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Pelvic inflammatory disease: bacteriology and sequelae
1Department of Obstetrics and Gynaecology, University of Lund, Sweden.
Abstract:
Pelvic inflammatory disease (PID) is defined as the acute clinical syndrome associated with ascending spread of micro-organisms from the lower to the upper female genital tract. The causative organisms can be divided into exogenous (mostly sexually transmittable) and endogenous agents. During the past three decades' epidemic of sexually transmitted diseases (STDs), STD agents have accounted for 60-80% of PIDs in women below the age of 25. After PID a total of 17.4% of the women become infertile because of post-PID tubal damage. Multiple infections, increasing age at the first infection, and severe infections are followed by a more unfavourable fertility prognosis. The risk of an ectopic pregnancy increases 7-10-fold after PID. In areas with high prevalence of STDs, use of IUDs among women in the high risk age group for PID (15-24 years) seems to increase the risk of acquiring the disease but has no influence on the clinical course of the infection. Use of combined oral contraceptive pills decreases both the risk of acquiring PID and the risk of infertility after the infection.
Insights
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. Sexually transmitted diseases are a major cause, leading to infertility and ectopic pregnancy risks, but oral contraceptives can reduce these risks.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Gynecology
Background:
- Pelvic inflammatory disease (PID) is an acute infection of the upper female genital tract.
- Microbial agents, including sexually transmitted diseases (STDs), are primary causes.
- PID significantly impacts reproductive health, particularly in young women.
Purpose of the Study:
- To define Pelvic Inflammatory Disease (PID) and its common causes.
- To investigate the impact of PID on female fertility and pregnancy outcomes.
- To evaluate the influence of contraceptive methods on PID risk and consequences.
Main Methods:
- Literature review on PID etiology and epidemiology.
- Analysis of data on PID prevalence and associated risk factors.
- Examination of studies on the effects of PID on fertility and ectopic pregnancy.
Main Results:
- Sexually transmitted disease agents cause 60-80% of PID in women under 25.
- 17.4% of women experience infertility post-PID due to tubal damage.
- PID increases ectopic pregnancy risk 7-10 fold; IUDs may increase risk, while oral contraceptives decrease it.
Conclusions:
- PID is a serious condition with significant reproductive health consequences.
- Prompt diagnosis and treatment are crucial to mitigate long-term effects like infertility.
- Contraceptive choices, particularly combined oral contraceptives, play a role in PID prevention and managing post-infection fertility outcomes.