PID

Pelvic Inflammatory Disease

Pelvic Inflammatory Disease

Introduction

Pelvic Inflammatory Disease (PID) is an infection that is ascending in nature; it passes from the vagina through the cervix and isthmus of the uterus up to the fallopian tubes. These infections sometimes involve the ovaries as well. Bacteria and other micro-organisms are the causative agents in the spread of infections up the genital tract(Pelvic Inflammatory Disease, 2013).

Discussion

Etiology

PID is mostly caused by the bacteria Chlamydia Trachomatis, Haemophilus Influenzae and Neisseria Gonorrhea etc. According to laparoscopic studies 30 to 40 percent of cases of PIDs are polymicrobial. These are the sexually transmitted organisms and the most common way females acquire them is having unprotected sex with someone who has been harbouring STD infection(Pelvic Inflammatory Diseases, 2013). However, bacteria may enter the genital system through some surgical interventions and procedures like Delivery, Endometrial biopsy, IUCDs, therapeutic infections etc.

Cultures of vaginal swaps reveal polymicrobial infections in 30 to 40 percent of cases. These microbes cause inflammation of upper genital tract that facilitates the growth of further organisms and abscess formation. The microscopic examination of specimen reveal sexually transmitted pathogen population varying in numbers in Bacteria Vaginosis which is an infection caused by normal flora that colonize vagina when immunity of host is compromised.

Pelvic Inflammatory Infections can be a tuberculous type such as granulomatous salpingitis ( tuberculous infection of ovarian epithelium). Co infections with Bacterial Vaginosis are associated with histological findings of Acute Endometritis (acute inflammation of Endometrium of uterus), fallopian tube inflammation and lower tract ulcerations that may cause destruction of endocervical mucousal barrier(PID, 2013). Women with HIV infections also have increase risk of progression to pelvic inflammation disease. PID ranked in the 5 top most diseases globally for seeking clinical help. The poor sanitation and unhygienic conditions support the spread of Sexually Transmitted Diseases.

Risk Factors

Frequent vaginal douch usage , endometrial biopsy, a history of previous sexually transmitted disease and sexual abuse has been considered as risk factors for PID. The increased cervical mucosal permeability and lower concentration of protective anti chlamydial antibodies can dispose to causation of infection.

Oral contraceptive pills (OCPs) are found out to increase the risk of Endocervical infections according to some researches where as other studies suggest that OCPs have no effects on PID incidence. Similarly Contraceptive Intra-Uterine Devices have also believed to be the risk factors for Sexually Transmitted Diseases. The tubal ligation techniques to block fallopian tubes patency are found out to decrease the risk for pelvic infections.

Patho physiology

The exact path and nature is unknown as to how infections ascend from the lower genital tract . The cervical mucous provides a barrier for the bacteria from ascending upwards and due to inflammation the efficacy of this barrier can be decreased and also by pH changes occurring due to ovulation and menstruation. Antibiotic treatments for other systemic infections can disrupt the normal flora in the vaginal epithelium causing non-vulnerable organisms to overgrow and cause localized infections. In cases of Endometriosis, the retro grade flow of menstruation can allow suitable environment for ...