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. 1998 Dec;74(6):426–432. doi: 10.1136/sti.74.6.426

Risk factors for laparoscopically confirmed pelvic inflammatory disease: findings from Mumbai (Bombay), India

A Gogate, L Brabin, S Nicholas, S Gogate, T Gaonkar, A Naidu, A Divekar, A Karande, C A Hart
PMCID: PMC1758165  PMID: 10195052

Abstract

OBJECTIVES: Sexually transmitted diseases (STDs) are an important cause of pelvic inflammatory disease (PID) but have often not been detected in microbiological studies of Indian women admitted to hospital gynaecology wards or private clinics. In this cross sectional study, women living in the inner city of Mumbai (Bombay) were investigated for socioeconomic, clinical, and microbiological risk factors for PID. METHODS: Microbiological tests and laparoscopic examination were carried out on 2736 women aged < or = 35 years who came to a health facility with suspected acute salpingitis or infertility or for laparoscopic sterilisation. 86 women with a clinical diagnosis of PID were not referred for laparoscopy although their characteristics are described. Associations between various risk factors and PID status were investigated and logistic regression performed on all factors that remained significant. RESULTS: Of women with a laparoscopically confirmed evaluation, 26 women had acute and 48 chronic pelvic infection. Independent risk factors for PID were later age at menarche (> or = 14 years), a history of stillbirth and no previous pregnancy, history of tuberculosis, STD, dilatation and curettage or previous laparoscopy, and presence of Gardnerella vaginalis. CONCLUSIONS: It is concluded that STD related risk factors applied to only a small proportion of PID cases and that other determinants of PID are important, including obstetric complications, invasive surgical procedures such as laparoscopy, and tuberculosis. 






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Selected References

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  1. Agarwal J., Gupta J. K. Female genital tuberculosis--a retrospective clinico-pathologic study of 501 cases. Indian J Pathol Microbiol. 1993 Oct;36(4):389–397. [PubMed] [Google Scholar]
  2. Bevan C. D., Johal B. J., Mumtaz G., Ridgway G. L., Siddle N. C. Clinical, laparoscopic and microbiological findings in acute salpingitis: report on a United Kingdom cohort. Br J Obstet Gynaecol. 1995 May;102(5):407–414. doi: 10.1111/j.1471-0528.1995.tb11294.x. [DOI] [PubMed] [Google Scholar]
  3. Blackwell A. L., Thomas P. D., Wareham K., Emery S. J. Health gains from screening for infection of the lower genital tract in women attending for termination of pregnancy. Lancet. 1993 Jul 24;342(8865):206–210. doi: 10.1016/0140-6736(93)92299-9. [DOI] [PubMed] [Google Scholar]
  4. Brabin L., Gogate A., Gogate S., Karande A., Khanna R., Dollimore N., de Koning K., Nicholas S., Hart C. A. Reproductive tract infections, gynaecological morbidity and HIV seroprevalence among women in Mumbai, India. Bull World Health Organ. 1998;76(3):277–287. [PMC free article] [PubMed] [Google Scholar]
  5. Brunham R. C., Cheang M., McMaster J., Garnett G., Anderson R. Chlamydia trachomatis, infertility, and population growth in sub-Saharan Africa. Sex Transm Dis. 1993 May-Jun;20(3):168–173. doi: 10.1097/00007435-199305000-00010. [DOI] [PubMed] [Google Scholar]
  6. Daling J. R., Weiss N. S., Metch B. J., Chow W. H., Soderstrom R. M., Moore D. E., Spadoni L. R., Stadel B. V. Primary tubal infertility in relation to the use of an intrauterine device. N Engl J Med. 1985 Apr 11;312(15):937–941. doi: 10.1056/NEJM198504113121501. [DOI] [PubMed] [Google Scholar]
  7. Farley T. M., Rosenberg M. J., Rowe P. J., Chen J. H., Meirik O. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet. 1992 Mar 28;339(8796):785–788. doi: 10.1016/0140-6736(92)91904-m. [DOI] [PubMed] [Google Scholar]
  8. Hudelson P. Gender differentials in tuberculosis: the role of socio-economic and cultural factors. Tuber Lung Dis. 1996 Oct;77(5):391–400. doi: 10.1016/s0962-8479(96)90110-0. [DOI] [PubMed] [Google Scholar]
  9. Kochar M. Etiology of pelvic infections treated by the gynecologic service of the Kasturba Hospital, Delhi, India. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):872–874. doi: 10.1016/0002-9378(80)91074-1. [DOI] [PubMed] [Google Scholar]
  10. Korn A. P., Hessol N., Padian N., Bolan G., Muzsnai D., Donegan E., Jonte J., Schachter J., Landers D. V. Commonly used diagnostic criteria for pelvic inflammatory disease have poor sensitivity for plasma cell endometritis. Sex Transm Dis. 1995 Nov-Dec;22(6):335–341. doi: 10.1097/00007435-199511000-00002. [DOI] [PubMed] [Google Scholar]
  11. Mayaud P., Grosskurth H., Changalucha J., Todd J., West B., Gabone R., Senkoro K., Rusizoka M., Laga M., Hayes R. Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics. Bull World Health Organ. 1995;73(5):621–630. [PMC free article] [PubMed] [Google Scholar]
  12. Mehta P. V. A total of 250,136 laparoscopic sterilizations by a single operator. Br J Obstet Gynaecol. 1989 Sep;96(9):1024–1034. doi: 10.1111/j.1471-0528.1989.tb03376.x. [DOI] [PubMed] [Google Scholar]
  13. Muir D. G., Belsey M. A. Pelvic inflammatory disease and its consequences in the developing world. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):913–928. doi: 10.1016/0002-9378(80)91082-0. [DOI] [PubMed] [Google Scholar]
  14. Pearce J. M. Pelvic inflammatory disease. BMJ. 1990 Apr 28;300(6732):1090–1091. doi: 10.1136/bmj.300.6732.1090. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rosene K., Eschenbach D. A., Tompkins L. S., Kenny G. E., Watkins H. Polymicrobial early postpartum endometritis with facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis: treatment with piperacillin or cefoxitin. J Infect Dis. 1986 Jun;153(6):1028–1037. doi: 10.1093/infdis/153.6.1028. [DOI] [PubMed] [Google Scholar]
  16. Soper D. E., Brockwell N. J., Dalton H. P., Johnson D. Observations concerning the microbial etiology of acute salpingitis. Am J Obstet Gynecol. 1994 Apr;170(4):1008–1017. doi: 10.1016/s0002-9378(94)70094-x. [DOI] [PubMed] [Google Scholar]
  17. Sweet R. L., Draper D. L., Schachter J., James J., Hadley W. K., Brooks G. F. Microbiology and pathogenesis of acute salpingitis as determined by laparoscopy: what is the appropriate site to sample? Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):985–989. doi: 10.1016/0002-9378(80)91093-5. [DOI] [PubMed] [Google Scholar]

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