Risk factors for pelvic inflammatory disease: a case control study

Article Abstract:

Several behavioral factors appear to predispose to developing pelvic inflammatory disease (PID). PID is a sexually transmitted disease that increases the risk of infertility, ectopic pregnancy, recurrent episodes of PID, and chronic abdominal pain in addition to direct problems of the illness itself. Researchers matched 268 low-income women hospitalized for PID at a San Francisco hospital with 174 similar women attending the associated women's clinic who had no history of upper genital tract infections. Infected women were less likely to report using birth control, more likely to report having more than one sexual partner in the previous 30 days, more likely to report intercourse during menstruation, and more likely to douche and especially to douche after menses or after sexual intercourse. Infected women were also more likely to have been pregnant, which probably means pregnancy serves as a marker for other sexual behaviors, since nearly 75% were unmarried.

Sexually transmitted diseases, Risk factors

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Commonly used diagnostic criteria for pelvic inflammatory disease have poor sensitivity for plasma cell endometritis

Article Abstract:

Centers for Disease Control and Prevention (CDC) guidelines for diagnosis of pelvic inflammatory disease (PID) may not identify all women with PID. Researchers performed biopsies of the uterine wall on 132 women with symptoms of PID and tested women for sexually transmitted diseases. Biopsy samples that showed plasma cell inflammation were declared to be evidence of PID. CDC diagnostic guidelines identified only 36% of the PID cases, compared to diagnoses based on the presence of plasma cell endometritis. CDC guidelines may need to be revised for high-risk patients by broadening the scope of symptoms to include any pelvic pain or abnormal test result. Such a revision would cause more patients to be tested and greater costs to be incurred, but might prevent ectopic pregnancies and infertility caused by untreated PID.

Standards, Diagnosis, United States. Centers for Disease Control and Prevention, Endometritis

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