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Characteristics of women at low risk of STI presenting with pelvic inflammatory disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård/Lindmark)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård/Lindmark)
2006 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 11, no 2, 60-68 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the background and reproductive history of women who are considered at low risk of sexually transmitted infection (STI) presenting with acute pelvic inflammatory disease (PID). Methods: Case-control study, investigating 51 women admitted to hospital with a diagnosis of acute PID and 50 healthy women attending for routine gynecological checkup. Results: Women with PID were older (p = 0.003) and more often unemployed (p = 0.008), and had a lower educational level (p = 0.000003). Healthy women reported more regular routine attendance to gynecologists (p = 0.0008) and were less often smokers (p = 0.0009). There was no difference between groups regarding age at first sexual intercourse, number of sex partners during life, duration of current sexual partnership, and frequency of sexual intercourse, total number of deliveries, spontaneous abortions, ectopic pregnancies and outcome of last pregnancy. The number of induced abortions was significantly higher in the PID group (p = 0.0004). There were no differences between the groups with regard to previous episodes of PID. Healthy controls more often reported a history of STI (p = 0.00007). IUD was the most commonly reported current contraceptive method in both groups, and there was no difference in contraceptive practices between groups. Conclusion: Women with PID differed from healthy controls only with regard to socio-demographic characteristics and not with regard to common risk factors for PID.

Place, publisher, year, edition, pages
2006. Vol. 11, no 2, 60-68 p.
Keyword [en]
Pelvic inflammatory disease, Contraception, Reproductive history
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-81965DOI: 10.1080/13625180500279789ISI: 000239780100002PubMedID: 16854678OAI: oai:DiVA.org:uu-81965DiVA: diva2:109880
Available from: 2006-09-06 Created: 2006-09-06 Last updated: 2017-12-14Bibliographically approved
In thesis
1. The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia: A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users
Open this publication in new window or tab >>The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia: A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The objectives of this case-control study, investigating 51 in-patient women with acute pelvic inflammatory disease (PID) and 50 healthy women attending for routine gynecological check-up, were to investigate the background and reproductive history of women, who are considered at low risk of sexually transmitted infection presenting with PID, to examine whether intrauterine device (IUD) use per se and long use affects the microbiology and clinical course of the disease, to identify risk factors for PID and to examine whether IUD use is an independent risk factor for PID.

The most striking difference regarding the background and reproductive history between women with PID and healthy women over age 25 were related to socio-demographic factors and not to common risk factors for PID.

There was little difference between healthy women and women with current PID with regard to single microbes. The finding of combinations of several anaerobic or aerobic/anaerobic microbes appeared to be associated with PID, particularly in women over 35. The pathogenesis of non-sexually transmitted PID appears to be associated with a synergistic effect between several pathogens, possibly facilitated by the presence of an IUD.

IUD use per se was associated with an increased risk of PID in women 35 and older. There was an association between IUD use and complicated PID in women over 35, which was possibly influenced by long-term IUD use. Age over 35 and IUD use, independently of each other, were associated with an increased risk of failed conservative treatment, necessitating surgery in patients with PID.

An observational study showed that Latvian obstetrician-gynecologists participate actively in contraceptive counseling and are very experienced with regard to IUD use. Physicians’ attitudes and perceptions towards IUD are generally positive and their clinical considerations are in good agreement with that of doctors in other countries. Antibiotics are widely used around IUD insertion by doctors, possibly driven by a liberal attitude towards IUD use in women with a potential risk of STI. The study could identify some possible gaps in the theoretical knowledge about the IUD and other methods.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 57 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 110
Keyword
Medical sciences, pelvic inflammatory disease, complicated pelvic inflammatory disease, contraception, intrauterine device, reproductive history, microbiology, anaerobes, surgery, gynecologist, practice, MEDICIN OCH VÅRD
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-6458 (URN)91-554-6471-8 (ISBN)
Public defence
2006-03-31, Rosénsalen, Kvinno- och Barnkliniken, AAkademiska Sjukhuset, SE-751 85 Uppsala, 09:15
Opponent
Supervisors
Available from: 2006-03-10 Created: 2006-03-10 Last updated: 2013-05-17Bibliographically approved

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