Pelvic infection after elective abortion associated with Chlamydia trachomatis

Area of Science:

• Reproductive Health
• Infectious Diseases
• Gynecology

Background:

• Pelvic inflammatory disease (PID) is a significant postoperative complication for women undergoing elective abortion.
• Chlamydia trachomatis and Neisseria gonorrhoeae are common sexually transmitted infections that can lead to PID.
• The role of C. trachomatis screening and treatment in preventing PID in this specific population requires further investigation.

Purpose of the Study:

• To prospectively evaluate the incidence of C. trachomatis and Neisseria gonorrhoeae infections in women undergoing elective abortion.
• To determine the association between C. trachomatis infection and the development of postoperative pelvic inflammatory disease (PID).
• To assess the effectiveness of antibiotic treatment for C. trachomatis in preventing postoperative PID.

Main Methods:

• A prospective study involving 943 healthy women in the first trimester of pregnancy undergoing elective abortion in Denmark and Sweden.
• Cervical samples were collected for the isolation of chlamydiae and gonococci before the procedure.
• Group 1 (Denmark) had no pre- or postoperative treatment for C. trachomatis, while Group 2 (Sweden) received antibiotics active against chlamydiae.

Main Results:

• Chlamydia trachomatis was isolated from 5.3% of women in Denmark and 4.9% in Sweden.
• In Denmark, 5 of 23 C. trachomatis-positive women developed PID postoperatively, with significant antibody titer changes.
• In Sweden, none of the C. trachomatis-positive women who received antibiotic treatment developed PID, a significant difference compared to Denmark (P = .0393).

Conclusions:

• C. trachomatis infection is a significant risk factor for postoperative PID in women undergoing elective abortion.
• Screening and treating C. trachomatis infection before or during elective abortion can effectively prevent postoperative PID.
• Routine screening for both gonorrhea and C. trachomatis is recommended for women seeking abortion services.