Chlamydia trachomatisInfection in Women With Ectopic Pregnancy

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Fifty women with ectopic pregnancy and 49 control women with intrauterine pregnancy were interviewed and evaluated for evidence ofChlamydia trachomatisinfection. Among women with ectopic pregnancy, 14 women were wearing an intrauterine contraceptive device or had a tubal ligation (group A), and 36 women had no readily identifiable risk factors (group B). Group B women had greater total numbers of sexual partners than did control women with intrauterine pregnancy (P < .005). Group B women more often hadC trachomatisantibody than group A (P = .03) and control women (P = .002). Of 27C trachomatiscultures from fallopian tube tissue from women with ectopic pregnancy, none were positive. Fallopian tube tissue distant from the site of ectopic implantation was available for histopathology of 41 cases. Nine (22%) had extensive subepithelial plasma cell infiltration. All nine were among group B women (P = .06) and all seven with plasma cell salpingitis who were tested forC trachomatisantibody were seropositive (P = .004). It is concluded that a subset of women with ectopic pregnancy were at increased risk for acquiring a sexually transmitted disease by virtue of their sexual behavior and that women in this subset frequently have serologic evidence ofC trachomatisinfection and histologic evidence of plasma cell salpingitis. Because few of these women recall having had pelvic infection, the authors speculate that subclinicalC trachomatistubal infection producing plasma cell salpingitis may commonly underly ectopic pregnancy.(Obstet Gynecol 67:722, 1986)

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