefore attempts to evaluate the association of various factors to high prevalence of pelvic inflammatory disease among women residing in developing countries such as Nigeria. Questionnaires were administered to all women enrolled for this study too obtain their data. Seven hundred and twenty (720) patients out of 1170 patients enrolled for this study were recorded to be pelvic inflammatory disease patients, of which 380(85%) were rural dwellers; 452(87.6%) were ignorant of pelvic inflammatory disease and were thus easily prone to the disease; 285(86.4%) were within the reproductive ages of 25-29 years; 350(85.2%) previously had urinary tract infection a year ago; 496(85.8%) and 343(83.5%) were both married and uneducated females. The high prevalence of pelvic inflammatory disease recorded in this study is due to certain predisposing factors practiced among females in their reproductive ages, hence it is necessary for government to enforce certain measures such as establishment of free education, continuous awareness of pelvic inflammatory disease and establishment of free medical check up to help prevent and control the spread of pelvic inflammatory disease.

A STATISTICAL ANALYSIS OF WOMEN’S REPRODUCTIVE HEALTH CHARACTERISTICS AFTER INEFFECTIVE REATTEMPTS OF USING ART

The aim: To carry out a statistical analysis of physical and reproductive health characteristics in women after ineffective reattempts of using assisted reproductive technologies and identify significant medical and social factors contributing to the development of chronic endometritis. Materials and methods: We carried out a statistical analysis involving 177 outpatient medical records: group 1 includes 127 women aged under 45 with two or more ineffective attempts of in vitro fertilization; group 2 comprised 50 healthy women without reproductive disorders. The complete physical exam included past history, clinical and gynecologic examination, lab techniques and medical imaging according to outpatient medical records obtained during the follow-up care in Isida-IVF Medical Center LLC. Chronic endometritis was recognized by means of histologic examination of endometrium, with the samples obtained by an endometrial pipelle biopsy on day 4-9 of the menstrual cycle. Results: The prevalence of pelvic inflammatory disease in patients of group 1 comprised 47.2%, endometritis - 41.7%; p1.2 <0.01. The prevalence of acute endometritis among patients of group 1 comprised 6.3%; p1.2 >0.05 and was associated with an infection after abortion. In group 1, sexually transmitted infections were reported in 67.7% of patients, p1.2> 0.05, bacterial vaginosis was registered 1.5 times more often - 28.4%; p1.2 <0.05. In group 1, single induced abortion was reported in 15.0%, while 2 times it took place in 15.7% (p1.2 <0.05). Laparoscopies were previously performed in 59.8% of women, laparotomies - in 62.2%, while in 25.4% of women these interventions were reperformed. Unilateral salpingectomy, due to ectopic pregnancy, was performed in 25.4% of women, bilateral - in 12.7%. Fallopian tube removal, due to sactosalpinx, was performed in 25.4% of women, unilateral salpingectomy took place in 3.9% of cases. The most significant risk factors of chronic endometritis in groups studied are acute postabortal endometritis, RR (relative risk) = 1.439, p = 0.029 and postoperative peritonitis provoked by the complications of appendectomy, RR = 1.430, p = 0.084. We detected none of significant effects of pelvic inflammatory disease on the development of chronic endometritis (RR = 45.132, Confidence interval (CI) (6.151-331.167), p = 0.001). The analysis of reproductive failures, as a risk factor of chronic endometritis in women of group 1, showed a significant relative risk: with the past history of premature birth, RR = 1.44, p = 0.039, in case of reattempts of induced abortions, RR = 1.5, p<0.001, Spontaneous miscarriage RR = 1.572, p = 0.001. A higher relative risk of developing chronic endometritis was observed during pregnancy - RR = 1.597, p = 0.001. Conclusions: Statistical analysis of women's reproductive health after ineffective reattempts of using ART revealed that the high rate of fetal interventions, low rate of alternative and safe abortion methods are registered in these women, as well as the nonavailability of any system of health measures after reproductive failures. A significant increase in miscarriage at early stages takes place, as well as the absence of a tendency for preterm labor to decrease in the rate. Maintaining women's reproductive health is a considerable medical and social issue, whose resolving depends on joint efforts of governmental and public entities, healthcare agencies and the population responsibility for own health. Designing and adopting the program of preconception care and planning for pregnancy in women after ineffective reattempts of using ART, with chronic endometritis as a primary disease, should be the top priority area of a health care system.

The incidence and prevalence of pelvic inflammatory disease and its impact in infertility, pelvialgy and surgical interventions

The incidence and prevalence of pelvic inflammatory disease and its impact in infertility, pelvialgy and surgical interventions

Inflammation calls for more: Severe pelvic inflammatory disease with or without endometriosis. Outcomes on 311 laparoscopically treated women

ObjectiveTo study possible associations between endometriosis and pelvic inflammatory disease (PID). DesignRetrospective cohort analysis over 14 consecutive years, based on medical records and insurance coding in a tertiary care endometriosis reference center. SettingTertiary care reference center for endometriosis. PatientsRetrospective analysis on all women submitted to laparoscopy in our Unit Main Outcome MeasuresIntra-operative data about complications and fertility-impairing procedures, intra-, peri- and post-operative complications. InterventionsRetrospective disease codes–triggered chart analysis. ResultsThe study population was divided into two groups: Group 1 included women with PID and no endometriosis (n = 115); Group 2 included women with PID and endometriosis (n = 96). Endometriosis had a prevalence of 63 % in patients submitted to surgery for PID, significantly higher than the one reported in general population and than the one reported in a Tertiary Care Endometriosis Unit.A significantly higher number of salpingectiomes was needed in group 2 patients (208 versus 80, p < 0.0001). ConclusionsThis study seems to confirm an higher prevalence of pelvic inflammatory disease in endometriosis patients.Intra-operative findings of PID with associated endometriosis show more aggressive patterns

Evaluation of positron emission tomography and contrast-enhanced computed tomography scan in nodal staging of early operable uterine cancers

Introduction:In early operable stages of cervical an endometrial malignancies, surgical staging of lymph nodes is advocated as contrast-enhanced computed tomography (CECT) has limited sensitivity and accuracy. Although fluorine-18 (F-18) fluorodeoxyglucose (FDG)/positron emission tomography (PET)-CT has potential to identify subcentimeter-sized nodal metastases, higher prevalence of pelvic inflammatory disease in developing countries could result in lower accuracy. The present study was undertaken to assess the incremental value of PET scan over CECT for nodal staging before radical surgery.Methods:Forty-four patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IA2–IIb carcinoma cervix and 28 patients of FIGO Stage I–II carcinoma endometrium underwent F-18 FDG-PET-CECT scan. A SUVmax value >2.5 g/ml based on body weight was considered as positive. An enhancing node with >1 cm size in the shortest dimension, with loss of fatty hilum was considered positive on CT images. The histological findings were considered the gold standard against which the two modalities were compared.Results:All 1226 pelvic nodes were dissected, of which 65 were found to be metastatic (i.e., 5.3%). Of the 72 patients, 15 (20.83%) had pelvic nodal metastases. The overall accuracy of PET and CECT for assessment of pelvic nodal metastases was comparable (i.e., 86% vs. 85%).Conclusion:PET and CECT scans have similar accuracy in pelvic nodal staging of operable uterine malignancies. Granulomatous inflammation may not be a major cause of false-positive results. The sensitivity and negative predictive values are not high enough to obviate need of surgical nodal staging.

Prevalence of microorganisms associated with Pelvic inflammatory disease in reproductive aged women in Onitsha North, Anambra state, Nigeria

The prevalence of pelvic inflammatory disease (PID) and its associated microbes among reproductive aged women in Onitsha north, Anambra state, Nigeria, were investigated. A total of 500 reproductive aged women between the ages of 10 - 50 years were examined; where 300 of them showed positive results. A total of 640 microorganisms were isolated. Nine (9) microbial genera were recovered consisting of seven bacterial genera; one yeast sp. and one protozoan isolate. Monomicrobial growth was recorded in 53 (7.17%), polymicrobial growth in 23 (7.7%) and bacterio-fungal growth in 10 cases (33%). Staphylococcus aureus accounted for 150 (50%) cases; followed by Escherichia coli 125 (41.7%), Streptococcus pyogenes 15 (5%), Klebsiella pneumonia 55 (18.3%), Proteus mirabilis 25 (8.3 %), Pseudomonas aeruginosa 64 (21.3%), Neisseria gonorrhoeae 62 (20.7%), Candida albicans 56 (18.7%), and Trichomonas vaginalis 88 (29.3%), respectively. Frequency of occurrence was predominant with the age groups of 21-30 and 31-40 years; conversely was least in ages of 10-20 and those age >51 years; respectively. There was significant statistical difference between microbial infection and the age-group (p < 0.05). PID is a major public health problem, thus needs to be prevented and controlled.

Prevalence of Pelvic Inflammatory Disease in Sexually Experienced Women of Reproductive Age - United States, 2013-2014.

Pelvic inflammatory disease (PID) is a clinical syndrome of the female reproductive tract characterized by inflammation of the endometrium, fallopian tubes, or peritoneum (1). PID occurs when microorganisms ascend from the vagina or cervix to the fallopian tubes and other upper genital tract structures (1). PID can result from untreated bacterial infections, including chlamydia and gonorrhea, and can lead to infertility, ectopic pregnancy, and chronic pelvic pain (1). Because there is no single diagnostic test for PID, clinicians rely on nonspecific signs and symptoms for diagnosis. The purpose of these analyses was to assess the burden of self-reported PID in a nationally representative sample using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle. Starting in 2013, NHANES female participants aged 18-44 years were asked about a lifetime history of PID diagnosis. Based on these data, the estimated prevalence of self-reported lifetime PID was 4.4% in sexually experienced women of reproductive age (18-44 years). The prevalence of self-reported lifetime PID was highest in women at increased risk, such as women reporting a previous sexually transmitted infection (STI) diagnosis. Stratified by race/ethnicity and having a previous STI diagnosis, non-Hispanic black (black) and non-Hispanic white (white) women reporting a previous STI diagnosis had nearly equal self-reported lifetime PID prevalence (10.0% versus 10.3%). However, the lifetime prevalence of PID among black women was 2.2 times that among white women if no previous STI was diagnosed (6.0% versus 2.7%). These findings suggest that PID is prevalent and associated with previous STI diagnoses; therefore, it is important for clinicians to screen female patients for chlamydia and gonorrhea to reduce the incidence of PID.

Comparing the Frequency of Endometritis in Unexplained Infertility and Anovulatory Infertility.

Background:Acute pelvic inflammatory disease (PID) is a common reason for infertility. This study aimed to evaluate the frequency distribution of endometritis in women with unexplained infertility and comparison with frequency distribution of endometritis in anovulatory infertility to identify the importance of endometritis due to subacute PID evaluation in the case of infertility.Materials and Methods:This case–control study was done on 100 women with unexplained infertility and ovulatory infertility who referred to Shahid Beheshti clinic in 2013 in Isfahan, Iran. They were divided into two groups of unexplained infertility and anovulatory infertility. Endometrial samples were given from all the patients by Pipelle biopsy under sterile conditions, and then prepared samples were sent to the pathology laboratory to evaluate the existence of plasma cells by a pathologist to diagnose endometritis.Results:Frequency distribution of acute PID history among the patients in both groups showed a significant difference (P < 0.05). Prevalence of endometritis in unexplained infertility group was 34% and in anovulatory group was 21% (P < 0.05). Prevalence of vaginitis was 46% in unexplained group and 40% in anovulatory group (P < 0.05), and prevalence of PID was 4% in unexplained infertility group and 0% in anovulatory infertility group.Conclusion:The prevalence of endometritis and vaginitis was more in the unexplained infertility group rather than the anovulatory infertility group that may reveal the importance of endometritis evaluation in the cases of unexplained infertility.

Correlation Between Bladder Pain Syndrome/Interstitial Cystitis and Pelvic Inflammatory Disease.

Pelvic inflammatory disease (PID) has been investigated in Western countries and identified to be associated with chronic pelvic pain and inflammation. Bladder pain syndrome/interstitial cystitis (BPS/IC) is a complex syndrome that is significantly more prevalent in women than in men. Chronic pelvic pain is a main symptom of BPS/IC, and chronic inflammation is a major etiology of BPS/IC. This study aimed to investigate the correlation between BPS/IC and PID using a population-based dataset.We constructed a case–control study from the Taiwan National Health Insurance program. The case cohort comprised 449 patients with BPS/IC, and 1796 randomly selected subjects (about 1:4 matching) were used as controls. A Multivariate logistic regression model was constructed to estimate the association between BPS/IC and PID.Of the 2245 sampled subjects, a significant difference was observed in the prevalence of PID between BPS/IC cases and controls (41.7% vs 15.4%, P < 0.001). Multivariate logistic regression analysis revealed that the odds ratio (OR) for PID among cases was 3.69 (95% confidence interval [CI]: 2.89–4.71). Furthermore, the ORs for PID among BPS/IC cases were 4.52 (95% CI: 2.55–8.01), 4.31 (95% CI: 2.91–6.38), 3.00 (95% CI: 1.82–4.94), and 5.35 (95% CI: 1.88–15.20) in the <35, 35–49, 50–64, and >65 years age groups, respectively, after adjusting for geographic region, irritable bowel syndrome, and hypertension. Joint effect was also noted, specifically when patients had both PID and irritable bowel disease with OR of 10.5 (95% CI: 4.88–22.50).This study demonstrated a correlation between PID and BPS/IC. Clinicians treating women with PID should be alert to BPS/IC-related symptoms in the population.

Epidemiology and Risk Factors of Pelvic Inflammatory Disease.

Introduction: Knowledge of pelvic inflammatory disease and its epidemiology is essential to understand reproductive morbidity in women. This paper estimates the level of association between demographic factors and pelvic inflammatory disease in women in their reproductive age. Methods: A descriptive study done in Humla, Kritipur and Baudha by organizing a health camp. Women of reproductive age group and who have lower abdominal pain, pervaginal discharge, fever, and dysparunia were included in the study after taking informed verbal consent from the patient. Patients who have lower abdominal pain and pervaginal discharge were diagnosed as pelvic inflammatory disease. Results: Diagnoses of pelvic inflammatory disease were made in 30% of attendances amongst women aged between 16 to 48. Increased risk of pelvic inflammatory disease was associated with smoking (P&lt;0.0001), age groups 31 – 40 yrs (44.6%),in rural areas(45%) and people who are illiterate (P&lt;0.0001). Among 400, 383(95%) were reported ever using a modern contraceptive. Conclusion: The prevalence of pelvic inflammatory disease was 30% in reproductive age group and was significantly associated with smoking.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.12992

Uterine Abscess Caused by the Use of Intrauterine Device in a 26-Year-Old Patient: A Case Report

Pelvic Inflammatory Disease (PID) refers to an infection of upper female genital tract, including uterus, fallopian tubes and ovaries, which might involve adjacent pelvic structures. It is generally caused by a sexually transmitted infection. It occurs due to migration of an infection up to the genital tract during a transcervical intervention or pregnancy. The prevalence of PID has decreased in USA in the last decade. Almost 106,000 patients presenting to hospitals in USA in a year are diagnosed with PID, and 60,000 of them require hospitalization. The primary risk factor for PID is sexual intercourse. The risk of developing PID is non-existent in virgin women. On the other hand, women having one sexual partner rarely develop PID in the long term. Having multiple sexual partners is the biggest risk factor for developing PID. Young age, history of chlamydia or PID, and having a sexual partner who has a sexually transmitted disease can be listed among the other risk factors. Methods of contraception affect the frequency of PID. Specifically, barrier methods provide protection from PID whereas the use of intrauterine device (IUD) increases the risk.

Association between myocardial infarction and patients with pelvic inflammatory disease

We thank Dr. Cheong for his suggestions for our articles [ 1 Liou T.H. Wu C.W. Hao W.R. Hsu M.I. Liu J.C. Lin H.W. Risk of myocardial infarction in women with pelvic inflammatory disease. Int J Cardiol. Jan 20 2012; https://doi.org/10.1016/j.ijcard.2012.01.006 Abstract Full Text Full Text PDF Scopus (3) Google Scholar , 2 Cheong K.M. Pelvic inflammatory disease and myocardial infarction. Int J Cardiol. 2012; 158: 463 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar ]. The original ideal in previous publication was to evaluate the relationship between female genital tract infection and risk of myocardial infarction (MI), therefore, studied populations contained all female with genital tract infection (ICD-9-CM codes 614 and 615 refer to the inflammatory disease of the ovary, fallopian tube, pelvic cellular tissue, peritoneum, and uterus; however, ICD-9-CM code 616 refers to the inflammatory disease of the cervix, vagina, and vulva). Actually, pelvic inflammatory disease (PID) is difficult to define as well as to diagnose [ [3] French C.E. Hughes G. Nicholson A. et al. Estimation of the rate of pelvic inflammatory disease diagnoses: trends in England, 2000–2008. Sex Transm Dis. Mar 2011; 38: 158-162 Crossref PubMed Scopus (50) Google Scholar ]. PID comprises a range of upper genital tract inflammatory disorders in women that usually result from microorganisms ascending from the cervix to the upper genital tract [ [3] French C.E. Hughes G. Nicholson A. et al. Estimation of the rate of pelvic inflammatory disease diagnoses: trends in England, 2000–2008. Sex Transm Dis. Mar 2011; 38: 158-162 Crossref PubMed Scopus (50) Google Scholar ]. PID can result in a wide range of symptoms and no sign or symptom in pathognomonic for the disease [ [3] French C.E. Hughes G. Nicholson A. et al. Estimation of the rate of pelvic inflammatory disease diagnoses: trends in England, 2000–2008. Sex Transm Dis. Mar 2011; 38: 158-162 Crossref PubMed Scopus (50) Google Scholar ]. Subclinical, mild, acute, chronic PID, tubo-ovarian abscess (TOA) were used to describe various types of PID. The prevalence of PID would depend on the diagnostic criteria applied. Although subclinical PID is common among women with lower genital tract infections [ [4] Wiesenfeld H.C. Hillier S.L. Krohn M.A. et al. Lower genital tract infection and endometritis: insight into subclinical pelvic inflammatory disease. Obstet Gynecol. Sep 2002; 100: 456-463 Crossref PubMed Scopus (246) Google Scholar ], the upper genital tract (uterus, fallopian tube, ovary) should be involved in cases of definite PID diagnosed. We are sorry to cause confusion with the loose inclusion criteria of PID in this study.

HCG as a patient

hCG as a patient

Prevalence of Tubo-Ovarian Abscess in Adolescents Diagnosed With Pelvic Inflammatory Disease in a Pediatric Emergency Department

The rate of tubo-ovarian abscess (TOA) in adolescents with pelvic inflammatory disease (PID) is reported to range from 17% to 20%. However, no reports have focused specifically on the adolescent patient presenting to the emergency department (ED), regardless of whether they are treated in the inpatient or outpatient setting. Recent changes in the 2002 Centers for Disease Control and Prevention (CDC) Guidelines for the Treatment of Sexually Transmitted Diseases and sexually transmitted infection screening programs are likely to have impacted both the prevalence of PID and the rates of its complications, particularly TOA. Given that most patients with PID are treated as outpatients, it is imperative to accurately assess the prevalence of TOA in this population. Therefore, we sought to determine the rate of TOA in female adolescents diagnosed with PID in a large urban pediatric ED. We performed a retrospective medical record review to assess the prevalence of TOA in adolescents diagnosed with PID in the ED by an attending physician in pediatric emergency medicine. All cases were identified on the basis of the clinical criteria from the 2002 CDC Guidelines for the Treatment of Sexually Transmitted Diseases. Data collected included historical and physical examination findings, and laboratory and radiological imaging results. Three (2.4%; 95% confidence interval, 0.5-6.7) of 127 patients diagnosed with PID in the ED who had imaging or clinical follow-up were also found to have a TOA. The mean age of the patients was 16 years. Most patients (89%) had imaging studies performed within 24 hours; most of these studies (97%) were pelvic ultrasounds. Eleven patients did not have imaging but had clinical follow-up within 72 hours. Four patients were diagnosed with PID during the study period and were lost to follow-up. The rate of TOA in adolescents diagnosed with PID in an urban pediatric ED is much lower than the rates previously reported in adolescents. This lower prevalence may be attributed to the broader 2002 CDC guidelines for diagnosing PID. In addition, community-based screening programs for Chlamydia trachomatis and Neisseria gonorrhoeae may help to identify young women at risk for developing PID earlier in the course of infection.

Assessment of tubal factor contribution to female infertility in a low resource setting (southwest Nigeria): Hysterosalpingography vs laparoscopy

Female factor contribution to infertility in Africa is commonly due to tubal disease. The incidence of bilateral tubal occlusion among infertile African patients is about three times higher than in the developed countries. This is largely due to a high prevalence of pelvic inflammatory disease in Africa. Tubal patency can be investigated using hysterosalpingography laparoscopy and dye test and more recently hysterosalpingo-contrast sonography. However laparoscopy is largely thought to be the gold standard for tubal assessment. Hysterosalpingography or hysteroscopy has a complimentary role to laparoscopy in excluding endometrial pathology in the evaluation of infertile patients. (excerpt)