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Pelvic inflammatory disease. A brief overview
1Department of Obstetrics and Gynecology, University of California, San Francisco.
Abstract:
Most pelvic inflammatory disease (PID) is caused by the ascent of sexually transmitted disease pathogens from the endocervix. In fact, PID remains the most common serious complication of infection from sexually transmitted bacterial pathogens. PID also may be caused by normal vaginal micro-organisms (such as those associated with bacterial vaginosis) that have overgrown in the vagina. PID has been linked to the occurrence of long-term sequelae, most commonly and most importantly infertility and ectopic pregnancy. In many patients PID may remain undiagnosed and asymptomatic, and may not become evident until such long-term consequences become manifest. We briefly review the epidemiology of PID including case definitions, the prevalence of the problem, and causal pathways and associated risk factors. Risk factors for both PID and its sequelae are discussed in relation to the mechanism of ascent of associated etiologic agents from the lower to the upper genital tract.
Insights
Pelvic inflammatory disease (PID) often stems from sexually transmitted infections ascending from the cervix. PID can lead to serious long-term health issues like infertility and ectopic pregnancy.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Gynecology
Background:
- Pelvic inflammatory disease (PID) is a common serious complication of sexually transmitted infections.
- It can also arise from overgrowth of normal vaginal micro-organisms, as seen in bacterial vaginosis.
- PID is frequently asymptomatic and undiagnosed until long-term consequences appear.
Purpose of the Study:
- To review the epidemiology of pelvic inflammatory disease (PID).
- To discuss causal pathways and risk factors for PID and its sequelae.
- To examine the mechanism of pathogen ascent in the female reproductive tract.
Main Methods:
- Literature review of PID epidemiology.
- Analysis of case definitions and prevalence data.
- Discussion of risk factors and etiological pathways.
Main Results:
- Sexually transmitted pathogens are the primary cause of PID via cervical ascent.
- Bacterial vaginosis-associated organisms can also cause PID.
- PID is a significant risk factor for infertility and ectopic pregnancy.
Conclusions:
- Understanding PID epidemiology and risk factors is crucial for prevention and early detection.
- The ascent of pathogens from the lower to the upper genital tract is a key mechanism.
- Prompt diagnosis and treatment are essential to mitigate long-term sequelae of PID.