Diagnosing Upper Genital Tract Infection in Women
Author Information
Author(s): Jeffrey F. Peipert, Lori A. Boardman, C. James Sung
Primary Institution: Women and Infants' Hospital, Brown University School of Medicine
Hypothesis
The study aims to validate the standard clinical and laparoscopic criteria for diagnosing acute upper genital tract infection.
Conclusion
The commonly used clinical and laparoscopic criteria for diagnosing pelvic inflammatory disease have low sensitivity and high false negative rates.
Supporting Evidence
- The sensitivity of the CDC's minimal clinical criteria for pelvic inflammatory disease was found to be 65%.
- The laparoscopic triad of edema, erythema, and purulent exudate had a sensitivity of 60%.
- Participants with any pelvic tenderness had the highest sensitivity for diagnosis at 91%.
- 40% of women meeting minimal criteria for PID had objective evidence of infection.
- 25% of women with non-classic signs of infection had objective evidence of upper genital tract infection.
Takeaway
Doctors need to be careful when diagnosing infections in women's reproductive organs because the usual tests might miss many cases.
Methodology
A cross-sectional study evaluating diagnostic criteria for upper genital tract infection through interviews, laboratory tests, and biopsies.
Potential Biases
Potential selection bias due to the criteria for including participants and the non-blinding of evaluators.
Limitations
The study may have detection bias due to the two-tiered evaluation process and the lack of blinding during laparoscopic evaluations.
Participant Demographics
Median age 24 years (range 16-45), median gravidity 2, median years of education 12.
Statistical Information
P-Value
0.001
Statistical Significance
p<0.05
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