CHLAMYDIA-TRACHOMATIS AND ECTOPIC PREGNANCY - RETROSPECTIVE ANALYSIS OF SALPINGECTOMY SPECIMENS, ENDOMETRIAL BIOPSIES, AND CERVICAL SMEARS

Aims-To examine the role of Chlamydia trachomatis in ectopic pregnancy by detection of DNA in archival salpingectomy specimens, and in their preceding cervical specimens and endometrial biopsies, by using the p olymerase chain reaction (PCR). Methods-Archival paraffin embedded sal pingectomy tissues (n=48) from 37 women with ectopic pregnancy were ex amined for the presence of C trachomatis plasmid and omp1 DNA by PCR. In addition, preceding cervical specimens (n=58) stored either as cerv ical cell suspensions or as archival cervical smears, and preceding en dometrial biopsies (n=18), taken 0-5.8 years before the ectopic pregna ncy, were examined by PCR for the presence of C trachomatis. Results-C trachomatis DNA was detected in only one of the 48 salpingectomy spec imens from 37 women. However, in six of the 37 women, C trachomatis DN A was detected in the genital specimens (cenix and/or endometrial) tak en before salpingectomy. C trachomatis infections were mostly found in endometrial or cervical specimens taken more than three years before ectopic pregnancy. No chlamydial DNA was found in endometrial or cervi cal specimens taken at the same time of the ectopic pregnancy. Conclus ions-Although no C trachomatis DNA was found in salpingectomy specimen s, several women with ectopic pregnancy had C trachomatis infections i n endometrial and cervical specimens in the past. This suggests that a t least in these cases the ectopic pregnancy is a late postinflammator y complication of an ascending C trachomatis infection resulting in a scarred fallopian tube.