Pre-HsG Microbial Isolates from Endocervical swabs in Infertile Women in Ilorin, Nigeria
Article Sidebar
Views | PDF/EPUB Downloads:
16
/ 3
/ 1
Main Article Content
Abstract
Background: Genital infections contribute significantly to infertility by causing tubal disease in our environment. This can be worsened by any instrumentation of the genital tract such as hysterosalpingography (HSG), which is the most common and affordable investigation by infertile couples for tubal factor.
Materials and Methods: A prospective study of 53 women who presented for HSG on account of infertility was done in a radio-diagnostic centre In Ilorin, Nigeria. Endo-cervical swabs were taken aseptically prior to standardized HSG in all clients. The swabs were sent for microscopy, culture, and antibiotic sensitivity and the HSG findings of patients were documented.
Results: The age ranged between 25 and 52 years with a mean of 34.26 + 5.762 years. Both fallopian tubes were patent in 10 patients and blocked in 14 cases. There were 14 cases of unilateral hydrosalpinx and 10 (18.9) bilateral hydrosalpinges. Either pelvic or cervico-uterine cavity adhesions were observed in 35 (66.0%) of the cases. Mild to heavy growth occurred in 67.9% of the cases. Gram stain was positive in 54.7% of cases. The most common organism was Staphylococcus spp (28.3%). Forty-five percent of yields were sensitive to more than two antimicrobials. There was statistical significant relationship between the presence of pathogens in the endo-cervix and the frequency of tubal disease (x2 = 2.71, P ≤ 0.05).
Conclusion: There was a positive or significant statistical relationship between presence of pathogens in the cervix and tubal disease. Pre-HSG endo-cervical swab for microscopy, culture and sensitivity is advisable to prevent genital infections after HSG.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
How to Cite
References
1. Westrom LV. Sexually transmitted diseases and infertility. Sex Transm Dis 1994;21:S32‑7.
2. Witkin SS, Toth A. Relationship between genital tract infections, sperm antibodies in seminal fluid and infertility. Fertil Steril 1983; 40:805‑8.
3. Achenbach DA. Infertility caused by infection. Contemp Obstet Gynecol 1987;32:29‑46.
4. Araoye MO. Epidemiology of Infertility: Social problems of the infertile couples. West Afr J Med 2003;22:101‑6.
5. Okonofua FE, Makinde ON, Ayangade SO. Yearly trends in caesarean section and caesarean mortality at Ile‑Ife, Nigeria. Trop J Obstet Gynaecol 1988;1:31‑5.
6. Okonofua FE, Onwudiegwu U, Odunsi OA. Illegal induced abortion: A study of 74 cases in Ile‑Ife, Nigeria. Trop Doct 1992; 22:75‑8.
7. Ibeziako PA. Effect of post‑caesarean section sepsis on subsequent fertility. West Afr J Med 1986;5:35‑9.
8. Lema VM, Majingi CR. Acute pelvic infection following hysterosalpingography at the Kenyatta National Hospital, Nairobi. East Afr Med J 1990;70:551‑5.
9. Tuveng JM, Vold I, Jerve F, Eng J, Skaug K, Eyolfsson O. Hysterosalpingography: Value in estimating tubal function, and risk of infectious complications. Acta Eur Fertil 1985;16:125‑8.
10. Forsey JP, Caul EO, Paul ID, Hull MG. Chlamydia trachomatis, tubal disease and the incidence of symptomatic and asymptomatic
infections following hysterosalpingograph. Hum Reprod 1990;5:444‑7.
11. Thinkhamrop J, Laopaiboon M, Lumbiganon P. Prophylactic antibiotics for transcervica intrauterine procedures. Cochrane
Database Syst Rev 2010;5.
12. Land JA, Gysen AP, Evers JL, Bruggeman CA. Chlamydia trachomatis in subfertile women undergoing uterine instrumentation: Screen or treat? Hum Reprod 2002;17:525‑7.
13. Stumpf PG, March CM. Febrile morbidity following HSG: Identification of risk factors and recommendations for prophylaxis.
Fertil Steril 1980;33:487‑92.
14. American College of Obstetrics and Gynecology: ACOG practice bulletins no 104: Antibiotic prophylaxis for gynaecologic
procedures. Obstet Gynecol 2009:113:1180‑9.
15. Acton CM, Devitt JM, Ryan EA. Hysterosalpingography in infertility‑ an experience of 3631 examinations. Aust N Z J Obstet
Gynaecol 1988;28:127‑33.
16. Eleje GU, Okaforcha EI, Umeononihu OS, Udegbunam OI, Etoniru IS, Okwuosa AO. Hysterosalpingographic Findings among Infertile Women: Review at a Tertiary health CareInstitution in Nnewi, South‑east Nigeria. Afrimedic J (NAUTH) 2012;3:21‑23.
17. Imo AO, Sunday‑Adeoye I. Radiological assessment of the uterus and fallopian tubes in infertile women at Abakaliki, Nigeria. Niger J Clin Pract 2008;11:211‑5.
18. Kiguli‑Malwadde E, Byanyima RK. Structural findings at hysterosalpingography in patients within fertility at two private clinics in Kampala, Uganda. Afr Health Sci 2004;4:178‑81.
19. Okpala OC, Okwoli NR. Genital tract microbial floral hysterosalpingography.Trop J Med Res 2005;9:28‑30.
20. Bello TO. Pattern of Tubal Pathology in Infertile Women on Hysterosalpingography in Ilorin. Ann Afr Med 2004;3:77‑9.
21. Akinola RA, Akinola OI, Fabamwo AO. Infertility in women: Hysterosalpingographic assessment of the fallopian tubes in Lagos,
Nigeria. Educ Res Rev 2009;4:86‑9.
22. Okonofua FE, Ako‑Nai KA, Dighitoghi MD. Lower genital tract infections in infertile Nigerian women compared with controls.
Genitourin Med 1995;71:163‑8.