In following which is the main cause of PID:
A. Abruptio placentae
B. Placenta previa
C. Ectopic pregnancy
D. PPH
Correct Answer: D. PPH
Explanation
Main cause of Pelvic Inflammatory Disease (PID):
👉 Gonorrhea (Neisseria gonorrhoeae)
(Also commonly caused by Chlamydia trachomatis)
Explanation:
PID is usually caused by ascending infection from the lower genital tract. Sexually transmitted infections—especially gonorrhea and chlamydia—are the most common causes. These organisms spread from the cervix to the uterus, fallopian tubes, and surrounding structures, leading to inflammation.
✅ Exam point:
- If one option is asked → Gonorrhea
- If multiple causes are considered → STIs (Gonorrhea & Chlamydia)
Other Options Details
Here is a clear, exam-oriented description of each condition:
A. Abruptio Placentae
Definition:
Premature separation of a normally implanted placenta from the uterine wall before delivery of the baby.
Causes/Risk factors:
- Hypertension, pre-eclampsia
- Trauma to abdomen
- Sudden decompression of uterus
- Smoking, cocaine use
Clinical features:
- Painful vaginal bleeding
- Rigid, tender uterus
- Fetal distress or fetal death
- Concealed or revealed bleeding
Complications:
- Maternal shock, DIC
- Fetal hypoxia or death
B. Placenta Previa
Definition:
Placenta is implanted in the lower segment of the uterus, partially or completely covering the cervical opening.
Risk factors:
- Previous cesarean section
- Multiparity
- Advanced maternal age
Clinical features:
- Painless, bright red vaginal bleeding
- Soft, non-tender uterus
- Normal fetal heart rate
Management:
- Avoid vaginal examination
- Cesarean section if placenta covers os
C. Ectopic Pregnancy
Definition:
Implantation of a fertilized ovum outside the uterine cavity, most commonly in the fallopian tube.
Risk factors:
- Pelvic inflammatory disease
- Tubal surgery
- Previous ectopic pregnancy
Clinical features:
- Amenorrhea
- Lower abdominal pain
- Vaginal spotting
- Signs of shock if rupture occurs
Complications:
- Internal hemorrhage
- Maternal mortality if untreated
D. Postpartum Hemorrhage (PPH)
Definition:
Excessive bleeding after delivery:
- 500 ml after vaginal birth
- 1000 ml after cesarean section
Common causes (4 T’s):
- Tone – uterine atony (most common)
- Trauma – lacerations
- Tissue – retained placenta
- Thrombin – coagulation disorders
Clinical features:
- Heavy vaginal bleeding
- Soft, boggy uterus
- Signs of shock
Management:
- Uterine massage
- Oxytocic drugs
- Blood transfusion if needed
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Writer: Vandita Singh, Lucknow (GS India Nursing Group