Sl. Hillier et al., ROLE OF BACTERIAL VAGINOSIS-ASSOCIATED MICROORGANISMS IN ENDOMETRITIS, American journal of obstetrics and gynecology, 175(2), 1996, pp. 435-441
OBJECTIVE: Our goal was to define the role of bacterial vaginosis and
bacterial vaginosis-associated microorganisms in endometritis. STUDY D
ESIGN: Endometrial biopsies were obtained for histologic and microbiol
ogic study from 178 consecutive women with suspected pelvic inflammato
ry disease, and 85 of them underwent laparoscopy to diagnose salpingit
is. RESULTS: Histologic endometritis was confirmed in 117 (65%) of the
women. Among women who underwent laparoscopy, salpingitis was present
in 68% of those with and 23% of those without endometritis. Some but
not all bacterial vaginosis-associated microorganisms were linked with
endometritis. By logistic regression analysis, after adjustment for b
acterial vaginosis and isolation of Neisseria gonorrhoeae and Chlamydi
a trachomatis, endometritis was associated with endometrial N. gonorrh
oeae (odds ratio 5.7, 95% confidence interval 1.8 to 17.5), C. trachom
atis (odds ratio 4.8, 95% confidence interval 1.3 to 18.2), anaerobic
gram-negative rods (odds ratio 2.6, 95% confidence interval 1.1 to 5.7
), and nonwhite race (odds ratio 2.3, 95% confidence interval 1.1 to 4
.8). CONCLUSIONS: The association of anaerobic gram-negative rods with
endometritis, after adjustment for bacterial vaginosis, N. gonorrhoea
e, and C. trachomatis, supports the role of these microorganisms in th
e etiology of histologic endometritis among women with clinically susp
ected pelvic inflammatory disease.