The Role of Vaginal Secretory Immunoglobulin a, Gardnerella Vaginalis, Anaerobes, and Chlamydia Trachomatis in Post Abort al Pelvic Inflammatory Disease

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Abstract
In a prospective study of 129 women undergoing induced first-trimester abortion, 14 (10.9%) contracted postabortal pelvic inflammatory disease (PID). Samples of vaginal secretion for quantitation of secretory immunoglo-bulin A (slgA) as well as isolates from cervix/urethra for the culture of anaerobes and aerobes, including Bacteroides fragilis et melaninogenicus and Gardnerella vaginalis, were obtained at the preoperative visit. Two blood samples from each woman with postabortal PID were analysed for antibodies against G. vaginalis. Twenty-five per cent of women with a history of PID developed postabortal PID, and 25% with vaginitis contracted postabortal infection (p< 0.001 and pC. trachomatis at the time of abortion developed infection. The presence of anaerobes or G. vaginalis was not associated with the frequency of postabortal PID (all p-values >0.1). One woman with postabortal PID produced a culture positive for G. vaginalis and a rise in specific antibody titer. The levels of vaginal sIgA were not significantly associated with a positive history of PID (p >0.6), with postabortal PID (p >0.4) or with the presence of anaerobes or G. vaginalis at the time of abortion (p>0.3). However, significantly elevated levels of slgA were found in women harboring C. trachomatis (p <0.05). Thus, the study could not demonstrate any correlation between vaginal slgA and PID, but increased sIgA in Chlamydia-positive women. A history of PID and vaginitis entailed a significant risk of contracting postabortal PID.