Complications of Pelvic Inflammatory Disease


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About complications: Complications of Pelvic Inflammatory Disease are secondary conditions, symptoms, or other disorders that are caused by Pelvic Inflammatory Disease. In many cases the distinction between symptoms of Pelvic Inflammatory Disease and complications of Pelvic Inflammatory Disease is unclear or arbitrary.

Complications list for Pelvic Inflammatory Disease: The list of complications that have been mentioned in various sources for Pelvic Inflammatory Disease includes:

Complications of Pelvic Inflammatory Disease: More than 100,000 women become infertile each year as a result of PID, and a large proportion of the 70,000 ectopic (tubal) pregnancies occurring every year are due to the consequences of PID.1

Women with recurrent episodes of PID are more likely than women with a single episode to suffer scarring of the tubes that leads to infertility, tubal pregnancy, or chronic pelvic pain. Infertility occurs in approximately 20 percent of women who have had PID.

Most women with tubal infertility, however, never have had symptoms of PID. Organisms such as C. trachomatis can silently invade the fallopian tubes and cause scarring, which blocks the normal passage of eggs into the uterus.

A women who has had PID has a six-to-tenfold increased risk of tubal pregnancy, in which the egg can become fertilized but cannot pass into the uterus to grow. Instead, the egg usually attaches in the fallopian tube, which connects the ovary to the uterus. The fertilized egg cannot grow normally in the fallopian tube. This type of pregnancy is life-threatening to the mother, and almost always fatal to her fetus. It is the leading cause of pregnancy-related death in African-American women.

In addition, untreated PID can cause chronic pelvic pain and scarring in about 20 percent of patients. These conditions are difficult to treat but are sometimes improved with surgery.

Another complication of PID is the risk of repeated attacks of PID. As many as one-third of women who have had PID will have the disease at least one more time. With each episode of reinfection, the risk of infertility is increased.

Prevention

Women can play an active role in protecting themselves from PID by taking the following steps:

  • Signs of discharge with odor or bleeding between cycles could mean infection. Early treatment may prevent the development of PID.
  • If used correctly and consistently, male latex condoms will prevent transmission of gonorrhea and partially protect against chlamydial infection.

Research

Although much has been learned about the biology of the microbes that cause PID and the ways in which they damage the body, there is still much to learn. Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID) are studying the effects of antibiotics, hormones, and substances that boost the immune system. These studies may lead to insights about how to prevent infertility or other complications of PID. Topical microbicides and vaccines to prevent gonorrhea and chlamydial infection also are being developed. Clinical trials are in progress to test a suppository containing lactobacilli the normal bacteria found in the vaginas of healthy women. These bacteria colonize the vagina and may be associated with reduced risk of gonorrhea and bacterial vaginosis, both of which can cause PID.

Rapid, inexpensive, easy-to-use diagnostic tests are being developed to detect chlamydial infection and gonorrhea. A recent study conducted by NIAID-funded researchers demonstrated that screening and treating women who unknowingly had chlamydial infection reduced cases of PID by more than 60 percent. Meanwhile, researchers continue to search for better ways to detect PID itself, particularly in women with "silent" or asymptomatic PID.

1

Following PID, scarring will cause approximately 20 percent of women to become infertile, 18 percent to develop chronic pelvic pain, and 9 percent to have ectopic pregnancies.2

Complication statistics for Pelvic Inflammatory Disease: The following are statistics from various sources about the complications of Pelvic Inflammatory Disease:

  • PID causes 15% of infertility cases in the US (American Social Health Association)


Footnotes:
1. excerpt from Pelvic Inflammatory Disease, NIAID Fact Sheet: NIAID
2. excerpt from Sexually Transmitted Diseases Statistics, NIAID Fact Sheet: NIAID

Last revision: June 10, 2003

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