Am J Obstet Gynecol. 2008 Jan;198(1):30.e1-7.
Do short-term markers of treatment efficacy
predict long-term sequelae of pelvic
inflammatory disease?
Trautmann GM, Kip KE, Richter HE, Soper DE,
Peipert JF, Nelson DB, Trout W, Schubeck D, Bass
DC, Ness RB.
University of Pittsburgh School of Public
Health, Pittsburgh, PA 15261, USA.
Objectives:
This study was undertaken to assess
whether short-term markers, often used to
measure clinical cure after treatment for pelvic
inflammatory disease, predict sequelae of lack
of pregnancy, recurrent pelvic inflammatory
disease, and chronic pelvic pain.
Study Design:
Women with mild-to-moderate pelvic inflammatory
disease were assessed after treatment initiation
at 5 days for tenderness (n = 713) and at 30
days for tenderness, cervical infections and
endometritis (n = 298). Pregnancy, recurrent
pelvic inflammatory disease, and chronic pelvic
pain were evaluated after 84 months, on average.
Results:
Pelvic tenderness at 5 and at 30 days
significantly elevated the risk for developing
chronic pelvic pain; tenderness at 30 days was
also significantly associated with recurrent
pelvic inflammatory disease. However, pelvic
tenderness at 5 and at 30 days was only modestly
clinically predictive of chronic pelvic pain or
recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term
marker significantly influenced the likelihood
of achieving a pregnancy.
Conclusion:
Tenderness
at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory
disease-related reproductive morbidities.
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