Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?

Gail Trautmann, Kevin E. Kip, Holly E. Richter, David E. Soper, Jeffrey F. Peipert, Deborah B. Nelson, Wayne Trout, Dianne Schubeck, Debra C. Bass, Roberta B. Ness
In: American Journal of Obstetrics and Gynecology · 2008 · vol. 198(1) , pp. 30.e1–30.e7 · doi:10.1016/j.ajog.2007.05.021 · PMID:18166300 · W1987497494
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This paper investigated whether early treatment response indicators can predict the long-term health outcomes and complications of pelvic inflammatory disease.

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Abstract

ObjectiveThis study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.Study designWomen with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.ResultsPelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.ConclusionTenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.

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