Adult Medical-Surgical Nursing Reproductive Health Module: Pelvic Inflammatory Disease

Pelvic Inflammatory Disease: Description  PID is inflammation of the female reproductive organs:  Endometritis (uterus)  Salpingitis (fallopian tubes)  Oophritis (ovaries)  Pelvic peritonitis  Inflammation may be acute, sub-acute, recurrent, chronic

Pelvic Inflammatory Disease: Aetiology  Mostly bacterial infection, especially related to sexually transmitted disease (STD): Gonorrhoea, Clamydia or other  May be viral or fungal  Entry of organisms via the vagina  Associated with:  Promiscuity  Unprotected sex with multiple partners

Pelvic Inflammatory Disease: Pathophysiology  Genital infection produces inflammation of the reproductive tract  Healing process results in fibrosis and scarring  Strictures and abscesses form  Often re-infection and recurrent inflammation occurs → chronic condition  Inflammation may occlude fallopian tubes

Pelvic Inflammatory Disease: Clinical Manifestations  Vaginal discharge  Low abdominal pain and tenderness which increases during voiding or defaecation  Fever and malaise  If acute, dyspareunia (painful intercourse)  Associated with infertility (blocked fallopian tubes)

Pelvic Inflammatory Disease: Complications  Infertility  Ectopic pregnancy  (Occlusion of fallopian tubes)  Peritonitis  Pelvic abscesses  Adhesions (chronic pelvic pain)

Pelvic Inflammatory Disease: Diagnosis  Patient history and clinical picture  Severe tenderness on:  Uterine palpation  Vaginal examination (movement of the cervix)  Pelvic and vaginal ultrasound  High vaginal swab for culture

Pelvic Inflammatory Disease: Management  If acute and severe:  Bedrest  IV fluids  IV antibiotics (Doxycycline or broad- spectrum)  *Treat partner (or partners)

Pelvic Inflammatory Disease: Nursing Considerations  Facilitate vaginal drainage (semi-sitting position)  Ensure good genital hygiene  Infection control measures  Health education: (lifestyle)  Reinforce risks related to promiscuity/STD  Advice on healthy nutrition and effects of smoking on immune response