Pelvic inflammatory disease

1. PELVIC
INFLAMMATORY
DISEASE (PID)
BHAVYA RAVAL
MSC IN CLINICAL EMBRYOLOGY AND ASSISSTED REPRODUCTIVE TECHNOLOGY
DEPARTMENT OF BIOCHEMISTRY AND FORENSIC SCIENCE
GUJARAT UNIVERSITY

2. OVERVIEW
Pelvic inflammatory disease (PID) is an
infection of the female reproductive organs. It
most often occurs when sexually transmitted
bacteria spread from your vagina to your
uterus, fallopian tubes or ovaries.

3. INTRODUCTION
Pelvic inflammatory disease (PID) is an infection of one or more
of the upper reproductive organs, including the uterus, fallopian
tubes and ovaries. Untreated can cause scar tissue and pockets
of infected fluid (abscesses) to develop in the reproductive tract,
which can cause permanent damage.
The signs and symptoms of pelvic inflammatory disease can be subtle
or mild. Some women don't experience any signs or symptoms. As a
result, you might not realize you have it until you have trouble getting
pregnant or you develop chronic pelvic pain.
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4. SYMPTOMS
The signs and symptoms of pelvic inflammatory disease might be mild and difficult to recognize. Some women don't have any signs or symptoms. When
signs and symptoms of pelvic inflammatory disease (PID) are present, they most often include:
• Pain — ranging from mild to severe — in your lower abdomen and pelvis
• Unusual or heavy vaginal discharge that may have an unpleasant odor
• Unusual bleeding from the vagina, especially during or after sex, or between periods
• Pain during sex
• Painful, frequent or difficult urination
• Fever, sometimes with chills

5. CAUSES
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• Many types of bacteria can cause PID, but gonorrhoea or chlamydia infections are the most common. These
bacteria are usually acquired during unprotected sex.
• Less commonly, bacteria can enter your reproductive tract anytime the normal barrier created by the cervix is
disturbed. This can happen during menstruation and after childbirth, miscarriage or abortion. Rarely, bacteria
can also enter the reproductive tract during the insertion of an intrauterine device (IUD) — a form of long-
term birth control — or any medical procedure that involves inserting instruments into the uterus.

6. RISK FACTORS
A number of
factors might
increase your risk
of pelvic
inflammatory
disease, including:
Being sexually
active and
younger than
25 years old
Having multiple sexual
partners
Being in a sexual
relationship with
someone who has more
than one sex partner
Having sex without a
condom
Douching regularly,
which upsets the
balance of good versus
harmful bacteria in the
vagina and might mask
symptoms
Having a history of
pelvic inflammatory
disease or a sexually
transmitted
infection
There is a small
increased risk
of PID after the insertion
of an intrauterine device
(IUD). This risk is
generally confined to the
first three weeks after
insertion.
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7. COMPLICATIONS
Ectopic pregnancy. PID is a major cause of tubal (ectopic)
pregnancy. An ectopic pregnancy can occur when
untreated PID has caused scar tissue to develop in the
fallopian tubes. The scar tissue prevents the fertilized egg
from making its way through the fallopian tube to implant in
the uterus. Instead, the egg implants in the fallopian tube.
Ectopic pregnancies can cause massive, life-threatening
bleeding and require emergency medical attention.
Infertility. Damage to your reproductive organs may cause
infertility — the inability to become pregnant. The more
times you've had PID, the greater your risk of infertility.
Delaying treatment for PID also dramatically increases your
risk of infertility.
Chronic pelvic pain. Pelvic inflammatory disease can cause
pelvic pain that might last for months or years. Scarring in
your fallopian tubes and other pelvic organs can cause pain
during intercourse and ovulation.
Tubo-ovarian abscess. PID might cause an abscess — a
collection of pus — to form in your reproductive tract. Most
commonly, abscesses affect the fallopian tubes and ovaries,
but they can also develop in the uterus or in other pelvic
organs. If an abscess is left untreated, you could develop a
life-threatening infection.
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Untreated pelvic inflammatory disease might cause scar tissue and pockets of infected fluid (abscesses) to
develop in the reproductive tract. These can cause permanent damage to the reproductive organs

8. PREVENTION
To reduce your
risk of pelvic
inflammatory
disease:
•Practice safe sex. Use condoms every time you have
sex, limit your number of partners and ask about a
potential partner's sexual history.
•Talk to your health care provider about
contraception. Many forms of contraception do not
protect against the development of PID. Using
barrier methods, such as a condom, helps to reduce
your risk. Even if you take birth control pills, use a
condom every time you have sex with a new partner
to protect against STIs.
•Get tested. If you're at risk of an STI, make an
appointment with your provider for testing. Set up a
regular screening schedule with your provider if
needed. Early treatment of an STI gives you the best
chance of avoiding PID.
•Request that your partner be tested. If you have
pelvic inflammatory disease or an STI, advise your
partner to be tested and treated. This can prevent the
spread of STIs and possible recurrence of PID.
•Don't douche. Douching upsets the balance of
bacteria in your vagina.

9. DIAGNOSIS
Your medical history. Your provider will likely ask
about your sexual habits, history of sexually
transmitted infections and method of birth control.
Signs and symptoms. Tell your provider about any
symptoms you're experiencing, even if they're mild.
•A pelvic exam. During the exam, your provider will
check your pelvic region for tenderness and swelling.
Your provider may also use cotton swabs to take fluid
samples from your vagina and cervix. The samples
will be tested at a lab for signs of infection and
organisms such as gonorrhea and chlamydia.
• Ultrasound. This test uses sound waves to
create images of your reproductive organs.
• Laparoscopy. During this procedure, your
provider inserts a thin, lighted instrument through a
small incision in your abdomen to view your pelvic
organs.
Endometrial biopsy. During this procedure, your
provider inserts a thin tube into the uterus to remove
a small sample of endometrial tissue. The tissue is
tested for signs of infection and inflammation.

10. TREATMENT
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Prompt treatment with medicine can get rid of the
infection that causes pelvic inflammatory disease.
But there's no way to reverse any scarring or
damage to the reproductive tract that pelvic
inflammatory disease (PID) might have caused.
Treatment for PID most often includes:
•Antibiotics. Your health care provider will
prescribe a combination of antibiotics to start
immediately. After receiving your lab test results,
your provider might adjust your prescription to
better match what's causing the infection. You'll
likely follow up with your provider after three
days to make sure the treatment is working. Be
sure to take all of your medication, even if you
start to feel better after a few days.
•Treatment for your partner. To prevent
reinfection with an sexually transmitted infection
(STI), your sexual partner or partners should be
examined and treated. Infected partners might
not have any noticeable symptoms.
•Temporary abstinence. Avoid sexual intercourse
until treatment is completed and symptoms have
resolved.
If you're pregnant, seriously
ill, have a suspected abscess
or haven't responded to oral
medications, you might
need hospitalization. You
might receive intravenous
antibiotics, followed by
antibiotics you take by
mouth.
Surgery is rarely needed.
However, if an abscess
ruptures or threatens to
rupture, your provider might
drain it. You might also need
surgery if you don't respond
to antibiotic treatment or have
a questionable diagnosis, such
as when one or more of the
signs or symptoms of PID are
absent.

11. THANK YOU