Vaginal polymorphonuclear leukocytes and bacterial vaginosis as markers for histologic endometritis among women without symptoms of pelvic inflammatory disease

Mark H. Yudin, Sharon L. Hillier, Harold C. Wiesenfeld, Marijane A. Krohn, Antonio A. Amortegui, Richard L Sweet

Research output: Contribution to journalArticle

68 Scopus citations

Abstract

OBJECTIVE: The study was performed to determine whether vaginal polymorphonuclear leukocytes can be used as predictors of histologic endometritis among women at risk for, but without symptoms of, acute pelvic inflammatory disease. STUDY DESIGN: Five hundred thirty-seven women with, or at risk for, pelvic infection underwent pelvic examinations, including endometrial biopsies. These women were assessed for the presence of vaginal polymorphonuclear leukocytes, bacterial vaginosis, sexually transmitted diseases, and histologic endometritis. RESULTS: Vaginal neutrophils were present in 240 (44.7%) and histologic endometritis was present in 77 (14.3%) of the study population. Women with histologic endometritis were significantly more likely to have vaginal neutrophils present, with an odds ratio of 3.2 (95% Cl 1.9-5.7). When study subjects were stratified by the presence of sexually transmitted diseases and vaginal neutrophils, the prevalence of histologic endometritis was highest in women with both conditions present, with an odds ratio of 7.0 (95% Cl 3.5-14.3). When subjects were stratified by the presence of bacterial vaginosis and vaginal neutrophils, the prevalence of histologic endometritis was again highest in women with both conditions present, with an odds ratio of 4.8 (95% Cl 1.4-16.3). The presence of vaginal neutrophils diagnosed by saline wet mount had a high sensitivity (90.9%) and negative predictive value (94.5%), but a low specificity (26.3%) and positive predictive value (17.1%) for the diagnosis of upper genital tract infection. CONCLUSION: The presence of vaginal polymorphonuclear leukocytes has a high sensitivity and negative predictive value for the diagnosis of upper genital tract infection.

Original languageEnglish (US)
Pages (from-to)318-323
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume188
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Keywords

  • Bacterial vaginosis
  • Endometritis
  • Pelvic inflammatory disease
  • Predictors
  • Vaginal polymorphonuclear leukocytes

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

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