Risk Factors For Pelvic Inflammatory Disease Research Articles

Chlamydia Trachomatis Infection among Pelvic Inflammatory Disease Patients Attending the Gynaecology Clinic of a Private Tertiary Hospital in Ogun State, Nigeria

Background: Pelvic inflammatory disease (PID) is one of the very serious complications arising from sexually transmitted infections (STIs) and Chlamydia trachomatis has been implicated as one of the commonest causes of STI. Considering the adverse sequelae of PID, there is a need for locally relevant data which will guide preventive and therapeutic efforts. Detection of a combination of immunoglobulin G (IgG) and immunoglobulin A (IgA) has been described as an indicator of an actively chronic infection Aims: The aim of this study was to determine the prevalence of Chlamydia trachomatis infection by the use of IgA and IgG and evaluate the associated risk factors among females that presented with Pelvic inflammatory disease at the gynaecology clinic of Babcock University Teaching Hospital. Ilishan-Remo, Ogun State, Nigeria. (BUTH) Materials and Methods: This was a hospital–based, case-controlled study involving 44 patients diagnosed with PID and 44 age-matched controls at the gynaecology clinic of BUTHI. Interviewer-administered questionnaires were used to obtain information on socio-demographic characteristics, and risk factors for PID, from consenting participants. Blood samples were collected from each participant and analysed, using the enzyme-linked immunosorbent assay, for Chlamydia trachomatis type‑specific for IgA and IgG. Analysis was done by SPSS, IBM version 23.0 Results: Both IgG and IgA were present in 15 cases (34.1%) as compared to none of the controls. The difference between Chlamydia IgG, IgA and (IgG+IgA) among the cases and the controls were statistically significant. Majority of the participants positive for the immunoglobulins were aged 25 years or younger (11, 73.3%), number of lifetime sex partners and age of first sexual intercourse being 18 years or younger were statistically associated with Chlamydia trachomatis causing PID. Conclusion: Chlamydia trachomatis remains an important causative pathogen of PID and more prevalent among the young people. Screening is advocated among the young in resource limited countries.

Acute pelvic inflammatory disease: a narrative review

Background and objective: Pelvic inflammatory disease (PID) is an upper genital tract infection in females that is typically acquired via sexual activity. It usually is initiated by the presence of Chlamydia trachomatis and/or Neisseria gonorrhoeae and escalates into a polymicrobial infection from local genital tract flora. Research identifies various known risk factors including young age, immunopathology and others. This article reviews the epidemiology, differential diagnosis, management, and concepts of prevention for PID. Methods: An electronic search was performed on MEDLINE to identify relevant articles from 2010 to 2018. Key Content and Findings: PID continues to be a major sexually transmitted disease among adolescent and young adult females. Among the 1 million cases that are found in the United States (U.S.) each year, about one-third are in adolescent females. It is typically a polymicrobial infection that can lead to acute salpingitis, perihepatitis, endometritis, oophoritis, pelvic peritonitis and/or tubo-ovarian abscess. Diagnostic criteria and recommended treatment have been developed by the U.S. Centers for Disease Control and Prevention (CDC). Complication of PID include chronic pelvic pain, ectopic pregnancy and infertility. Conclusions: PID is a common sexually transmitted disease that is found in many adolescents and young women. The possibility of PID should be seriously considered by clinicians when evaluating a sexually active teenage or young adult female with lower abdominal pain, vaginal discharge, vaginal bleeding, urinary symptoms, post-coital bleeding and/or dyspareunia. It may be a silent infection as well. Various risk factors for PID are noted including the adolescent age group, ectropion of young adolescent females, immature immune system, multiple coital partners and others. Clinicians should follow treatment protocols established by the CDC and the World Health Organization (WHO). The problem of PID should stimulate clinicians and society to provide comprehensive sexuality education to our youth.

Which sexually active young female students are most at risk of pelvic inflammatory disease? A prospective study

ObjectiveTo identify risk factors for pelvic inflammatory disease (PID) in female students.MethodsWe performed a prospective study set in 11 universities and 9 further education colleges in London. In 2004–2006, 2529...

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.

P1-S3.09 Estimating the incidence of pid following chlamydia infection in sex workers

BackgroundThere is a lack of consensus on the true incidence of PID following chlamydia infection with few published prospective studies. We have used data from an old prospective cohort of...

Characteristics of women at low risk of STI presenting with pelvic inflammatory disease

Objective To investigate the background and reproductive history of women who are considered at low risk of sexually transmitted infection (STI) presenting with acute pelvic inflammatory disease (PID).Methods Case-control study, investigating 51 women admitted to hospital with a diagnosis of acute PID and 50 healthy women attending for routine gynecological checkup.Results Women with PID were older (p = 0.003) and more often unemployed (p = 0.008), and had a lower educational level (p = 0.000003). Healthy women reported more regular routine attendance to gynecologists (p = 0.0008) and were less often smokers (p = 0.0009). There was no difference between groups regarding age at first sexual intercourse, number of sex partners during life, duration of current sexual partnership, and frequency of sexual intercourse, total number of deliveries, spontaneous abortions, ectopic pregnancies and outcome of last pregnancy. The number of induced abortions was significantly higher in the PID group (p = 0.0004). There were no differences between the groups with regard to previous episodes of PID. Healthy controls more often reported a history of STI (p = 0.00007). IUD was the most commonly reported current contraceptive method in both groups, and there was no difference in contraceptive practices between groups.Conclusion Women with PID differed from healthy controls only with regard to socio-demographic characteristics and not with regard to common risk factors for PID.

Pelvic inflammatory disease in the lesbian population—lesbian health issues: asking the right questions

Background: It is widely believed that the lesbian population is at a lower risk for sexually transmitted diseases. This myth has been perpetuated by misperception of lesbian patients and sexual practices associated with this lifestyle. Physician failure to identify lesbian patients and address issues confronting these patients is a confounding factor. We report two patients whose diagnosis was obscured by their sexual orientation.Cases: We report a lesbian patient admitted with the diagnosis of pelvic inflammatory disease (PID) possible tuboovarian abscess (TOA). Although history and physical examinations were consistent with this diagnosis, the patient was taken to the operating room for diagnostic laparoscopy based partly on the assumption that because she was a lesbian she was at low risk for PID. The second patient presented with PID possible TOA. The patient was taken for diagnostic laparoscopy for worsening symptoms. Pelvic inflammatory disease was confirmed surgically in both cases. The more detailed history acquired after surgery would have been helpful if taken at the time of admission.Conclusions: The practices of the lesbians vary widely, risk factors for PID may be similar to heterosexual patients. It is essential as physicians to elicit good histories from patients. The lesbian population is often overlooked and important questions missed. As physicians and health care providers, patients can only be treated when their needs are understood.

Prevalence and correlates of antibody to chlamydial heat shock protein in women attending sexually transmitted disease clinics and women with confirmed pelvic inflammatory disease.

A cross-sectional study of 306 women was done to correlate antibody to the chlamydial hsp60 (Chsp60) with epidemiologic, serologic, and laparoscopic findings of women with and without pelvic inflammatory disease (PID). Of the 306 women, 150 had confirmed PID by laparoscopic (n = 69) or histologic (n = 81) criteria, and 156 sexually transmitted disease clinic attendees without clinical PID did (n = 94) or did not (n = 62) have chlamydia. In multivariate analyses, Chsp60 antibody was independently associated with confirmed PID, age > 20 years, nonwhite race, > 10 lifetime sex partners, current oral contraceptive use, and IgG antibody titers; it was not associated with a positive Chlamydia trachomatis culture. Among the 69 women with laparoscopic evidence of PID, the highest level of Chsp60 antibody (optical density > 1.0) was found in 8 (80%) of 10 women with occluded tubes, compared with 11 (19%) of 58 with patent tubes (P < .001). We conclude that antibody to Chsp60 was significantly correlated with risk factors for PID, confirmed PID, and occluded fallopian tubes but not with acute C. trachomatis infection without PID.

Risk factors for pelvic inflammatory disease. A case control study.

Pelvic inflammatory disease (PID) is associated with major medical and economic consequences for women of reproductive age. Identification of the risk factors associated with PID is crucial to efforts for prevention of these consequences. To identify risk factors and markers for symptomatic PID. A case-control study of 234 women with PID treated at San Francisco General Hospital between October 1986 and August 1989 and 122 controls attending the Women's Clinic at the same institution. The two groups were comparable in sociodemographic, reproductive, sexual, and medical history. Risk factors and markers identified by univariate analysis were < 12 years education, gravidity > 0, parity > 0, spontaneous abortion > 0, lack of a birth control method, > 1 male sexual partner in the previous 30 days, younger than 18 years at age of first sex, history of gonorrhea, sex during the previous menses, douching, exposure to nongonococcal urethritis in the previous 30 days, and history of crack cocaine use. With multivariate analysis to control for confounders the risks still identified were parity > 0, (odds ratio [OR] 4.44; 95% confidence interval [CI] 2.34 to 8.42), > 1 sexual partner in the previous 30 days (OR 11.08; 95% CI 4.31 to 28.5), sex during the previous menses (OR 5.22; 95% CI 1.88 to 14.48), and a lack of contraception (OR 7.6; 95% CI 4.10 to 14.09). Findings indicated that certain reproductive behaviors could be targeted for public health attention and risk reduction interventions to reduce the incidence of PID. These include limiting numbers of sexual partners and encouraging the use of barrier methods of contraception for sexually transmitted disease prevention. Another finding was that it is probably best to avoid sexual intercourse during the menses. The question of douching as a risk factor for PID could not be answered by this study.

Pelvic inflammatory disease and tubal infertility: the preventable conditions.

There are three clear links in the causal pathway for pelvic inflammatory disease (PID): lower genital tract sexually transmitted disease (STD) followed by upper genital tract PID and then tubal infertility. This pathway also entails two clear relationships that have a temporal lag in clinical expression: STD leading to PID and PID leading to tubal infertility. The genital microbial environment the individual behavioral environment (e.g. sexual behavior) and the sociogeographic environment have overlapping effects on these relationships. Neisseria gonorrhoeae Chlamydia trachomatis and anaerobic bacteria are the most common pathogens associated with upper genital tract infection. STD organisms initially infect the cervix endometrium and tubal mucosa and prepare the tissue for subsequent polymicrobial infection. A concurrent prolonged inflammatory response and latent chlamydia infection of the endometrium and/or fallopian tube may further predispose infection with aerobic and anaerobic bacteria. The anaerobic bacteria cause damage by both direct effects of virulence factors and secondary effects on host defenses. Risk factors for PID and infertility include age contraceptive choice and cigarette smoking. Other PID risk factors are race frequency of intercourse timing of coitus sex practices age of onset of sexual activity previous episodes of gonococcal PID and douching. Other risk factors for infertility are number of previous PID episodes severity of pelvic inflammation and chlamydia infection. Asymptomatic PID accounts for more than 50% of all PID cases. Atypical symptoms (e.g. oligomenorrhea) or biochemical (e.g. metabolic or immunologic) markers may need to be used to identify PID. Tubal infertility occurs in 10-30% of couples seeking infertility services in developed countries. All studies show a strong relationship between STD/PID and infertility. The pathogenesis of infertility includes postinfectious scarring microbiologic virulence and host immune factors. The most cost effective way to reduce tubal infertility is prevention of lower genital tract STDs.

Pelvic inflammatory disease, intrauterine contraception, and the conduct of epidemiologic studies.

Pelvic inflammatory disease (PID) has been described in the medical literature for more than a century as a specific entity. Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma hominis, along with Bacteroides fragilis and other anaerobic bacteria, have been most frequently associated with PID. Factors affecting the occurrence of PID have been extensively studied during the past two decades and include number of sexual partners, age, race, socioeconomic status, education, and contraceptive method. As knowledge concerning factors that contribute to PID increases, epidemiologic studies addressing such issues must become increasingly sophisticated, and the literature needs to be re-evaluated in light of present knowledge. Various risk factors for PID, types of epidemiologic studies, methods for conducting such studies, and data interpretation are reviewed.