Pelvic Inflammatory Disease (PID)

Article

Pelvic inflammatory disease (PID) is an acute inflammation (McCance, 2020), which is caused by infection of any organ in the upper genital tract of young sexually active women (Curry et al., 2019). This disease affects the uterus, the ovaries, the fallopian tubes, and the peritoneal cavity (McCance, 2020). It is commonly an ascending infection which is associated with a sexually transmitted infection that begins in the lower genital tract. This infection of the upper genital tract can lead to damage and necrosis of the affected area which will end up in total obstruction of the fallopian tube.

The chronic consequences of PID include infertility and tubal obstruction, ectopic pregnancy, pelvic pain of varying degrees, and intestinal obstruction from adhesions between the bowel and pelvic organs (McCance, 2020). The most frequently affected women are of the ages 18 to 44 years of age, which according to Curry et al., (2019) accounts for 4.4% of women in the United States who had a history of PID between 2013 to 2014.

Ann our patient in this discussion post is 32 years which is a risk factor, as stated earlier ages 18 to 44 years are a risk factor. Other risk factors include multiple sex partners, being sexually active before age 25, history of STIs or PID, and having intercourse with a symptomatic partner (McCance, 2020). The signs and symptoms of PID can be mild and sometimes hard to recognize or some women may end up not having the signs and symptoms, but if they are present, they include, abdominal and pelvic pain, heavy unusual vaginal discharge, pain during sex, fever, dysuria, and irregular bleeding. Some of these signs and symptoms are present in Ann.

According to McCance, (2020) outlined CDC- the recommendation for the treatment of PID is the use of intramuscular or oral medication. The third generation Cephalosporins are recommended for anaerobes and the addition of metronidazole to effectively treat BV.

Reference

Curry, A., MD, Williams, T., MD, & Penny, M. L., DO. (2019). Pelvic inflammatory disease: Diagnosis, management, and prevention. American Family Physician, 100(6), 357-364.

McCance, L.K. (2020). Alteration of the Female Reproductive System. In S.E. Huether, K.L. McCance, V.L. Brashers & N.S. Rote (Eds.), Understanding pathophysiology (7th ed., pp.780-827). Elsevier.

 

Response 

Hi ,

Your initial discussion is amazing, full of relevant points, and clearly presented. I appreciate the information you provided in your initial discussion regarding the pathophysiology of pelvic inflammatory disease. I believe is it an important topic to explore as a nurse. I also feel that it is less explored because it affects women alone. Mine is to support your points while adding any necessary new knowledge.

I agree with your statement that pelvic inflammatory disease (PID) is majorly associated with infections occurring around the upper genital tract of sexually active women. According to Greydanus & Bacopoulou (2019), PID is a major sexually transmitted infection that involves sexually active adolescent and young adult females. This information is in line with your viewpoint.

According to Jennings & Krywko (2022), PID affects the uterus, ovaries, and fallopian tubes, hence, it is defined as the inflammation of the upper genital tract. PID should be assessed in females with complaints of lower abdominal pain (pelvic pain) and individuals manifesting genital tract tenderness. The doctor should also assess and rule out other conditions such as ectopic pregnancy.

The recommended treatment of the illness is antibiotics to cover primary disease-causing organisms such as Neisseria gonorrhoeae and Chlamydia trachomatis (Jennings & Krywko, 2022). In the majority of PID cases, the main causes of the infections are Neisseria gonorrhoeae or Chlamydia trachomatis. Other pathogens include Mycoplasma genitalium, Peptostreptococcus species, Bacteroides species, Escherichia coli, and others. Gonorrheal PID is perceived as the most severe compared to PID due to other pathogens.

According to Greydanus & Bacopoulou (2019), the US alone experiences about one million cases of PID every year. Of the total PID cases, about one-third are diagnosed in the adolescent population. There is a rising trend currently reported in the United States following a steady decline before 2014. The initial PID infection begins in the region around the vagina and cervix and then spreads to the upper genital tract causing complications such as acute salpingitis, perihepatitis, and others. Scarring, adhesions, and obstruction of the fallopian tubes may occur due to PID-induced inflammation (Greydanus & Bacopoulou, 2019).

Ovum transport is normally affected by the loss of ciliary epithelial cells in the fallopian tube. There are many risk factors associated with PID, such as age, immature immune system, ectropion of young adolescent females, multiple coital partners, ineffective condom usage, presence of bacterial vaginosis, vaginal douching, past PID, and others.

References

Greydanus, D. E., & Bacopoulou, F. (2019). Acute pelvic inflammatory disease: a narrative review. Pediatric Medicine, 2. doi:10.21037/pm.2019.07.05

Jennings, L., & Krywko, D. (2022). Pelvic Inflammatory Disease. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK499959/