Chlamydia trachomatis and ectopic pregnancy: recent epidemiological findings.
ABSTRACT Genital Chlamydia trachomatis is common among young, sexually active people. Infections are most often asymptomatic but have potential long-term consequences for female reproductive health. The link between C. trachomatis and ectopic pregnancy is mainly based on early seroepidemiological case-control studies including women who had their sexual debut at a time at which testing was sparse. The purpose of the present review is to summarize recent findings in C. trachomatis and ectopic pregnancy epidemiology.
The number of prevalence studies is high but results are specific for the setting in which the study was conducted. High prevalences are often found among adolescents and young adults. At the same time, decreased ectopic pregnancy rates are reported. Registry studies from the Scandinavian countries have shown low ectopic pregnancy rates among women tested for C. trachomatis and diverging results considering whether women are at increased risk following infection.
Recent studies on C. trachomatis infection and ectopic pregnancy are few. The recent Scandinavian registry studies include women with diagnosed, and hence presumably treated, infections. The observation of low complication rates in these studies cannot be used as an argument against the importance of screening for C. trachomatis infections.
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ABSTRACT: Objectives To investigate the association between selected sexually transmitted infections (STIs) and the later occurrence of ectopic pregnancy. Methods A total of 125 women with ectopic pregnancy and 125 pregnant controls were recruited between January 2003 and February 2005 at Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, in Ankara, Turkey. Enzyme-linked immunosorbent assay was used to determine the prevalence of serum antibodies to Chlamydia (C.) trachomatis and to Herpes simplex virus (HSV)-2 IgG and, indirect immunofluorescence test was used to determine the prevalence of serum antibodies to Mycoplasma (M.) hominis and Ureaplasma (U.) urealyticum. Results The prevalence of C. trachomatis Ig G antibody in women with ectopic pregnancy (31/125; 25%) was significantly higher than in controls (12/125; 9.6%) (crude Odds Ratio [OR]: 3.1, 95% confidence interval [CI]: 1.51-6.38; p = 0.001). However, there was no significant association between C. trachomatis IgM; M. hominis IgG, IgM; U. urealyticum IgG, IGM; and HSV-2 IgG, and ectopic pregnancy. Conclusions Previous chlamydial infection plays an important role in the aetiology of ectopic pregnancy. There was no association between M. hominis, U. urealyticum and HSV-2 infections, and ectopic pregnancy.The European Journal of Contraception and Reproductive Health Care 12/2012; 18(1). DOI:10.3109/13625187.2012.744818 · 1.84 Impact Factor
Article: Ectopic pregnancy: a review[Show abstract] [Hide abstract]
ABSTRACT: Ectopic pregnancy (EP) presents a major health problem for women of child-bearing age. EP refers to the pregnancy occurring outside the uterine cavity that constitutes 1.2-1.4 % of all reported pregnancies. All identified risk factors are maternal: pelvic inflammatory disease, Chlamydia trachomatis infection, smoking, tubal surgery, induced conception cycle, and endometriosis. These developments have provided the atmosphere for trials using methotrexate as a non-surgical treatment for EP. The diagnosis measure of EP is serum human chorionic gonadotropin, urinary hCGRP/i-hCG, progesterone measurement, transvaginal ultrasound scan, computed tomography, vascular endothelial growth factor, CK, disintegrin and metalloprotease-12 and hysterosalpingography. The treatment option of EP involves surgical treatment by laparotomy or laparoscopy, medical treatment is usually systemic or through local route, or by expectant treatment. It was concluded that review data reflect a decrease in surgical treatment and not an actual decline in EP occurrence so that further new avenues are needed to explore early detection of the EP.Archives of Gynecology 06/2013; 288(4). DOI:10.1007/s00404-013-2929-2 · 1.28 Impact Factor
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ABSTRACT: Ectopic pregnancy remains a major public health problem especially in many developing countries where it is a significant contributor to pregnancy related morbidity and mortality. To determine the association between prior Chlamydia trachomatis infection and the risk of ectopic pregnancy. A case-control study from two tertiary health care facilities in Benin City, Nigeria. Ninety eight women with ectopic pregnancy (cases) and another 98 women with uncomplicated intrauterine pregnancy (controls) matched for age, were interviewed using a semi-structured questionnaire and evaluated for serological evidence of prior Chlamydia trachomatis infection. The antibody titres in cases (48%) were significantly higher than in controls (16.3%) (p<0.001). However, the association between Chlamydia antibodies and ectopic pregnancy was attenuated when the effects of indicators of previous pelvic infections, socio-demographic characteristics, contraceptive and sexual history were controlled for. Primary level of education (OR = 6.32; CI, 2.31 - 17.3), three or more lifetime sexual partners (OR = 5.71; CI, 2.39 - 13.65) and prior history of vaginal discharge (OR = 5.00; CI, 2.03 - 12.3) were more likely to be associated with ectopic pregnancy than with the presence of antibodies to Chlamydia trachomatis (OR = 2.82; 95% CI, 1.33 - 5.95). The Population Attributable Risk was 30.9%. Chlamydial infections play only a limited role in the pathogenesis of ectopic pregnancy.African health sciences 06/2013; 13(2):430-40. DOI:10.4314/ahs.v13i2.33 · 0.66 Impact Factor