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. 1993;1(1):12–15. doi: 10.1155/S1064744993000043

Pregnancy Outcome Following Pelvic Infection

Miklos Toth 1,2,✉, Anu Chaudhry 1, William J Ledger 1, Steven S Witkin 1
PMCID: PMC2364674  PMID: 18476199

Abstract

To determine whether a previous pelvic infection has an effect on the outcome of a subsequent pregnancy, we identified women with a diagnosis of pelvic inflammatory disease (PID), amnionitis, and postpartum or postabortal endometritis-salpingitis by a retrospective chart review of all patients admitted to the Department of Obstetrics and Gynecology at The New York Hospital-Cornell Medical Center between 1975 and 1977 and between 1985 and 1988. Antimicrobial regimens effective against Chlamydia trachomatis were initiated in 1985. Controls were randomly selected patients presenting during the same time period for routine examinations who had normal Pap smears and no infections. Both groups were comparable for age, race, gravity, and parity. Differences were evaluated by chi square analysis, using the Yates correction factor. We identified 183 women with a history of the above infections who subsequently conceived, and 82 controls. There were no differences in outcome between the two index groups. Term vaginal deliveries occurred in 14.2% of the women with a prior pelvic infection and in 56% of the controls (P < 0.001). Among the 97 women who had had PID, 21 (21.6%) had a spontaneous abortion in the subsequent pregnancy, as opposed to 6 (7.3%) of the controls (P = 0.013). In addition, eight of the women with PID (but no controls) went into preterm labor (P = 0.021). An increased incidence of preterm labor (P = 0.001) was also observed in women with a history of amnionitis. A history of endometritis was not associated with an increased prevalence of abnormal outcome in subsequent pregnancies. PID and amnionitis may adversely affect the outcome of subsequent pregnancies.

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Selected References

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  1. Fedele L., Acaia B., Parazzini F., Ricciardiello O., Candiani G. B. Ectopic pregnancy and recurrent spontaneous abortion: two associated reproductive failures. Obstet Gynecol. 1989 Feb;73(2):206–208. [PubMed] [Google Scholar]
  2. Grifo J. A., Jeremias J., Ledger W. J., Witkin S. S. Interferon-gamma in the diagnosis and pathogenesis of pelvic inflammatory disease. Am J Obstet Gynecol. 1989 Jan;160(1):26–31. doi: 10.1016/0002-9378(89)90080-x. [DOI] [PubMed] [Google Scholar]
  3. Henry-Suchet J., Catalan F., Loffredo V., Serfaty D., Siboulet A., Perol Y., Sanson M. J., Debache C., Pigeau F., Coppin R. Microbiology of specimens obtained by laparoscopy from controls and from patients with pelvic inflammatory disease or infertility with tubal obstruction: Chlamydia trachomatis and Ureaplasma urealyticum. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):1022–1025. doi: 10.1016/0002-9378(80)91100-x. [DOI] [PubMed] [Google Scholar]
  4. Holland S. M., Hudson A. P., Bobo L., Whittum-Hudson J. A., Viscidi R. P., Quinn T. C., Taylor H. R. Demonstration of chlamydial RNA and DNA during a culture-negative state. Infect Immun. 1992 May;60(5):2040–2047. doi: 10.1128/iai.60.5.2040-2047.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Licciardi F., Grifo J. A., Rosenwaks Z., Witkin S. S. Relation between antibodies to Chlamydia trachomatis and spontaneous abortion following in vitro fertilization. J Assist Reprod Genet. 1992 Jun;9(3):207–210. doi: 10.1007/BF01203814. [DOI] [PubMed] [Google Scholar]
  6. Lunenfeld E., Shapiro B. S., Sarov B., Sarov I., Insler V., Decherney A. H. The association between chlamydial-specific IgG and IgA antibodies and pregnancy outcome in an in vitro fertilization program. J In Vitro Fert Embryo Transf. 1989 Aug;6(4):222–227. doi: 10.1007/BF01132869. [DOI] [PubMed] [Google Scholar]
  7. Morrison R. P., Belland R. J., Lyng K., Caldwell H. D. Chlamydial disease pathogenesis. The 57-kD chlamydial hypersensitivity antigen is a stress response protein. J Exp Med. 1989 Oct 1;170(4):1271–1283. doi: 10.1084/jem.170.4.1271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Morrison R. P., Lyng K., Caldwell H. D. Chlamydial disease pathogenesis. Ocular hypersensitivity elicited by a genus-specific 57-kD protein. J Exp Med. 1989 Mar 1;169(3):663–675. doi: 10.1084/jem.169.3.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Quinn P. A., Petric M., Barkin M., Butany J., Derzko C., Gysler M., Lie K. I., Shewchuck A. B., Shuber J., Ryan E. Prevalence of antibody to Chlamydia trachomatis in spontaneous abortion and infertility. Am J Obstet Gynecol. 1987 Feb;156(2):291–296. doi: 10.1016/0002-9378(87)90270-5. [DOI] [PubMed] [Google Scholar]
  10. Toth M., Jeremias J., Ledger W. J., Witkin S. S. In vivo tumor necrosis factor production in women with salpingitis. Surg Gynecol Obstet. 1992 May;174(5):359–362. [PubMed] [Google Scholar]
  11. Toth M., Witkin S. S., Ledger W., Thaler H. The role of infection in the etiology of preterm birth. Obstet Gynecol. 1988 May;71(5):723–726. [PubMed] [Google Scholar]
  12. Witkin S. S., Ledger W. J. Antibodies to Chlamydia trachomatis in sera of women with recurrent spontaneous abortions. Am J Obstet Gynecol. 1992 Jul;167(1):135–139. doi: 10.1016/s0002-9378(11)91647-0. [DOI] [PubMed] [Google Scholar]
  13. Witkin S. S., Toth M., Jeremias J., Ledger W. J. Increased inducibility of inflammatory mediators from peripheral blood mononuclear cells of women with salpingitis. Am J Obstet Gynecol. 1991 Sep;165(3):719–723. doi: 10.1016/0002-9378(91)90316-j. [DOI] [PubMed] [Google Scholar]

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