Chlamydia trachomatis in subfertile women undergoing uterine instrumentation

被引:16
|
作者
Land, JA
Gijsen, AP
Evers, JLH
Bruggeman, CA
机构
[1] Acad Ziekenhuis Maastricht, Dept Obstet & Gynaecol, Res Inst Growth & Dev, NL-6202 AZ Maastricht, Netherlands
[2] Dept Med Microbiol, Maastricht, Netherlands
关键词
Chlamydia trachomatis; prophylactic antibiotics; screening; subfertility; uterine instrumentation;
D O I
10.1093/humrep/17.3.525
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Women who undergo uterine instrumentation are considered at risk for pelvic infections by Chlamydia trachomatis, which may derive either from ascending endocervical infections or from reactivation of micro-organisms persisting in the genital tract after previous chlamydia infections. Women presenting at fertility clinics frequently undergo uterine instrumentation (e.g. hysterosalpingography and laparoscopy with hydrotubation). Studies in subfertile women using DNA amplification techniques have shown that the prevalence of endocervical chlamydia infections is low (1.8%). In contrast, in 30-60% of subfertile women chlamydia IgG antibodies can be found in serum, indicating previous chlamydia infections. It has been demonstrated that, several years after chlamydia infections, viable micro-organisms may still be present in the upper genital tract. Therefore, subfertile women with chlamydia antibodies should be considered at risk for reactivation of persistent chlamydia infections after uterine instrumentation, even after exclusion of endocervical chlamydia infections. Moreover, in subfertile women without chlamydia antibodies, the presence of viable micro-organisms in the genital tract cannot be excluded. As a consequence, prophylactic antibiotics before uterine instrumentation should be considered in all subfertile women, instead of endocervical screening for C trachomatis and treatment of positive cases only.
引用
收藏
页码:525 / 527
页数:3
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