THE ASSOCIATION BETWEEN CHLAMYDIA-TRACHOMATIS SEROLOGY AND PELVIC DAMAGE IN WOMEN WITH TUBAL ECTOPIC GESTATIONS

Objective: To determine whether pelvic damage is associated with posit ive Chlamydia trachomatis serology in women with tubal ectopic pregnan cy. Design: Cross-sectional retrospective study. Setting: A prepaid he alth maintenance organization. Patients: Two-hundred eighty-one women admitted with confirmed tubal ectopic pregnancy were interviewed for h istory of sexually transmitted diseases. Chlamydia serology was obtain ed for 135 subjects, and operative findings were available for 121 of these. Interventions: None. Main Outcome Measure: Pelvic damage, as de termined by review of operative findings of the pelvis at the time of ectopic surgery. Results: Pelvic damage was associated with positive c hlamydia serology with an adjusted odds ratio of 4.2 (95% confidence i nterval: 1.8 to 9.7). Moderate and severe pelvic damage were more stro ngly associated with positive serology than mild damage. Conclusions: Women with ectopic pregnancies and antibodies to C. trachomatis are mo re likely to have damaged pelves than women with ectopic pregnancies w ithout such antibodies. Prevention or early treatment of C. trachomati s infection may reduce pelvic damage and, therefore, reduce incidence of ectopic pregnancy.