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DR. RAZIA AKTER
FCPS ( Gynae & Obst.)
Assistant Professor
Dhaka Community Medical College & Hospital,
Moghbazar , Dhaka
PID is the spectrum of infection and inflammation of the upper
genital organs typically involving the
 uterus ( endometrium),
 fallopian tubes ,
 ovaries ,
 pelvic peritonium and
 surrounding structures (parametrium)
 Ascending spread of infection from cervico-vaginal
canal to the contiguous pelvic structures.
 Not related to pregnancy or surgical condition
The terminology is currently used to express
the specific organ pathology :
Endometritis
Salphingitis
Pelvic peritonitis
Tubo-ovarian abscess
Parametritis
Cervicitis is not included
Incidence :
1-2% among sexually active women
85% are spontaneous infection in sexually active females of
reproductive age.
Risk factors :
1. Menstruating teenagers
2. Multiple sexual partners
3. Abscence of use of
contraceptive pill
4. IUD uses
5. IUD uses
6. Previous H/o acute PID
7. Sexual partner has STDs
8. Poor socio-economic
status.
 Barrier methods specially condoms
 Oral contraceptive have 2 preventive
aspects
1. Produce thick mucous plug preventing ascends of sperm
and bacterial penetration
2. Decrease in duration of menstruation creates a shorter
interval of bacterial colonization of the upper tract
 Pregnancy
 Menopause
 Vaccines eg: Hepatitis B, HPV
Acute PID is usually a poly-microbial infection
( ascending uptair from downstair)
Primary common :
Nisseria gonorrhea- 30%
Chlamydia trachomatis- 30%
Mycoplasma hominis – 10%
2ndary organism is normally found in vagina :
Aerobic – E. coli , Staphylococcus, streptococcus B
Anerobic - Bacteroids fragilis & bovis , peoto streptococcus
1. The classic concept is
 Gonococcus ascends up to affect the tubes through
mucosal continuity and contiguity
 Reflux of menstrual blood along with gonococcus into the
fallopian tubes
2. Mycoplasma hominis - spreads across – the
paramatium to affect the tube
3. 2ndary organism affects the tube -through
lymphatics.
4. Organism from the gut affect tube- directly

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PID.pptx

  • 1. DR. RAZIA AKTER FCPS ( Gynae & Obst.) Assistant Professor Dhaka Community Medical College & Hospital, Moghbazar , Dhaka
  • 2. PID is the spectrum of infection and inflammation of the upper genital organs typically involving the  uterus ( endometrium),  fallopian tubes ,  ovaries ,  pelvic peritonium and  surrounding structures (parametrium)  Ascending spread of infection from cervico-vaginal canal to the contiguous pelvic structures.  Not related to pregnancy or surgical condition
  • 3. The terminology is currently used to express the specific organ pathology : Endometritis Salphingitis Pelvic peritonitis Tubo-ovarian abscess Parametritis Cervicitis is not included
  • 4. Incidence : 1-2% among sexually active women 85% are spontaneous infection in sexually active females of reproductive age. Risk factors : 1. Menstruating teenagers 2. Multiple sexual partners 3. Abscence of use of contraceptive pill 4. IUD uses 5. IUD uses 6. Previous H/o acute PID 7. Sexual partner has STDs 8. Poor socio-economic status.
  • 5.  Barrier methods specially condoms  Oral contraceptive have 2 preventive aspects 1. Produce thick mucous plug preventing ascends of sperm and bacterial penetration 2. Decrease in duration of menstruation creates a shorter interval of bacterial colonization of the upper tract  Pregnancy  Menopause  Vaccines eg: Hepatitis B, HPV
  • 6. Acute PID is usually a poly-microbial infection ( ascending uptair from downstair) Primary common : Nisseria gonorrhea- 30% Chlamydia trachomatis- 30% Mycoplasma hominis – 10% 2ndary organism is normally found in vagina : Aerobic – E. coli , Staphylococcus, streptococcus B Anerobic - Bacteroids fragilis & bovis , peoto streptococcus
  • 7. 1. The classic concept is  Gonococcus ascends up to affect the tubes through mucosal continuity and contiguity  Reflux of menstrual blood along with gonococcus into the fallopian tubes 2. Mycoplasma hominis - spreads across – the paramatium to affect the tube 3. 2ndary organism affects the tube -through lymphatics. 4. Organism from the gut affect tube- directly