American journal of obstetrics and gynecology · 2008
Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка NIH: внешняя программаПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Trautmann Gail M, Kip Kevin E, Richter Holly E, Soper David E, Peipert Jeffrey F, Nelson Deborah B, Trout Wayne, Schubeck Dianne, Bass Debra C, Ness Roberta B
Аннотация
OBJECTIVE: This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.
STUDY DESIGN: Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.
RESULTS: Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.
CONCLUSION: Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.
STUDY DESIGN: Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.
RESULTS: Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.
CONCLUSION: Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.
Предметные рубрики MeSH
Administration, OralAdolescentAdultCefoxitinDose-Response Relationship, DrugDoxycyclineDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesHumansInfertility, FemaleInflammation MediatorsInfusions, IntravenousPain MeasurementPelvic Inflammatory DiseasePredictive Value of TestsProbabilityProbenecidProportional Hazards ModelsRecurrenceSeverity of Illness IndexTime FactorsTreatment Outcome