Chlamydia trachomatis Infection: Serological Evidence in Women with Ectopic Pregnancy in Port Harcourt

Abstract

Background: Genital chlamydial infection is the most commonly reported bacterial sexually transmitted disease worldwide. It poses a public health problem of epidemic proportions. Untreated or poorly treated cases result in endosalpingeal damage and destruction of tubular architecture with multiple sequelae including tubal infertility and ectopic pregnancy. Aims: To determine serological evidence of prior chlamydial infection in patients with ectopic pregnancy and to investigate associations between prior Chlamydia infection, its risk factors and ectopic pregnancy in Port Harcourt. Materials and Methods: This was a case-control study carried out at the University of Port Harcourt Teaching Hospital, involving 64 women treated for ectopic pregnancy who served as subjects and the 64 women with normal intrauterine pregnancies drawn from the antenatal clinic who served as controls. Information on their socio-demographic characteristics and sexual behaviour were obtained using a semi-structured questionnaire. Serological evidence of prior chlamydial infection was determined in both groups by testing for the presence of Chlamydia immunoglobulin G antibodies in their blood. Statistical analysis was done using SPSS 20 statistical software. Results: Chlamydia antibiodies were found in 53.1% of patients with ectopic pregnancy and 28.1% of the control (p=0.03). The presence of Chlamydia antibodies was associated with a two-fold risk of ectopic pregnancy with an Odd’s ratio (O.R 2.25; CI 1.02-5.03). Two-thirds of the patients with Chlamydia antibodies had pelvic adhesions at laparotomy. Early coitarche, previous history of pelvic inflammatory disease, history of induced abortion and single women were the risk factors of Chlamydia trachomatis infection found to be positively associated with ectopic pregnancy. Conclusion: There was a risk association between Chlamydia trachomatis infection and ectopic pregnancy.