Risk Of Pelvic Inflammatory Disease Research Articles

Causal Relationship Between Endometriosis and Pelvic Inflammatory Diseases: Mendelian Randomization Study.

This study explores the causal relationship between endometriosis and pelvic inflammatory diseases (PID). The study utilized genome-wide association study (GWAS) datasets for endometriosis ("finn-b-N14_ENDOMETRIOSIS") and PID ("finn-b-N14_OTHFEMPELINF"). Subsequently, two-sample Mendelian randomization (MR) analyses were conducted using inverse variance weighting (IVW), Egger regression (MR-Egger), and weighted median (WM) methods. Heterogeneity was evaluated using Cochran's Q test, and in case of detected outliers, they were removed for re-evaluation of MR causality. From the endometriosis GWAS dataset, 33 single nucleotide polymorphisms (SNPs) were selected as instrumental variables. All three methods, IVW (OR = 1.39, P < 1×10-8), MR-Egger (OR = 1.41, P = 0.003), and WM (OR = 1.37, P = 1.16×10-5) confirmed a causal relationship between endometriosis and PID. The association between endometriosis and pelvic inflammation remained unaffected by the exclusion of individual SNPs. Lastly, Cochran's Q test and funnel plots showed no evidence of SNP asymmetry. The results of the MR analysis support a potential causal relationship between endometriosis and an increased risk of PID.

Chlamydial and Gonococcal Infections and Adverse Reproductive Health Conditions Among Patients Assigned Female at Birth in the Veterans Health Administration.

Reproductive age female individuals comprise the fastest-growing segment of Veterans Health Administration patients, but little is known about rates of reproductive health outcomes among those with chlamydia or gonorrhea infections. Our aim was to estimate the risk of pelvic inflammatory disease, ectopic pregnancy, infertility, and pelvic pain in female veterans tested for chlamydia or gonorrhea. We performed a retrospective cohort analysis of female veterans tested for chlamydia or gonorrhea between January 1, 2010, and December 31, 2020. We calculated rates of pelvic inflammatory disease, ectopic pregnancy, infertility, and pelvic pain per 100,000 person-years and used Cox proportional hazards regression models to estimate the risk of these reproductive health conditions according to infection status after adjustment for age, race, ethnicity, military sexual trauma, mental health diagnoses, and substance use disorder. Of female veterans, 232,614 were tested at least once for chlamydia or gonorrhea, with a total of 1,665,786 person-years of follow-up. Of these, 12,971 had positive chlamydia or gonorrhea results (5.8%, 796 cases per 100,000 person-years). Compared with people who tested negative, those testing positive had double the risk of pelvic inflammatory disease (adjusted hazard ratio [aHR], 1.94; 95% confidence interval [CI], 1.81-2.07), 11% increased risk of infertility (aHR, 1.11; 95% CI, 1.04-1.18), 12% increased risk of pelvic pain (aHR, 1.12; 95% CI, 1.08-1.17), and 21% increased risk of any of these conditions (aHR, 1.21; 95% CI, 1.17-1.25). People with positive chlamydia or gonorrhea testing tended to have an increased risk of ectopic pregnancy (aHR, 1.14; 95% CI, 1.0-1.30). Among those with a positive test result, 2218 people (17.1%) had 1 or more additional positive test results. Compared with those with 1 positive test result, people with more than 1 positive test result had a significantly increased risk of pelvic inflammatory disease (aHR, 1.37; 95% CI, 1.18-1.58), infertility (aHR, 1.20; 95% CI, 1.04-1.39), and pelvic pain (aHR1.16; 95% CI, 1.05-1.28), but not ectopic pregnancy (aHR, 1.09; 95% CI, 0.80-1.47). Female veterans with positive chlamydia or gonorrhea results experience a significantly higher risk of pelvic inflammatory disease, infertility, and pelvic pain, especially among those with repeat infection.

Association between the dietary inflammatory index and pelvic inflammatory disease - Findings from the NHANES data (2015-2018).

pelvic inflammatory disease (PID) is a common gynecological condition. The dietary inflammatory index (DII) scoring algorithm is a novel tool for evaluating the inflammatory potential of a diet. However, the association between DII and PID remains unexplored. This study aimed to evaluate and quantify the relationship between DII and the risk for PID. the present study included two cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2015 and 2018. A total of 2769 participants with complete information were enrolled. Weighted univariate and multivariate logistic regression analyses were performed to examine the association between DII and the risk for PID. Subsequently, the association was graphically represented using a restricted cubic spline (RCS). univariate and multivariate regression analyses revealed a strong correlation between DII and PID occurrence. After adjusting for all covariates, the odds ratio for the effect of DII on PID remained significant (OR = 1.220, 95 % CI: 1.024-1.452). The correlation analysis revealed a linear relationship between DII and the risk for PID. This study unravels a significant positive correlation between DII and the risk for PID. This finding highlights the potential of anti-inflammatory diet therapy as a novel therapeutic intervention for PID. However, due to the limitations of the study design, further research is needed to explore this relationship in detail.

Awareness of risk factors associated with tubal infertility among female youth corps members in Benin City, Nigeria

Infertility is the inability to achieve pregnancy within one year of regular unprotected coital exposures. It is a common gynecological problem in our environment. The cause of infertility could be of female origin, male origin, a combination of both, or idiopathic. It can be primary when there is no previous pregnancy, or secondary infertility when there is an inability to conceive after a previous conception. In secondary infertility, a tubal factor is the most typical cause globally. In a review of factors associated with tubal factor infertility in a tertiary hospital in southern Nigeria, the tubal aspect constituted 13.5%. It was due to previous post-abortion sepsis, puerperal sepsis, and Pelvic Inflammatory Disease (PID). Awareness of infertility risk factors is an essential first step to safeguard future fertility; however, several studies demonstrated poor knowledge of tubal infertility and its risk factors, especially among infertile couples and couples attending gynecology clinics. This study assesses the knowledge of female youth corps members in Benin City, Edo State, on tubal factor infertility, its risk factors, and management. A cross-sectional analytical study was conducted among female youth corps members in Benin City using a multi-stage sampling technique. A self-administered questionnaire was used for data collection. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) Version 25.0 (IBM SPSS V 25.0, Chicago, IL, USA) and presented using tables. From this study, there is good knowledge of the burden of tubal infertility and treatment implications (50.4%). However, the knowledge of tubal infertility (34.3%) and its risk factors (27.0%) was poor. Age, marriage, and the medical profession are associated with sound knowledge of the burden of tubal infertility (p=0.02). However, only the medical profession is independently associated with good knowledge of tubal infertility (AOR=2.963, p=0.006, CI=1.370-6.411). There is generally poor knowledge of tubal infertility among females of reproductive age, who are at higher risk of pelvic inflammatory disease being the most typical risk factor for tubal infertility. This calls for more health awareness programs for the youth to help safeguard their future fertility.

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.

Neuroprotective effects of estetrol in combined oral contraceptives: A review

One of the most effective contraception methods is combined hormonal contraceptives. According to the current prescribing information, in addition to their primary effect, they have several concomitant positive effects on the female body non-contraceptive effects. These include a well-predictable and controlled "menstrual cycle" (menstrual-like reaction), anti-androgenic effect, anti-anemic effect due to reduced menstrual blood loss, reducing the severity of dysmenorrhea and premenstrual syndrome, reducing the risk of pelvic inflammatory diseases, ectopic pregnancy, and some benign and malignant tumors of the reproductive system. Combined oral contraceptives (COCs) also have effects on the central nervous system, hypothalamic-pituitary structures that regulate sex hormones, and the psycho-emotional health of women. For a long time, the main estrogen component of COCs remained ethinylestradiol. Although not well-studied, its mechanisms of action on the nervous system are similar, regardless of the progestogen component. However, the effect was not entirely positive: taking contraceptives containing ethinylestradiol can lead to increased emotional lability, anxiety, and depressive disorders. It drives researchers to search for new estrogen without these adverse properties. Such is the long-known but overlooked esthetrol. Numerous studies indicate a pronounced neuroprotective effect of esthetrol, which can increase patients' satisfaction with hormonal contraceptives and their compliance. It also opens up great opportunities for the use of this drug beyond gynecological practice.

Effect of Dhanwantharam Taila Uttaravasthi and Guggulupanchapala Choorna in Bilateral Tubal Block: A Case Study

The prevalence of tubal factor infertility is higher in India due to higher rates of unrecognized PID (pelvic Inflammatory Disease). The risk of PID leading to scarring, adhesions, and partial or total obstruction of fallopian tubes necessities an aggressive approach to managing PID. PID has features similar to Yoniroga paripluta caused by Vata pitta dusti. In this case study, the patient experienced thick yellowish-white mucoid vaginal discharge while also suffering from recurrent UTIs for six months. She was diagnosed with bilateral tubal block and had a one-year history of infertility. The line of treatment was to normalize Vata-pitta dosha, as Paripluta was the root cause of tubal blockage here. Here the aim was to alleviate vitiated Vata pitta dosha and achieve Artava vaha sroto sodhana. Srotorodha in the Artava vaha srotas were eliminated by proper Sodhana, Shamana, and Sthanika chikitsa. Uttara vasthi effectively removes tubal block as it can deliver medicines close to the fallopian tube. Uttara vasthi with Dhanwantharam tailam can relieve abnormalities of the fallopian tube generated by Rooksha, Daruna, and Khara guna of Vata. All this management not only helps to get tube patency but also restores its normal physiological function. After receiving treatment for six months, the patient came with a normal Hysterosalpingography (HSG) report and reported symptomatic improvement.

Similarities in Pathogenetic Mechanisms Underlying the Bidirectional Relationship between Endometriosis and Pelvic Inflammatory Disease

Endometriosis is a common inflammatory disease characterized by the presence of endometrial cells outside of the uterine cavity. Endometriosis affects 10% of women of reproductive age and significantly reduces their quality of life as a result of chronic pelvic pain and infertility. Biologic mechanisms, including persistent inflammation, immune dysfunction, and epigenetic modifications, have been proposed as the pathogenesis of endometriosis. In addition, endometriosis can potentially be associated with an increased risk of pelvic inflammatory disease (PID). Changes in the vaginal microbiota associated with bacterial vaginosis (BV) result in PID or a severe form of abscess formation, tubo-ovarian abscess (TOA). This review aims to summarize the pathophysiology of endometriosis and PID and to discuss whether endometriosis may predispose to PID and vice versa. Papers published between 2000 and 2022 in the PubMed and Google Scholar databases were included. Available evidence supports that women with endometriosis are at increased risk of comorbid PID and vice versa, supporting that endometriosis and PID are likely to coexist. There is a bidirectional relationship between endometriosis and PID that shares a similar pathophysiology, which includes the distorted anatomy favorable to bacteria proliferation, hemorrhage from endometriotic lesions, alterations to the reproductive tract microbiome, and impaired immune response modulated by aberrant epigenetic processes. However, whether endometriosis predisposes to PID or vice versa has not been identified. This review summarizes our current understanding of the pathogenesis of endometriosis and PID and discusses the similarities between them.

Endometrioma increases the risk of antibiotic treatment failure and surgical intervention in patients with pelvic inflammatory disease

To evaluate the outcome of pelvic inflammatory disease (PID) in patients with endometriosis with and without ovarian endometrioma. A retrospective cohort study. A single university-affiliated tertiary center. A total of 116 patients with endometriosis hospitalized because of PID between the years 2011-2021. Fifty-nine patients with an ovarian endometrioma component were compared with 57 patients with endometriosis without endometrioma. None. The primary outcome was severe PID defined as the need for surgical intervention or drainage. Secondary outcomes included tubo-ovarian abscess, number of hospitalization days, a positive cervical bacterial culture or urine sexually trasmitted disease polymerase chain reaction (STD PCR) test, and readmission because of partially treated or relapsing PID. PID in patients with endometrioma was found less likely to respond to antibiotic treatment with increased risk for surgical intervention or drainage compared with endometriosis patients without endometrioma (adjusted odds ratio, 3.5; confidence interval, 1.25-9.87). On admission, patients with endometrioma were older (26.5 vs. 31.0) and less likely to have an intrauterine device (19.3% vs. 5.1%) compared with patients without endometrioma. The rate of the tubo-ovarian abscess (52.5% vs. 19.3%) was significantly higher in patients with endometrioma. Readmission rate, positive bacterial culture, and hospitalization duration were higher in the endometrioma group; however, they did not reach statistical significance. Recent oocyte retrieval and patient's age were not associated with an increased risk of severe PID. Endometrioma patients with PID are less likely to respond to antibiotic treatment and present a higher risk for surgical intervention.

The association between the prevalence of HIV infection and ectopic pregnancy.

Women infected with the human immunodeficient virus have a higher risk of pelvic inflammatory disease, which could lead to development of ectopic pregnancy due to fallopian tubal pathology. Due to short pregnancy period, women with ectopic pregnancy unlikely complete the antenatal screening, which includes HIV tests. Therefore, it is postulated that unscreened HIV infection prevalence in women with ectopic pregnancy diagnosis could be significantly higher than in women with normal intrauterine pregnancy (IUP). The aim of the present retrospective cross-sectional study was to determine the association between ectopic pregnancy and HIV infection in KwaZulu Natal Province hospital setting, between 2016 and 2017. 5427 pregnant women with normal pregnancies formed the intrauterine pregnancy (IUP) cohort, while 83 patients were part of the ectopic pregnancy cohort. The statistical HIV prevalence was significantly higher in the ectopic pregnancy cohort (56.63% vs 39.4%, P-value of 0.001). In addition, HIV prevalence in the ectopic pregnancy cohort was analyzed per age group, and it was found to be higher in the 25-34 years age group (88.3%) than the 16-24 (43.3%) and 35-42 (60%) years age groups. This study highlights the significance of conducting a full antenatal screening programme in patients who present with ectopic pregnancy, to improve the rate of HIV infection testing and treatment in women who present with ectopic pregnancy.

The key role of hepatology providers in optimizing reproductive care in patients with liver disease: A call to action.

The key role of hepatology providers in optimizing reproductive care in patients with liver disease: A call to action.

Incidence of Trichomonas vaginalis Infection Among Female Smokers: A Narrative Review

Background: The harmful effects of smoking on women’s bodies have been proven. One of these effects is an increase in sexually transmitted diseases, including Trichomonas vaginalis infection. Smoking is one of the main risk factors for infections in the respiratory, digestive, and reproductive systems in humans. Mechanisms of susceptibility to infection in smokers may involve changes in the host’s structural, functional, and immunological defenses. T. vaginalis infection is one of the non-viral sexually transmitted diseases and the most common curable sexually transmitted infection in the world, which can increase the risk of pelvic inflammatory disease and HIV transmission. This infection is still relatively common, especially in women who smoke and in groups with lower socioeconomic status. We aimed to present a compressive review of the probability of being infected with T. vaginalis in smokers compared to non-smokers. Materials and Methods: PubMed and Google databases were searched for research articles related to smoking and its association with T. vaginalis infection. Results: The smoking status of the person is an independent risk factor for T. vaginalis infection and leads to an increased likelihood of developing this infection. Conclusion: Finally, the results of various studies showed that the prevalence of T. vaginalis infection is higher in smokers than in non-smokers.

The severity of depression is associated with pelvic inflammatory diseases: A cross-sectional study of the United States National Health and Nutrition Examinations from 2013 to 2018.

PurposeAs depression in patients with pelvic inflammatory diseases (PID) has received increasing attention in recent years, this study aims to investigate the relationship between depression severity and risk factors for pelvic inflammatory disease, and to provide new perspectives in the treatment of PID.Patients and methodsMultivariate regression was used to evaluate the association between pelvic inflammatory disease and the severity of depression. Females who participated in the United States National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018 were included. In addition, risk factors for PID and depression were also included in the analysis as adjustment factors.ResultsThe risk of developing PID was associated with depressive status (odds ratio, OR 1.10, 95% confidence interval, CI 1.08–1.12), especially in people with severe depression (odds ratio, OR 6.34, 95% confidence interval, CI 3.72–10.79). Subgroup analysis showed differences in the risk of PID among people with different characteristics.ConclusionThis study showed that there may be a potential positive association between depressive status and the prevalence of PID in the United States adult female population. Depression should be actively looked for in all patients with PID and treated appropriately

Gonococcal Pelvic Inflammatory Disease with Sepsis Criteria: Review of 2 Cases

Background: Infection caused by Neisseria Gonorrhoeae increases the risk of pelvic inflammatory disease (PID). Gonococcal PID tends to be clinically more severe than non-gonococcal ones. The main is to present two cases of gonococcal PID, with rapid clinical and analytic progression, leading to severe sepsis, but without imaging manifestations. Clinical presentation: 1. 41-year-old patient with replacement of intrauterine releasing levonorgestrel device (IUD), presented abdominal pain and green vaginal discharge. Abdominal examination revealed signs of peritoneal irritation and blood test showed leukocytosis, increased C Reactive Protein and procalcitonin, as well as coagulation abnormalities. Imaging tests (vaginal ultrasound/tomography) revealed no structural pathology, without collections. Given the criteria of severe sepsis, broadspectrum intravenous (iv) antibiotic therapy was started and laparoscopy and IUD removal were performed. Cervical and IUD cultures were positive for Neisseria gonorrhoeae. 2. 20-year-old woman, with an IUD, consulted for abdominal pain, low-grade fever and green vaginal discharge. Abdominal examination suggested peritoneal sensitivity and laboratory tests leukocytosis, increased C Reactive Protein and procalcitonin with coagulation abnormalities. Imaging tests (vaginal ultrasound/tomography) showed no structural pathology, without collections. Despite analgesia and broad-spectrum iv antibiotics, the patient worsened, proceeding to remove the IUD. Given the criteria compatible with severe sepsis, laparoscopy was decided. Endocervical and IUD cultures revealed Neisseria gonorrhoeae. Conclusions: Facing the situation of an acute PID with severe and fast clinical worsening even without findings in imaging tests, we should consider gonococcal ethiology as a possible cause. Surgical approach shouldn’t be delayed in order to control the infection and rule out other possible diagnosis.

Diagnostic accuracy of pelvic examination in pelvic inflammatory disease: A meta-analysis.

Pelvic inflammatory disease (PID) is not a mere transient infection. PID can lead to chronic pain, ectopic pregnancy, and infertility. Although the Centers for Disease Control and Prevention have established minimum diagnostic criteria, including pelvic examination, the diagnostic value of pelvic tenderness has recently garnered controversy. Our meta-analysis aimed to confirm whether pelvic tenderness, cervical motion tenderness, and adnexal tenderness can help diagnose PID. We searched for studies reporting the diagnostic test accuracy of pelvic tenderness, cervical motion tenderness, and adnexal tenderness among female patients at risk for PID, using MEDLINE, EMBASE, CENTRAL, CINAHL, Google, and Google Scholar through May 25th, 2022. After quality assessment using QUADAS-2, we performed data synthesis using a bivariate random effect model and Bayesian hierarchical summary receiver operating characteristic model. We then conducted sensitivity analysis excluding studies with non-PID cases. The literature search produced 6769 articles. After quality assessment, 14 studies and their 2808 participants were eligible for synthesis on pelvic tenderness. Laparoscopy, either alone or in combination, was the most frequent reference standard. The main results for pelvic tenderness sensitivity and specificity were 0.81, 95% confidence interval (CI) [0.67-0.90] and 0.40, 95% CI [0.25-0.57], respectively. Sensitivity and specificity were 0.72, 95% CI [0.57-0.83] and 0.50, 95% CI [0.34-0.66], for cervical motion tenderness, and 0.87 [0.64-0.96] and 0.27, 95% CI [0.12-0.52] for adnexal tenderness, respectively. Our meta-analysis suggests that pelvic tenderness assessed by pelvic examination may be useful for PID examination with moderate-to-high sensitivity, whereas clinicians should be aware of the diagnostic significance of pelvic tenderness.

Modern treatment options for mixed and aerobic vaginitis

Mixed vaginitis is closely associated with an increased risk of pelvic inflammatory disease, reproductive failures, preterm births, postpartum infectious and inflammatory complications, and cervical neoplasiae. The article considers the main issues of diagnosis and treatment of the disease, mainly caused by the polyetiological nature of mixed vaginitis and relapse tendencies. Effective techniques of integrated approach and impact on all etiological agents of mixed vaginitis with a minimal effect on the normal vaginal microflora are presented. In the modern obstetrics-gynecology practice, preference is given to combination drugs intended for topical use, and a rational choice of the dosage form ensures maximum patient compliance and treatment efficiency. It is topical dosage forms that contribute to the rapid delivery of the active substance to the inflammation site and do not have systemic effects characteristic of oral dosage forms. A new domestic multicomponent drug to treat vaginitis and prevent its development has been provided a market authorization on the Russian market. Its action is ensured by combined effects of the components in its composition, such as metronidazole (500 mg), chloramphenicol (200 mg), natamycin (150 mg), hydrocortisone acetate (15 mg), due to which the drug provides a wide range of etiotropic and symptomatic effects. The article presents the results of comparative clinical studies on assessment of the efficacy, tolerability and safety of the drug in the treatment of vulvovaginitis of mixed etiology. The Russian studies showed that this combination provides a minimal risk of systemic effects and the most favourable safety and tolerability profile of therapy as compared to the oral dosage forms, which gives grounds to recommend it for use in the clinical obstetrics-gynecology practice.

Successful Provision of Long-Acting Reversible Contraception in a Sexual Health Clinic.

Women who attend sexual health clinics are at high risk for sexually transmitted infections and unintended pregnancy. Long-acting reversible contraceptives (LARC) are very effective contraceptive methods, but the provision of LARC in such clinics is not well described in the literature. We conducted a retrospective chart review of women who presented to Denver Sexual Health Clinic for any reason and received family planning services between April 1, 2016, and October 31, 2018. We assessed demographic and clinical factors associated with contraceptive method received and conducted a subanalysis of those with intrauterine device (IUD) insertions on the same-day versus delayed insertion. Among those who received an IUD, we assessed rates of pelvic inflammatory disease (PID) 30 days after insertion. Of the 5064 women who received family planning services in our clinic, 1167 (23%) were using a LARC method at the time of their visit. Of the 3897 who were not using a LARC, fewer women, 12.6%, chose LARC (IUD and progestin implant), compared with 33.3% who chose new short-acting reversible contraceptives. Further analysis of the 270 IUD initiators revealed 202 (74.8%) received the IUD on the same day, whereas 68 (25.2%) had delayed IUD insertion. There were 9 incident cases of gonorrhea or chlamydia in those who received same-day IUD and 1 incident case among those who had delayed IUD insertion. There were no cases of PID at 30 days after insertion in either group. Study findings support IUD provision in a sexual health clinic on the day of initial visit without increased risk of PID.

101 The association between total bacterial load, the amount and proportion of lactobacillus in vaginal and endometrial samples

The non-Lactobacillus dominated microbiota in the uterus cavity is associated with the higher risk of pelvic inflammatory diseases and unsuccessful IVF outcomes. It is questionable whether or not the vaginal microbiota examination is the useful tool for prediction of the state of endometrial microbiota. The aim of the study is to find out the association between total bacterial load (TBL), the amount and proportion of Lacrobacillus in vaginal and endometrial samples. The study included 75 women (age 32.2±5.0) who attended “Garmonia” Medical Center (Yekaterinburg, Russia) seeking infertility treatment.

Prevalence and determinants of ectopic pregnancy in Ethiopia: Systematic review and meta-analysis

Background: Ectopic pregnancy is a life-threatening obstetric emergency, and is a major health problem for women of fertile age. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence, determinant factors, and outcomes of ectopic pregnancy among fertile age women in Ethiopia. Method: International databases (MEDLINE/Pub Med, Hinari, Scopus, Google scholar, African journals, and literatures were searched and nine eligible cross sectional and two case control studies were included in this systematic review and meta-analysis. Eggers test and funnel plot were computed to check publication bias across the studies. Publication bias was computed using a funnel plot and eggers test. Heterogeneity of the studies was checked using Cochrane Q-test and I2 statistic. Results: The pooled prevalence of ectopic pregnancy in Ethiopia was 3.61% (95%CI: 2.24–4.98, I2 = 89.2.0%, p &lt; 0.001). Having cesarean section scar (AOR = 7.44, 95%CI: 5.48–10.09), single marital status (AOR = 5.71, 95%CI: 4.76–6.85), history of sexually transmitted infection (AOR = 4.68, 95%CI: 3.04–7.19), history of abortion (AOR = 3.89, 95%CI: 3.35–4.52), history of ectopic pregnancy (AOR = 5.74, 95%CI: 3.81–8.65), and emergency contraceptive use (AOR = 8.72, 95%CI: 2.90–26.20) were the determinant factors for the occurrence of ectopic pregnancy. Conclusion: This systematic review and meta-analysis showed that the prevalence of ectopic pregnancy was high in Ethiopia. Thus, educating women to limit the number of sexual partners, smoking cessation, using a condom during sex helps prevent sexually transmitted infections and the risk of pelvic inflammatory disease is crucial.

Characteristics of Vaginal Microbiome in Women with Pelvic Inflammatory Disease in Korea.

Human vaginal microorganisms play an important role in maintaining good health throughout the human life cycle. An imbalance in the vaginal microbiota is associated with an increased risk of pelvic inflammatory disease (PID). This study aimed to characterize and compare vaginal microbial profiles of premenopausal Korean women with and without PID. 74 Korean premenopausal female vaginal samples were obtained; 33 were from healthy women (a control group) and 41 from PID patients. Vaginal fluid samples were collected from the vaginal wall and posterior cervix and then analyzed by 16S ribosomal ribonucleic acid (rRNA) gene-based amplicon sequencing. Results showed a significant difference between the vaginal microbial communities of the two groups (Jensen-Shannon, p = 0.014; Bray-Curtis, p = 0.009; Generalized UniFrac, p = 0.007; UniFrac, p = 0.008). Lactobacillus accounted for the highest percentage (61.0%) of the control group but was significantly decreased (34.9%) in PID patients; this was the most significant difference among all bacterial communities (p = 0.028, LDA effect size = 5.129). In addition, in the PID patient group, species diversity significantly increased (Simpson, p = 0.07) as the proportion of various pathogens increased evenly, resulting in a polymicrobial infection. Similarly, lactate, which constituted the highest percentage of the organic acids in the control group, was significantly decreased in the PID patient group (p = 0.04). The present study’s findings will help understand PID from the microbiome perspective and are expected to contribute to the development of more efficient PID diagnosis and treatment modalities.