Long-term Sequelae of Pelvic Inflammatory Disease: Tubal Factor Infertility, Ectopic Pregnancy, and Chronic Pelvic Pain

In: Pelvic Inflammatory Disease · 1997 · pp. 152–169 · doi:10.1007/978-1-4612-0671-2_11 · W13882017
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Pelvic inflammatory disease can cause tissue destruction and scarring leading to tubal factor infertility, ectopic pregnancy, and chronic pelvic pain, with similar sequelae observed in silent PID.

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This paper reviews the long-term sequelae of pelvic inflammatory disease, focusing on three outcomes—tubal factor infertility, ectopic pregnancy, and chronic pelvic pain—using evidence from follow-up studies, seroepidemiologic data on both symptomatic and “silent” infections, and animal models of PID pathogenesis. It emphasizes that tissue destruction and scarring in the absence of aggressive treatment can produce persistent fallopian tube morphological changes, and that untreated or inadequately treated sexually transmitted pelvic infections are linked to reduced fertility. A major limitation is that the article is a narrative synthesis rather than a single original study with uniform methods, and it relies heavily on observational associations and model-based inference. Relevance to endometriosis: the paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

In pelvic inflammatory disease (PID) there is a process of tissue destruction and scarring that, in the absence of aggressive treatment, may lead to irrevocable changes in fallopian tubal morphology. The implications for subsequent fertility have been recognized since the last century. Women with untreated or inadequately treated pelvic infections due to sexually transmitted diseases (STDs) are less fertile.1 With the use of follow-up studies, three major sequelae of symptomatic PID have been identified: tubal factor infertility (TFI), ectopic pregnancy, and chronic pelvic pain.2–4 Results from seroepidemiological studies have associated similar sequelae with “silent” or unrecognized PID.5 Animal models of PID pathogenesis have also provided some additional data on the development of sequelae. The considerable physical and economic cost ($1 billion in the United States in 1990) associated with these sequelae further justifies greater efforts to develop intervention strategies to prevent PID.6 Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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Long-term Sequelae of Pelvic Inflammatory Disease: Tubal Factor Infertility, Ectopic Pregnancy, and Chronic Pelvic Pain. In: Landers, D.V., Sweet, R.L. (eds) Pelvic Inflammatory Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-0671-2_11 Download citation DOI: https://doi.org/10.1007/978-1-4612-0671-2_11 Publisher Name: Springer, New York, NY Print ISBN: 978-1-4612-6863-5 Online ISBN: 978-1-4612-0671-2 eBook Packages: Springer Book Archive

Keywords

- Ectopic Pregnancy - Chlamydia Trachomatis - Pelvic Inflammatory Disease - Chronic Pelvic Pain - Neisseria Gonorrhoeae These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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