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—-

  • D & C
  • Hystero-salpingography
  • Manual removal of placenta
  • Douche
  • Endogenous microorganism
  • Post-abortal and puerperal sepsis
  • IUCD
  • More than 1 sex partner
  • Sexually transmitted diseases(Gonococcal, Chlamidia)     
  • 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 pelvic inflammatory disease
  • 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
  • Female condom (Femshield) 
  • Prompt treatment with antibiotics

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