Pelvic inflammatory disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Natural history
If left untreated it may lead to infertility in approximately 16% of affected women.[1] it may progress to adjacent organ involvement or even peritonitis.
Prognosis
The overall prognosis of PID is good if patients treated within 3 days of symptoms onset but the clinical improvement can not guaranty protection against infertility.[2]
Factors that predict poor prognosis include:[3]
- Advanced age,
- History of previous open gynecological surgery,
- Any cystic lesion identified by ultrasonography,
- High CRP levels
Complications
- Chronic pelvic pain
- It is defined as, lower abdominal pain that lasts for at least 6 months and causes functional disability. 1/3 of PID affected women will experience chronic pelvic pain.[4]
- Recurrent PID is the strongest predictor for developing chronic pelvic pain because of scars and adhesions due to repeated inflammation.[5]
References
- ↑ Weström L, Joesoef R, Reynolds G, Hagdu A, Thompson SE (1992). "Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results". Sex Transm Dis. 19 (4): 185–92. PMID 1411832.
- ↑ Ross J (2004). "Pelvic inflammatory disease". Clin Evid (11): 2121–7. PMID 15652102.
- ↑ Terao M, Koga K, Fujimoto A, Wada-Hiraike O, Osuga Y, Yano T, Kozuma S (2014). "Factors that predict poor clinical course among patients hospitalized with pelvic inflammatory disease". J. Obstet. Gynaecol. Res. 40 (2): 495–500. doi:10.1111/jog.12189. PMID 24118399.
- ↑ Ness RB, Soper DE, Holley RL, Peipert J, Randall H, Sweet RL, Sondheimer SJ, Hendrix SL, Amortegui A, Trucco G, Songer T, Lave JR, Hillier SL, Bass DC, Kelsey SF (2002). "Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial". Am. J. Obstet. Gynecol. 186 (5): 929–37. PMID 12015517.
- ↑ Haggerty CL, Peipert JF, Weitzen S, Hendrix SL, Holley RL, Nelson DB, Randall H, Soper DE, Wiesenfeld HC, Ness RB (2005). "Predictors of chronic pelvic pain in an urban population of women with symptoms and signs of pelvic inflammatory disease". Sex Transm Dis. 32 (5): 293–9. PMID 15849530.