For many years the definitive diagnostic procedure for PID was considered to be laparoscopy and it probably remains more sensitive than any other investigation currently available. In many cases there will be clear evidence of dilated, hyperaemic tubes with an inflammatory, fibri-nous exudate covering the tubes and the fundus of the uterus. In mild cases, however, intraluminal inflammation of the tubes may be missed and significant inter-and intra-observer variation in reporting the appearance of salpingitis at laparoscopy has been reported . It does enable swabs to be taken from the fimbrial ends of the tubes, which may be more accurate than endocer-vical swabs, but the principal benefit of laparoscopy is to exclude other diagnoses. As an invasive procedure it should be reserved for those cases where there is an element of doubt as to the diagnosis of acute PID or in cases where the patient fails to respond to antibiotics within 48-72 h.
There is no evidence to support the routine use of hys-teroscopy or endometrial biopsy in the routine diagnosis of acute PID. More invasive endoscopic techniques, such as fallaposcopy, may be potentially dangerous and have no place in management.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.