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. 1995 Sep;48(9):815–819. doi: 10.1136/jcp.48.9.815

Chlamydia trachomatis and ectopic pregnancy: retrospective analysis of salpingectomy specimens, endometrial biopsies, and cervical smears.

J Lan 1, A J van den Brule 1, D J Hemrika 1, E K Risse 1, J M Walboomers 1, M E Schipper 1, C J Meijer 1
PMCID: PMC502868  PMID: 7490313

Abstract

AIMS--To examine the role of Chlamydia trachomatis in ectopic pregnancy by detection of DNA in archival salpingectomy specimens, and in their preceding cervical specimens and endometrial biopsies, by using the polymerase chain reaction (PCR). METHODS--Archival paraffin embedded salpingectomy tissues (n = 48) from 37 women with ectopic pregnancy were examined for the presence of C trachomatis plasmid and omp1 DNA by PCR. In addition, preceding cervical specimens (n = 58) stored either as cervical cell suspensions or as archival cervical smears, and preceding endometrial biopsies (n = 18), taken 0-5.8 years before the ectopic pregnancy, were examined by PCR for the presence of C trachomatis. RESULTS--C trachomatis DNA was detected in only one of the 48 salpingectomy specimens from 37 women. However, in six of the 37 women, C trachomatis DNA was detected in the genital specimens (cervix and/or endometrial) taken before salpingectomy. C trachomatis infections were mostly found in endometrial or cervical specimens taken more than three years before ectopic pregnancy. No chlamydial DNA was found in endometrial or cervical specimens taken at the same time of the ectopic pregnancy. CONCLUSIONS--Although no C trachomatis DNA was found in salpingectomy specimens, several women with ectopic pregnancy had C trachomatis infections in endometrial and cervical specimens in the past. This suggests that at least in these cases the ectopic pregnancy is a late post-inflammatory complication of an ascending C trachomatis infection resulting in a scarred fallopian tube.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. An Q., Radcliffe G., Vassallo R., Buxton D., O'Brien W. J., Pelletier D. A., Weisburg W. G., Klinger J. D., Olive D. M. Infection with a plasmid-free variant Chlamydia related to Chlamydia trachomatis identified by using multiple assays for nucleic acid detection. J Clin Microbiol. 1992 Nov;30(11):2814–2821. doi: 10.1128/jcm.30.11.2814-2821.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beral V. An epidemiological study of recent trends in ectopic pregnancy. Br J Obstet Gynaecol. 1975 Oct;82(10):775–782. doi: 10.1111/j.1471-0528.1975.tb00572.x. [DOI] [PubMed] [Google Scholar]
  3. Boom R., Sol C. J., Salimans M. M., Jansen C. L., Wertheim-van Dillen P. M., van der Noordaa J. Rapid and simple method for purification of nucleic acids. J Clin Microbiol. 1990 Mar;28(3):495–503. doi: 10.1128/jcm.28.3.495-503.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brunham R. C., Binns B., Guijon F., Danforth D., Kosseim M. L., Rand F., McDowell J., Rayner E. Etiology and outcome of acute pelvic inflammatory disease. J Infect Dis. 1988 Sep;158(3):510–517. doi: 10.1093/infdis/158.3.510. [DOI] [PubMed] [Google Scholar]
  5. Brunham R. C., Binns B., McDowell J., Paraskevas M. Chlamydia trachomatis infection in women with ectopic pregnancy. Obstet Gynecol. 1986 May;67(5):722–726. doi: 10.1097/00006250-198605000-00022. [DOI] [PubMed] [Google Scholar]
  6. Brunham R. C., Peeling R., Maclean I., Kosseim M. L., Paraskevas M. Chlamydia trachomatis-associated ectopic pregnancy: serologic and histologic correlates. J Infect Dis. 1992 Jun;165(6):1076–1081. doi: 10.1093/infdis/165.6.1076. [DOI] [PubMed] [Google Scholar]
  7. Campbell L. A., Patton D. L., Moore D. E., Cappuccio A. L., Mueller B. A., Wang S. P. Detection of Chlamydia trachomatis deoxyribonucleic acid in women with tubal infertility. Fertil Steril. 1993 Jan;59(1):45–50. [PubMed] [Google Scholar]
  8. Chow J. M., Yonekura M. L., Richwald G. A., Greenland S., Sweet R. L., Schachter J. The association between Chlamydia trachomatis and ectopic pregnancy. A matched-pair, case-control study. JAMA. 1990 Jun 20;263(23):3164–3167. [PubMed] [Google Scholar]
  9. Chow W. H., Daling J. R., Cates W., Jr, Greenberg R. S. Epidemiology of ectopic pregnancy. Epidemiol Rev. 1987;9:70–94. doi: 10.1093/oxfordjournals.epirev.a036309. [DOI] [PubMed] [Google Scholar]
  10. Chrysostomou M., Karafyllidi P., Papadimitriou V., Bassiotou V., Mayakos G. Serum antibodies to Chlamydia trachomatis in women with ectopic pregnancy, normal pregnancy or salpingitis. Eur J Obstet Gynecol Reprod Biol. 1992 Apr 21;44(2):101–105. doi: 10.1016/0028-2243(92)90053-2. [DOI] [PubMed] [Google Scholar]
  11. Coste J., Job-Spira N., Fernandez H., Papiernik E., Spira A. Risk factors for ectopic pregnancy: a case-control study in France, with special focus on infectious factors. Am J Epidemiol. 1991 May 1;133(9):839–849. doi: 10.1093/oxfordjournals.aje.a115964. [DOI] [PubMed] [Google Scholar]
  12. Coste J., Laumon B., Brémond A., Collet P., Job-Spira N. Sexually transmitted diseases as major causes of ectopic pregnancy: results from a large case-control study in France. Fertil Steril. 1994 Aug;62(2):289–295. doi: 10.1016/s0015-0282(16)56881-2. [DOI] [PubMed] [Google Scholar]
  13. Diquelou J. Y., Pia P., Tesquier L., Henry-Suchet J., Gicquel J. M., Boyer S. La place de Chlamydia trachomatis dans l'étiologie infectieuse des grossesses extra-utérines. J Gynecol Obstet Biol Reprod (Paris) 1988;17(3):325–332. [PubMed] [Google Scholar]
  14. Gjønnaess H., Dalaker K., Anestad G., Mårdh P. A., Kvile G., Bergan T. Pelvic inflammatory disease: etiologic studies with emphasis on chlamydial infection. Obstet Gynecol. 1982 May;59(5):550–555. [PubMed] [Google Scholar]
  15. Griffais R., Thibon M. Detection of Chlamydia trachomatis by the polymerase chain reaction. Res Microbiol. 1989 Feb;140(2):139–141. doi: 10.1016/0923-2508(89)90047-8. [DOI] [PubMed] [Google Scholar]
  16. Griffais R., Thibon M. Detection of Chlamydia trachomatis by the polymerase chain reaction. Res Microbiol. 1989 Feb;140(2):139–141. doi: 10.1016/0923-2508(89)90047-8. [DOI] [PubMed] [Google Scholar]
  17. Hartford S. L., Silva P. D., diZerega G. S., Yonekura M. L. Serologic evidence of prior chlamydial infection in patients with tubal ectopic pregnancy and contralateral tubal disease. Fertil Steril. 1987 Jan;47(1):118–121. doi: 10.1016/s0015-0282(16)49946-2. [DOI] [PubMed] [Google Scholar]
  18. Kihlström E., Lindgren R., Rydén G. Antibodies to Chlamydia trachomatis in women with infertility, pelvic inflammatory disease and ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol. 1990 May-Jun;35(2-3):199–204. doi: 10.1016/0028-2243(90)90162-t. [DOI] [PubMed] [Google Scholar]
  19. Lan J., Walboomers J. M., Roosendaal R., van Doornum G. J., MacLaren D. M., Meijer C. J., van den Brule A. J. Direct detection and genotyping of Chlamydia trachomatis in cervical scrapes by using polymerase chain reaction and restriction fragment length polymorphism analysis. J Clin Microbiol. 1993 May;31(5):1060–1065. doi: 10.1128/jcm.31.5.1060-1065.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Mårdh P. A., Ripa T., Svensson L., Weström L. Chilamydia trachomatis infection in patients with acute salpingitis. N Engl J Med. 1977 Jun 16;296(24):1377–1379. doi: 10.1056/NEJM197706162962403. [DOI] [PubMed] [Google Scholar]
  21. Roosendaal R., Walboomers J. M., Veltman O. R., Melgers I., Burger C., Bleker O. P., MacClaren D. M., Meijer C. J., van den Brule A. J. Comparison of different primer sets for detection of Chlamydia trachomatis by the polymerase chain reaction. J Med Microbiol. 1993 Jun;38(6):426–433. doi: 10.1099/00222615-38-6-426. [DOI] [PubMed] [Google Scholar]
  22. Saiki R. K., Scharf S., Faloona F., Mullis K. B., Horn G. T., Erlich H. A., Arnheim N. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. Science. 1985 Dec 20;230(4732):1350–1354. doi: 10.1126/science.2999980. [DOI] [PubMed] [Google Scholar]
  23. Schachter J., Moncada J., Dawson C. R., Sheppard J., Courtright P., Said M. E., Zaki S., Hafez S. F., Lorincz A. Nonculture methods for diagnosing chlamydial infection in patients with trachoma: a clue to the pathogenesis of the disease? J Infect Dis. 1988 Dec;158(6):1347–1352. doi: 10.1093/infdis/158.6.1347. [DOI] [PubMed] [Google Scholar]
  24. Sherman K. J., Daling J. R., Stergachis A., Weiss N. S., Foy H. M., Wang S. P., Grayston J. T. Sexually transmitted diseases and tubal pregnancy. Sex Transm Dis. 1990 Jul-Sep;17(3):115–121. doi: 10.1097/00007435-199007000-00001. [DOI] [PubMed] [Google Scholar]
  25. Shiono P. H., Harlap S., Pellegrin F. Ectopic pregnancies: rising incidence rates in Northern California. Am J Public Health. 1982 Feb;72(2):173–175. doi: 10.2105/ajph.72.2.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Svensson L., Mårdh P. A., Ahlgren M., Nordenskjöld F. Ectopic pregnancy and antibodies to Chlamydia trachomatis. Fertil Steril. 1985 Sep;44(3):313–317. [PubMed] [Google Scholar]
  27. Thejls H., Gnarpe J., Lundkvist O., Heimer G., Larsson G., Victor A. Diagnosis and prevalence of persistent chlamydia infection in infertile women: tissue culture, direct antigen detection, and serology. Fertil Steril. 1991 Feb;55(2):304–310. [PubMed] [Google Scholar]
  28. Thompson C. H., Rose B. R., Cossart Y. E. Detection of HPV DNA in archival specimens of cervical cancer using in situ hybridisation and the polymerase chain reaction. J Med Virol. 1992 Jan;36(1):54–59. doi: 10.1002/jmv.1890360111. [DOI] [PubMed] [Google Scholar]
  29. Walters M. D., Eddy C. A., Gibbs R. S., Schachter J., Holden A. E., Pauerstein C. J. Antibodies to Chlamydia trachomatis and risk for tubal pregnancy. Am J Obstet Gynecol. 1988 Oct;159(4):942–946. doi: 10.1016/s0002-9378(88)80177-7. [DOI] [PubMed] [Google Scholar]
  30. Weström L., Bengtsson L. P., Mårdh P. A. Incidence, trends, and risks of ectopic pregnancy in a population of women. Br Med J (Clin Res Ed) 1981 Jan 3;282(6257):15–18. doi: 10.1136/bmj.282.6257.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Weström L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol. 1975 Mar 1;121(5):707–713. doi: 10.1016/0002-9378(75)90477-9. [DOI] [PubMed] [Google Scholar]
  32. Weström L., Wölner-Hanssen P. Pathogenesis of pelvic inflammatory disease. Genitourin Med. 1993 Feb;69(1):9–17. doi: 10.1136/sti.69.1.9. [DOI] [PMC free article] [PubMed] [Google Scholar]

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