[Serology of Chlamydia and ectopic pregnancies. Incidence of Fitz-Hugh-Curtis syndrome].

The authors report a prospective study of anti-chlamydia trachomatis serology in extra-uterine pregnancies, which happened to coincide with an increase in the ectopic rate during the year 1989 (p less than 1.10(-6]. The subjects of the study were those patients operated on for ectopic pregnancy between the 1st January and the 31st May 1989. There were two control groups: the first were those that were delivered and the second were those pregnant women who were at risk of ectopic pregnancy because of their age, or the number of pregnancies they had had and their parity, without taking any account of the duration of the pregnancy. The level for sero-positive reading was 1 in 64 using an indirect immunofluorescent method (Spot IF, Bio Merieux). The results showed 81% sero-positive in those who had had ectopic pregnancies as against 63% in the control groups. The two control groups had identical readings. There was a significant difference statistically (p less than 0.01). There was no statistical difference in the incidence of HIV (human immunodeficiency virus) in the two groups (3% and 1%). The clinical study of the other tube showed no particular lesions. On the other hand, adhesions between the liver and the diaphragm (Fitz-Hugh-Curtis Syndrome) were demonstrated in 34% of those with ectopic pregnancy with a statistical significant level of igG above or equal to 1:128 (p 0.02). Perisplenitis was rare (3 cases). Histological finding of salpingitis isthmica nodosa in 49% of cases raises the problem of the pathology of chlamydial lesions being due to a host invader reaction. The increase in the incidence of ectopic pregnancy (1 in 44 deliveries) was accompanied by an increase in the prevalence of chlamydia trachomatis in the group with ectopics and the control groups. If the frequency of ectopics creates a major problem of public hygiene, the prevalence of chlamydia in the female population, apart from its effect on fertility, explains the action of sexually transmitted diseases as a factor in the heterosexual transmission of HIV in Africa.