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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Up to 70% of cases of pelvic inflammatory disease do not have a known cause. We recruited 115 women who had presented to a clinic for sexually transmitted diseases in Nairobi, Kenya with pelvic pain that had persisted for 14 days or less, to look for an association between Mycoplasma genitalium and endometritis. With PCR, we detected M genitalium in the cervix, endometrium, or both in nine (16%) of 58 women with histologically confirmed endometritis and in one (2%) of 57 women without endometritis (p=0.02). Our results suggest that infection with M genitalium is strongly associated with acute endometritis in this population.
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PMID:Association between Mycoplasma genitalium and acute endometritis. 1188 91

354 women seeking abortions were treated at a hospital in Paris between February-September 1988 with 600 mg of RU 486 taken orally in 1 dose and an injection of 500 mg sulprostone 48 hours later. The women all had amenorrhea of less than 49 days. 1/3 were 18-25 years old, 1/2 were 25-35, and 16% were over 35. 206 were nulliparas. 110 were married and the rest were separated, widowed, divorced, or single. Sulprostone was injected early in the morning in the hospital and the women were discharged after expulsion of the products of conception, which occurred usually 2 1/2 to 3 1/2 hours later. If expulsion did not occur, the woman returned in 3 days for a sonogram to confirm uterine vacuity. 13 of the 354 women had RU 486 only. 2 refused the sulprostone and underwent aspiration and 11 experienced spontaneous expulsions in the 48 hours following RU 486 administration. 338 of the women had spontaneous expulsions. 2 pregnancies were terminated but not expelled and aspiration was required. 285 of the women expelled in the hospital within 4 hours of sulprostone administration and the other 55 did so at home 6 or more hours later. RU 486 was very well tolerated. Secondary effects were more common with sulprostone but generally subsided within 3 hours. 70 patients required treatment for uterine pain after sulprostone administration. 150 complained of nausea but only 6 required treatment. 5 women required aspiration of curettage for hemorrhage but none required transfusion. In 3 cases the hemorrhages were due to histologically proven retention. 1 patient developed endometritis 3 days after expulsion and another, who had a history of extrauterine pregnancy, developed salpingitis 15 days after expulsion. Both patients were treated with antibiotics. The method appears to be safe and effective. Its major disadvantages are that it prolongs the amount of time required for abortion and it frequently causes pelvic pain. The responsibility of the patient is also increased.
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PMID:[Clinical trial of pregnancy terminations in 353 patients where amenorrhea was present for less than 49 days by 600 mg of RU 486 (administered orally) and 500 mg of sulprostone (Nalador) administered intramuscularly]. 1228 75

As part of a multinational trial, this study compared the safety and efficacy of the TCu 200 IUD with the locally used TCu 200 IUD at the Maternity Hospital in Thapathali, Kathmandu, Nepal, with 24 months of subject follow-up. 200 subjects were enrolled over a 7-month enrollment period beginning in November 1981. By random allocation, 100 subjects received the TCu 380A IUD and 100 subjects received the TCu 200 IUD. All subjects had the IUDs inserted 6 weeks or more after the end of their last pregnancy. The mean age was 23.1 years for the TCu 380 IUD group and 23.5 years for the TCu 200 IUD group. All subjects in each IUD study group had at least 1 live birth prior to admission into the study and the overall mean was similar for both study groups. The only insertion-related complaint reported was mild pelvic pain: in 16.0% of the women receiving the TCu 380A and 19.0% of those receiving the TCu; this difference was not statistically significant. Menorrhagia was reported in both the TCu 380A and TCu 200 IUD groups (3% and 5%, respectively). Intermenstrual pelvic pain, spotting, and bleeding were also reported, although the proportion of subjects in either study group experiencing these complaints did not exceed 7%. One case of pelvic inflammatory disease, i.e., endometritis, in a TCu 200 IUD user was reported, but no cases were reported among TCu 380A users. One case of a mucoid vaginal discharge was reported in each IUD study group. Significantly more TCu 200 IUD users (p = 0.02) experienced removal of their IUD during the 24-month follow-up period for personal reasons than did TCu 380A IUD users (6.7 and 1.2 per 100 women, respectively; p = 0.02). The overall continuation rate at 24 months was higher for TCu 380A IUD users than for TCu 200 IUD users (82.8 and 14.9 per 100 women, respectively), although this difference was not statistically significant (p = 0.18).
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PMID:A comparative study of the TCu 380A versus TCu 200 IUDs in Nepal. 1231 65

Douching has been linked to gonococcal or chlamydial cervicitis and pelvic inflammatory disease (PID) in retrospective studies. The authors conducted a 1999-2004 prospective observational study of 1,199 US women who were at high risk of acquiring chlamydia and were followed for up to 4 years. Cervical Neisseria gonorrhoeae and Chlamydia trachomatis were detected from vaginal swabs by nucleic acid amplification. PID was characterized by histologic endometritis or pelvic pain and tenderness plus one of the following: oral temperature >38.3 degrees C, leukorrhea or mucopus, erythrocyte sedimentation rate >15 mm/hour, white blood cell count >10,000, or gonococcal/chlamydial lower genital tract infection. Associations between douching and PID or gonococcal/chlamydial genital infections were assessed by proportional hazards models. The 4-year incidence rate of PID was 10.9% and of gonococcal and/or chlamydial cervicitis was 21.9%. After adjustment for confounding factors, douching two or more times per month at baseline was associated with neither PID (adjusted hazard ratio = 0.76, 95% confidence interval: 0.42, 1.38) nor gonococcal/chlamydial genital infection (adjusted hazard ratio = 1.16, 95% confidence interval: 0.76, 1.78). Frequency of douching immediately preceding PID or gonococcal/chlamydial genital infection was not different between women who developed versus did not develop outcomes. These data do not support an association between douching and development of PID or gonococcal/chlamydial genital infection among predominantly young, African-American women.
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PMID:Douching, pelvic inflammatory disease, and incident gonococcal and chlamydial genital infection in a cohort of high-risk women. 1563 69

Controversy surrounds the association between bacterial vaginosis (BV) and pelvic inflammatory disease (PID). Women (N = 1,140) were ascertained at five US centers, enrolled (1999-2001), and followed up for a median of 3 years. Serial vaginal swabs were obtained for Gram's stain and cultures. PID was defined as 1) histologic endometritis or 2) pelvic pain and tenderness plus oral temperature >38.8 degrees C, leukorrhea or mucopus, erythrocyte sedimentation rate >15 mm/hour, white blood cell count >10,000, or gonococcal/chlamydial lower genital infection. Exploratory factor analysis identified two discrete clusters of genital microorganisms. The first correlated with BV by Gram's stain and consisted of the absence of hydrogen peroxide-producing lactobacillus, Gardnerella vaginalis, Mycoplasma hominis, anaerobic gram-negative rods, and, to a lesser degree, Ureaplasma urealyticum. The second, unrelated to BV by Gram's stain, consisted of Enterococcus species and Escherichia coli. Being in the highest tertile in terms of growth of BV-associated microorganisms increased PID risk (adjusted rate ratio = 2.03, 95% confidence interval: 1.16, 3.53). Carriage of non-BV-associated microorganisms did not increase PID risk. Women with heavy growth of BV-associated microorganisms and a new sexual partner appeared to be at particularly high risk (adjusted rate ratio = 8.77, 95% confidence interval: 1.11, 69.2). When identified by microbial culture, a combination of BV-related microorganisms significantly elevated the risk of acquiring PID.
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PMID:A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. 1609 89

Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. The spectrum of disease ranges from subclinical, asymptomatic infection to severe, life-threatening illness; sequelae include chronic pelvic pain, ectopic pregnancy, and infertility. PID is diagnosed clinically, with laboratory and imaging studies reserved for patients who have an uncertain diagnosis, are severely ill, or do not respond to initial therapy. The Centers for Disease Control and Prevention diagnostic criteria include uterine, adnexal, or cervical motion tenderness with no other obvious cause in women at risk of PID. Empiric treatment should be initiated promptly and must cover Chlamydia trachomatis and Neisseria gonorrhoeae; the possibility of fluoroquinolone-resistant N. gonorrhoeae also should be considered. Hospitalization for initial parenteral therapy is necessary for patients with tubo-ovarian abscess and for those who are pregnant, severely ill, unable to follow a prescribed treatment plan, or unable to tolerate oral antibiotics. Patients also should be hospitalized if a surgical emergency cannot be excluded or if no clinical improvement occurs after three days. Routine screening for asymptomatic chlamydial infection can help prevent PID and its sequelae.
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PMID:The challenge of pelvic inflammatory disease. 1652 95

Pelvic inflammatory disease (PID) is a frequent condition of young women, often resulting in reproductive morbidity. Although Neisseria gonorrhoeae and/or Chlamydia trachomatis are/is recovered from approximately a third to a half of women with PID, the etiologic agent is often unidentified. We need PCR to test for M genitalium among a pilot sample of 50 women with nongonococcal, nonchlamydial endometritis enrolled in the PID evaluation and clinical health (PEACH) study. All participants had pelvic pain, pelvic organ tenderness, and leukorrhea, mucopurulent cervicitis, or untreated cervicitis. Endometritis was defined as > or =5 surface epithelium neutrophils per x400 field absent of menstrual endometrium and/or > or =2 stromal plasma cells per x120 field. We detected M genitalium in 7 (14%) of the women tested: 6 (12%) in cervical specimens and 4 (8%) in endometrial specimens. We conclude that M genitalium is prevalent in the endometrium of women with nongonococcal, nonchlamydial PID.
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PMID:Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease. 1748 98

Because of the increasing number of cicatricial uteruses, uterine ruptures are likely to become more frequent. However, few cases discovered in the postpartum period are described in literature. Our case report describes a uterine rupture, which occurred during a quick vaginal delivery, in a patient with previous cesarian section. The diagnosis has been made few days after delivery, the patient presenting pelvic pain and fever. We do not disagree with the principle to check uterine scar only when suspicion of rupture, but we should keep in mind that in case of endometritis in the postpartum period, with cicatricial uterus, it would be necessary to research uterine rupture by fitted imaging.
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PMID:[A case of uterine rupture discovered in the postpartum period]. 1802 97

Determining the cause of acute pelvic pain in the female patient is often a clinical challenge. Diagnostic imaging can be invaluable in this situation. Ectopic pregnancy, pelvic inflammatory disease, and hemorrhagic ovarian cysts are the most commonly diagnosed gynecologic conditions presenting with acute pelvic pain. Ovarian torsion and degenerating fibroids occur less frequently. Other causes to consider include endometriosis, and postpartum causes such as endometritis, or ovarian vein thrombosis. Finally, nongynecologic conditions may overlap in their presentation of acute pelvic pain and should also be considered. The most important of these is acute appendicitis.
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PMID:Imaging of acute pelvic pain. 2208 69

Pelvic inflammatory diseases (PID) include salpingitis and endometritis. They usually result from the infection of upper genital tract by pathogens ascending from the cervix or the vagina. Since the clinical signs of uncomplicated forms are frequently mild or misleading, diagnosis require other exams such as microbiology (samples from the cervix and, if applicable, from the pelvis) and laparoscopy. Acute complications (pelvic abscesses, peritonitis) can occur, that call for both surgical drainage and antibiotics. Pelvic sequelae with permanent tubal alterations due to immuno-allergic reactions can also happen, that lead to chronic pelvic pain and infertility. Treatment consists in broad-spectrum antibiotics by oral route, combined with non steroid anti-inflammatory drugs. Atraumatic laparoscopic procedure can also be performed.
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PMID:[Pelvic inflammatory diseases]. 1923 Jul 39


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