Pelvic inflammatory disease associated with Chlamydia trachomatis infection after therapeutic abortion. A prospective study.

Abstract

C. trachomatis was cultured from the cervix of 70 of 557 (12.6%) patients admitted for therapeutic abortion. Postoperatively, 22 (3.9%) developed acute pelvic inflammatory disease (PID); of these women, 14 (63.6%) harbored C. trachomatis in the cervix before the abortion. thus, of 70 patients with chlamydial infection, 14 (20%) developed PID postoperatively. Of the chlamydia-positive patients, 6 of the 15 (40%) aged < 20 years and 8 of the 53 (15%) patients aged 20-30 yr developed PID. Twelve of the 70 women with chlamydial infections showed a significant increase in serum chlamydial IgG antibody titers over a 4 wk period; 4 of these women developed PID. Neisseria gonorrhoeae was recovered from only 4 patients, 1 of whom developed PID after the abortion. Treatment with a single dose of i.v. doxycycline (200 mg) was given before and during surgery to about half of the patients. This regimen had no protective effect against the development of PID associated with C. trachomatis.