Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is inflammation of the female upper genital tract- the uterus, fallopian tubes and ovaries. Most cases of PID are caused by an infection in the vagina or cervix that has spread to the pelvic organs higher up.

Causes of Pelvic inflammatory disease

  • D & C
  • Hysterosalpingography
  • Manual removal of placenta
  • Douche
  • Endogenous microorganism
  • Post-abortal and puerperal sepsis
  • IUCD
  • More than 1 sex partner
  • Sexually transmitted diseases(Gonococcal, Chlamydia)¬† ¬† ¬†
  • Tuberculosis¬†
  • Pelvic peritonitis (appendicitis)
  • Diverticulitis

Symptoms and signs

  • Abnormal discharge from vagina or cervix
  • Abscesses near ovaries and tubes
  • Bilateral lower abdominal pain
  • Bleeding between periods and after sex
  • Cervical movement tenderness
  • Discomfort or pain during sexual intercourse that is felt deep inside the pelvis
  • Fever(high grade) and vomiting
  • Fixed, tender pelvic mass in lateral fornices
  • Irregular menstruation
  • Pain in the rectum (back passage)
  • Unusual vaginal discharge( yellow or green)

Investigations

  • Test  for STDs (HIV and syphilis)
  • Urine test for UTI
  • Pelvic ultrasound
  • Blood counts
  • Cervical and Vaginal swab culture
  • CT and MRI

Treatment

  • Ayurvedic Medicines
  • Surgery

Complications

  • Recurrent PID
  • Abscesses
  • Ectopic pregnancy
  • Infertility

Prevention

  • Hospital delivery
  • Avoid septic abortion
  • Barrier method i.e. condom, Oral contraceptive pills( especially minipills)
  • In suspected cases, IUCD should be avoided
  • The female condom
  • Prompt treatment with antibiotics

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