Pelvic inflammatory disease overview
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Differentiating Pelvic Inflammatory Disease from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus,fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. This may lead to tissue necrosis with/or without abscess formation. Pus can be released into the peritoneum. Two thirds of patients with laparoscopic evidence of previous PID were not aware they had had PID [1] (Cecil's 5th ed). PID is often associated with sexually transmitted diseases, as it is a common result of such infections. PID is a vague term and can refer to viral, fungal, parasitic, though most often bacterial infections. PID should be classified by affected organs, the stage of the infection, and the organism(s) causing it. Although an STD is often the cause, other routes are possible, including lymphatic, postpartum, postabortal (either miscarriage or abortion) or intrauterine device (IUD) related, and hematogenousspread.
Epidemiology and Demographics
In the United States, more than one million women are affected by PID each year, and the rate is highest with teenagers. Approximately 50,000 women become infertile in the US each year from PID. N. gonorrhoea is isolated in only 40-60% of women with acute salpingitis [2] . C. trachomatis was estimated by current obgyn 9th ed to be the cause in about 60% of cases ofsalpingitis, which may lead to PID. It is unsure how much is due to a single organism and how much is due to multiple organisms; many other pathogens that are in normalvaginal flora become involved in PID. 10% of women in one study had asymptomatic Chlamydia trachomatis infection and 65% had asymptomatic infection with Neisseria gonorrhoeae[2] It was noted in one study that 10-40% of untreated women with N. gonorrhoea develop PID and 20-40% of women infected with C. trachomitis developed PID. PID is the leading cause of infertility. "A single episode of PID results in infertility in 13% of women." This rate of infertility increases with each infection.
Risk Factors
Pelvic inflammatory disease is more likely to occur when there is a history of pelvic inflammatory disease, recent sexual contact, recent onset of menses, or an IUD in place or if the partner has a sexually transmitted disease. Acute pelvic inflammatory disease is highly unlikely when recent intercourse has not taken place or an IUD is not being used.
References
- ↑ "STD Facts - Pelvic inflammatory disease (PID)". Retrieved 2007-11-23.
- ↑ 2.0 2.1 Lauren Nathan; DeCherney, Alan H.; Pernoll, Martin L. (2003). Current obstetric & gynecologic diagnosis & treatment. New York: Lange Medical Books/McGraw-Hill. ISBN 0-8385-1401-4.
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