Ectopic pregnancy has been serologically associated with C. trachomatis in many studies but the role of persistent chlamydial infection of the Fallopian tubes in ectopic pregnancy is still unsolved. Fresh frozen tubal and cervical tissue from 121 patients with ectopic pregnancy in a hospital setting were examined for the presence of C.trachomatis, Mycoplasma hominis/genitalium, Ureaplasma urealyticum, Neisseria spp. (including N. gonorrhoeae) and Trichomonas vaginalis DNA by polymerase chain reaction (PCR). Blood samples were analysed for antibodies to C. trachomatis (immunoglobulin (Ig) G, M and A, IgG antibodies to Chlamydia heat shock protein 60 (cHSP60) and Major Outer Membrane Protein (MOMP) and Pgp3.
Results U. urealyticum (UU) was the most common pathogen (22.31% in tubal tissue and 27.27% in cervix) while M. hominis was a more rare agent (4.96% in tubal tissue and 4.13% in cervix) and other agents were detected even more rarely (2.48% genitalium in tubal tissue and 0% in cervix, Neisseria spp. 2.48% in tubal tissue and 5.79% in cervix, C. trachomatis 4.96% in tubal tissue and 0% in cervix, Tr. vaginalis 2.48% in tubal tissue and cervix). In most cases (73.55%) tubal pathology was associated with presence of serum G antibodies against the Chlamydial major outer membrane protein (MOMP) and Pgp3.
Conclusions In 83.47% cases we found different kind of Chlamydial antibodies. Persistent Chlamydial infection could not be widely demonstrated in tubal tissue from these patients and the infection had probably resolved prior to the ectopic pregnancy. We believe that our negative results in PCR reflect a true absence of C. trachomatis and suggest that persistent infection of C. trachomatis in the Fallopian tubes is rare in ectopic pregnancy in our population. UU was more frequently found in both points, without a significant difference between cervical and tubal tissue, indicating that UU is a commensal microrganism.
- Chlamydia trachomatis
- Ectopic pregnancy
- Fallopian tubes
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