Infection In Infection In Reproduction Reproduction SystemSystemR.Varidianto Yudo T., dr., MKesR.Varidianto Yudo T., dr., MKesLab. MikrobiologiLab. Mikrobiologi Fakultas Kedokteran Universitas HangFakultas Kedokteran Universitas Hang Tuah Tuah Pelvic Infammatory Pelvic Infammatory DiseaseDiseaseAcute PID arises following ascent, of Acute PID arises following ascent, of gonococcugonococcus and s and chlamydiachlamydia through the through the uterine cavity to the Fallopian tubes uterine cavity to the Fallopian tubes and adnexae. and adnexae. Both subclinical and chronic disease Both subclinical and chronic disease can then occur, where bacteria of the can then occur, where bacteria of the vaginal ora are also involved. vaginal ora are also involved. Inammation and !brosis damage the Inammation and !brosis damage the Fallopian tubes, obstructing the normal Fallopian tubes, obstructing the normal movement of ova to the uterusmovement of ova to the uterus Bacteria ascend the uterus "nter the Fallopian tubes Infection in the tubes results in !brosis and a tubo#ovarian abscess can also developTubo-ovarian abscessFibrosis of the uterus can lead to infertility or ectopic pregnancy If a fertili$ed ovum implants in the tube, If a fertili$ed ovum implants in the tube, an ectopic pregnancy results, which is a an ectopic pregnancy results, which is a gynaecological emergency. gynaecological emergency. %hen both tubes are a&ected, infertility %hen both tubes are a&ected, infertility can rise. can rise. A pelvic abscess is also a complication of A pelvic abscess is also a complication of PID, and when on the right side, this or an PID, and when on the right side, this or an ectopic pregnancy need to be ectopic pregnancy need to be di&erentiated from disease of the appendixdi&erentiated from disease of the appendix Congenital InfectionsCongenital Infections During pregnancy certain infections During pregnancy certain infections 'coccidioidomycosis, inuen$a( can be more 'coccidioidomycosis, inuen$a( can be more severe than usual, and there can be severe than usual, and there can be reactivation of certain persistent infections reactivation of certain persistent infections 'polyomaviruses, )*+(. 'polyomaviruses, )*+(. A few infections are able to pass to the fetus via A few infections are able to pass to the fetus via the placenta and cause damage. ,hese the placenta and cause damage. ,hese infections are generally mild or subclinical in infections are generally mild or subclinical in the mother 'rubella, )*+, toxoplasmosis(, but the mother 'rubella, )*+, toxoplasmosis(, but this is not always the case 'syphilis(. this is not always the case 'syphilis(. -nce infected the fetus may die, but more -nce infected the fetus may die, but more importantly may survive and be born with the importantly may survive and be born with the infection '.I+, toxoplasmosis(, often showing infection '.I+, toxoplasmosis(, often showing characteristic malformations 'rubella, syphilis(. characteristic malformations 'rubella, syphilis(. Post-Partum Infections Septic Post-Partum Infections Septic !bortions " #ynaecological !bortions " #ynaecological InfectionsInfectionsIn post#partum infections and septic In post#partum infections and septic abortions, organisms of the vaginal or abortions, organisms of the vaginal or bowel ora are important bowel ora are important /roup A /roup A streptococcusstreptococcus and and clostridiaclostridia should always be considered as well. should always be considered as well. Damage to the myometrium, retained Damage to the myometrium, retained products of conception, and in the case products of conception, and in the case of a septic abortion, uterine perforation, of a septic abortion, uterine perforation, enable organisms to establish a focus of enable organisms to establish a focus of infection infection 0ome reasons why infection may arise post#partum or as a result of an abortion 0ome types of infection that may arise following a hysterectomy )aesarean section wounds may also be a )aesarean section wounds may also be a focus of infection, and in the case of focus of infection, and in the case of group A streptococcus, necroti$ing group A streptococcus, necroti$ing fasciitis and ,00 can occur. fasciitis and ,00 can occur. In hysterectomy operations, vaginal In hysterectomy operations, vaginal organisms may establish infections such organisms may establish infections such as cu& cellulitis, cu& abscess, or pelvic as cu& cellulitis, cu& abscess, or pelvic abscess despite the use of prophylactic abscess despite the use of prophylactic antibiotics. antibiotics. -besity, diabetes, and di&icult -besity, diabetes, and di&icult operations predispose to thisoperations predispose to this Infection of the infant during birth or shortly Infection of the infant during birth or shortly afterwards can cause local disease afterwards can cause local disease 'con1unctivitis due to gonococci or chlamydia( 'con1unctivitis due to gonococci or chlamydia( or occasionally severe life#threatening illness or occasionally severe life#threatening illness ''E. coliE. coli meningitis, herpes simplex virus or meningitis, herpes simplex virus or group B streptococcal infection(. group B streptococcal infection(. 2ife#threatening bacterial infection of the 2ife#threatening bacterial infection of the mother via the postpartum uterus 'puerperal mother via the postpartum uterus 'puerperal sepsis( used to be common but is now rare in sepsis( used to be common but is now rare in developed countries. developed countries. 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