Pelvic Inflammatory Disease and the Risk Factor

Pelvic inflammatory disease (PID) is a significant cause of female reproductive morbidity, leading to complications such as infertility, ectopic pregnancy, and chronic pelvic pain. Understanding the risk factors for PID in local populations is essential for prevention and timely management. Objective: This study aimed to determine the prevalence and associated risk factors of PID among women attending the Department of Gynecology at Bolan Medical Hospital, Quetta. Methods: A cross-sectional study was conducted on 180 women using a non-probability convenience sampling technique. Participants were women aged 18–45 years presenting to the gynecology department over a 6months period. Data were collected using a structured questionnaire covering demographic details, sexual and reproductive history, behavioral factors, and past medical history. Clinical diagnosis of PID was confirmed based on standard criteria including pelvic pain, cervical motion tenderness, and laboratory findings where applicable. Data were analyzed using descriptive statistics and chi-square tests to identify associations between risk factors and PID occurrence. Results: Among the 180 participants, the prevalence of clinically diagnosed PID was 28% (n = 50). Significant risk factors included age 18–25 years (p = 0.01), multiple sexual partners (p = 0.003), history of prior sexually transmitted infections (p < 0.001), vaginal douching (p = 0.02), and smoking (p = 0.04). Procedural risk factors such as recent intrauterine device insertion were observed in 6% of participants but showed a non-significant association with PID. Conclusions: PID prevalence in this cohort is substantial, with behavioral, demographic, and personal health factors significantly contributing to risk. Targeted screening, health education on safe sexual practices, discouraging vaginal douching, and promoting smoking cessation are recommended to reduce PID burden in women attending gynecology services in Quetta. Downloads

1. Asghar, F. (2019). Pelvic Inflammatory Disease and IUCD. Pakistan Armed Forces Medical Journal, 69(6), 1221–1225. https://pafmj.org/PAFMJ/article/download/2887/2225/6974 2. Bhurt, A. W., Fikree, F. F., Bhurt, A. M., Channa, G. Z., Soomro, R. A., & Bhurt, N. (1999). Prevalence and risk factors of symptoms of pelvic inflammatory disease in a rural community of Jamshoro, Sindh, Pakistan. JPMA. The Journal of the Pakistan Medical Association, 49(8), 188–194. https://pubmed.ncbi.nlm.nih.gov/10641502/ 3. Brunham, R. C., Gottlieb, S. L., & Paavonen, J. (2015). Pelvic inflammatory disease. The New England journal of medicine, 372(21), 2039–2048. https://doi.org/10.1056/NEJMra1411426 4. He, D., Wang, T., & Ren, W. (2023). Global burden of pelvic inflammatory disease and ectopic pregnancy from 1990 to 2019. BMC Public Health, 23(1), 1894. https://link.springer.com/article/10.1186/s12889-023-16663-y 5. Amir, Z. and A. Shah (2024). "Maternal Cardiovascular Health After Complicated Pregnancies: Insights from Preeclampsia and IUGR Cases in Pakistan." Pakistan Journal of Clinical Research 1(1): 6-9. 6. Islam, M. S., & Khan, M. A. (2023). Nurses' knowledge and practice regarding pelvic inflammatory disease. Saudi Journal of Nursing and Health Care, 10(1), 369–377. https://saudijournals.com/media/articles/SJNHC_610_369-377.pdf 7. Kreisel, K., & Hatcher, R. A. (2017). Pelvic inflammatory disease. In Contraceptive Technology (21st ed., pp. 563–576). Ayer Company Publishers. 8. Lopez-Zeno, J. A., Keith, L. G., & Berger, G. S. (1985). The Fitz-Hugh-Curtis syndrome revisited. Changing perspectives after half a century. The Journal of reproductive medicine, 30(8), 567-582. https://europepmc.org/article/med/2931518 9. Mayo Clinic. (2022). Pelvic inflammatory disease (PID) - symptoms and causes. Mayo Clinic. 10. Mohllajee, A. P., Curtis, K. M., & Peterson, H. B. (2006). Pelvic inflammatory disease and infertility: A review of the literature. Obstetrics & Gynecology, 107(3), 671–680. https://doi.org/10.1097/01.AOG.0000199506.30945.5d 11. Ness, R. B., Hillier, S. L., Richter, H. E., Soper, D. E., Stamm, W. E., & McGregor, J. A. (2004). A cluster randomized trial of chlamydia screening in pregnancy. Obstetrics & Gynecology, 103(3), 561–568. https://doi.org/10.1097/01.AOG.0000116949.78552.0b 12. Rajput, H. A., & Khan, M. A. (2025). Impact of antibiotic stewardship on the management of pelvic inflammatory disease: A multicenter gynecological and public health perspective in Pakistan. Cureus, 17(3), e37359. https://doi.org/10.7759/cureus.37359 13. Sami, N., & Saeed Ali, T. (2012). Perceptions and Experiences of Women in Karachi, Pakistan Regarding Secondary Infertility: Results from a Community-Based Qualitative Study. Obstetrics and Gynecology International, 6(2), 1–7. https://doi.org/10.1155/2012/108756 14. StatPearls. (2023). Pelvic inflammatory disease. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.statpearls.com/ArticleLibrary/viewarticle/15556 15. Pakyanadhan, S. (2018). Pelvic inflammatory disease and the risk factors. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(9), 3573. http://dx.doi.org/10.18203/2320-1770.ijrcog20183373 16. World Health Organisation. (2008, August 27). Closing the gap in a generation: health equity through action on the social determinants of health. Www.who.int. https://www.who.int/publications/i/item/9789241563703 17. Yousif, M. G., Al-Amran, F. G., Sadeq, A. M., & Yousif, N. G. (2023). Prevalence and associated factors of human papillomavirus infection among Iraqi women. arXiv preprint arXiv:2307.14806. https://doi.org/10.48550/arXiv.2307.14806 18. Naaz, F., Khan, N., & Mastan, A. (2016). Risk factors of pelvic inflammatory disease: A prospective study. Int J Herbal Med, 4(4), 129-133. 19. Bhurt, A. W., Fikree, F. F., Bhurt, A. M., Channa, G. Z., Soomro, R. A., & Bhurt, N. (1999). Prevalence and risk factors of symptoms of pelvic inflammatory disease in a rural community of Jamshoro, Sindh, Pakistan. Journal of Pakistan Medical Association, 49(8), 188. https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/652/ 20. Asghar, F. (2019). Pelvic Inflammatory Disease and IUCD. Pakistan Armed Forces Medical Journal, 69(6), 1221–1225. 21. Darville, T. (2021). Pelvic inflammatory disease. New England Journal of Medicine, 385(12), 1149–1159. 22. Hubacher, D., Trussell, J., & Lader, D. (2014). Pelvic inflammatory disease risk among users of intrauterine devices: A systematic review. Obstetrics & Gynecology, 123(6), 1145–1152. 23. Kreisel, K., & Hatcher, R. A. (2017). Pelvic inflammatory disease. In Contraceptive Technology (21st ed., pp. 563–576). Ayer Company Publishers. 24. Lopez-Zeno, J. A., Keith, L. G., & Berger, G. S. (1985). The Fitz-Hugh-Curtis syndrome revisited. Changing perspectives after half a century. The Journal of reproductive medicine, 30(8), 567-582. https://europepmc.org/article/med/2931518 25. Mayo Clinic. (2022). Pelvic inflammatory disease (PID) - symptoms and causes. Mayo Clinic. 26. Mohllajee, A. P., Curtis, K. M., & Peterson, H. B. (2006). Pelvic inflammatory disease and infertility: A review of the literature. Obstetrics & Gynecology, 107(3), 671–680. 27. Ness, R. B., Hillier, S. L., Richter, H. E., Soper, D. E., Stamm, W. E., & McGregor, J. A. (2004). A cluster randomized trial of chlamydia screening in pregnancy. Obstetrics & Gynecology, 103(3), 561–568. 28. Rajput, H. A. S., Suffyan, M., Jabeen, S., Noureen, M., Shaheen, R., Noor, S., & Imran, S. (2025). Impact of Antibiotic Stewardship on the Management of Pelvic Inflammatory Disease: A Multicenter Gynecological and Public Health Perspective in Pakistan. Cureus, 17(7). https://assets.cureus.com/uploads/original_article/pdf/392948/20250824-52424-plaikb.pdf 29. Sami, N., & Khan, M. A. (2012). Perceptions and experiences of women in Karachi regarding infertility. International Journal of Fertility & Sterility, 6(2), 108–115. 30. Franco, P. N., García-Baizán, A., Aymerich, M., Maino, C., Frade-Santos, S., Ippolito, D., & Otero-García, M. (2023). Gynaecological causes of acute pelvic pain: common and not-so-common imaging findings. Life, 13(10), 2025. Downloads Published Issue Section License Copyright (c) 2025 Indus Journal of Bioscience Research This work is licensed under a Creative Commons Attribution 4.0 International License.