Serology of Chlamydia and ectopic pregnancies. Incidence of Fitz-Hugh-Curtis syndrome
Picaud, A.; Berthonneau, J.P.; Nlome-Nze, A.R.; Ogowet-Igumu, N.; Engongah-Beka, T.; Faye, A.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 20(2): 209-215
1991
ISSN/ISBN: 0368-2315 PMID: 2071865 Document Number: 318155
A prospective study of antichlamydia trachomatis serology in extrauterine pregnancies which coincided with an increase in the rate of ectopic pregnancy during the year 1989 (p1.10-6) is reported. The subjects were patients operated on for ectopic pregnancy between January 1-May 31, 1989. There were 2 control groups, those who were delivered and those who were at risk for ectopic pregnancy because of their age or their parity. The level for seropositive reading was 1 in 64 using a direct immunofluorescent method (Spot IF, Bio Merieux). Results showed 81% seropositive in those who had ectopic pregnancies as compared with 63% in the control groups. The 2 control groups had identical readings. There was a significant difference statistically (p.01) but there was no statistical difference in the incidence of HIV among the 2 groups (3% and 1%). The clinical study of the other tube showed no specific lesions. However, adhesions between the liver and diaphragm (Fitz-Hugh-Curtis syndrome) were demonstrated in 34% of those with ectopic pregnancy with a statistically significant level of IgG or= 1:128 (p.02). Perisplenitis was rare (3 cases). Histological findings of salpingitis isthmica nodosa in 49% of the cases raises the problem of pathology of chlamydial lesions due to a host invader reaction. The increase in incidence of ectopic pregnancy (1 in 44 deliveries) was accompanied by an increase in prevalence of chlamydia trachomatis among the group of ectopics and the controls. If the frequency of ectopics creates a major problem with public hygiene, the prevalence of chlamydia among the female population, apart from its effect on fertility, explains the action of sexually transmitted diseases as a factor in the heterosexual transmission of HIV in Africa. (author's modified)