Objectives
Many women with tubal factor infertility do not report a prior episode of pelvic inflammatory disease (PID). In many cases upper genital tract infection and inflammation are asymptomatic, leading to lack of detection and treatment. Subclinical PID can lead to chronic sequelae. Our objective was to compare bacterial etiologies of endometritis in women with symptomatic versus subclinical PID.
Methods
Women presenting with symptoms meeting the CDC criteria for PID and women at risk for PID [mucopurulent cervicitis, endocervical C. trachomatis (CT), or a recent sex partner infected with N. gonorrhoeae (GC), CT, or non-gonococcal urethritis] but without signs or symptoms were enrolled. An endometrial biopsy was obtained from all women prior to treatment. Histologic assessment for endometritis, defined as >1 plasma cell per 100X microscopic field, was assessed independently by 2 pathologists blinded to the design. Women having symptoms of PID (n=208) who had endometritis were defined as symptomatic PID cases, while women at risk of PID (n=134) who had endometritis were defined as subclinical PID. Endometrial tissue was tested for GC, CT, and M. genitalium (MG) by NAAT and cultured for aerobic and anaerobic bacteria. Differences in bacterial prevalence were evaluated by Fisher’s exact test.
Methods
Women presenting with symptoms meeting the CDC criteria for PID and women at risk for PID [mucopurulent cervicitis, endocervical C. trachomatis (CT), or a recent sex partner infected with N. gonorrhoeae (GC), CT, or non-gonococcal urethritis] but without signs or symptoms were enrolled. An endometrial biopsy was obtained from all women prior to treatment. Histologic assessment for endometritis, defined as >1 plasma cell per 100X microscopic field, was assessed independently by 2 pathologists blinded to the design. Women having symptoms of PID (n=208) who had endometritis were defined as symptomatic PID cases, while women at risk of PID (n=134) who had endometritis were defined as subclinical PID. Endometrial tissue was tested for GC, CT, and M. genitalium (MG) by NAAT and cultured for aerobic and anaerobic bacteria. Differences in bacterial prevalence were evaluated by Fisher’s exact test.
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