O23.523 Salpingo-oophoritis in pregnancy, third trimester

Name of the Condition

• Salpingo-oophoritis in pregnancy, third trimester
• ICD-10 Code: O23.523

Summary

Salpingo-oophoritis in pregnancy, third trimester, refers to inflammation of the fallopian tubes and ovaries during the final 13 weeks of pregnancy. This condition may result from ascending infections or hematogenous spread and requires prompt evaluation to prevent complications for both the mother and fetus. Management focuses on identifying the underlying cause and initiating appropriate treatment to reduce risks of adverse outcomes.

Causes

Salpingo-oophoritis in pregnancy is often caused by bacterial pathogens, such as Chlamydia trachomatis, Neisseria gonorrhoeae, or other ascending infections from the lower genital tract. Hormonal changes and altered immune responses during pregnancy can increase susceptibility to infection. Pelvic inflammatory disease (PID) or untreated genital tract infections may also contribute to the development of this condition.

Risk Factors

• Previous history of pelvic inflammatory disease or salpingo-oophoritis.
• Untreated or recurrent genital tract infections.
• Multiple sexual partners or unprotected intercourse.
• Invasive procedures during pregnancy (e.g., cervical dilation).
• Underlying immunosuppression or diabetes.
• Prolonged rupture of membranes.

Symptoms

• Pelvic or lower abdominal pain (often unilateral).
• Abnormal vaginal discharge (color, odor, or consistency).
• Fever or chills.
• Nausea or vomiting.
• Dyspareunia (pain during intercourse).

Diagnosis

Diagnosis involves a combination of clinical evaluation, including a detailed history and physical examination, and laboratory testing. Pelvic examination may reveal tenderness, adnexal mass, or cervical motion tenderness. Laboratory tests may include blood cultures, complete blood count (CBC), and cervical or vaginal swabs for microbial identification. Imaging studies, such as ultrasound, may be used to assess for abscesses or other complications.

Treatment Options

Treatment typically includes antibiotic therapy targeted at the identified or suspected pathogens. Hospitalization may be necessary for severe cases or when intravenous antibiotics are required. Supportive care, such as pain management and hydration, may also be provided. In cases of abscess formation or treatment failure, surgical intervention may be considered.

Prognosis and Follow-Up

With prompt and appropriate treatment, the prognosis is generally favorable, though complications can occur. Follow-up care is essential to monitor for resolution of infection and to assess fetal well-being. Repeat testing may be performed to ensure eradication of the pathogen. Long-term follow-up may be needed to evaluate for potential reproductive sequelae.

Complications

• Preterm labor or delivery.
• Intrauterine infection or fetal sepsis.
• Pelvic abscess formation.
• Chronic pelvic pain.
• Infertility or ectopic pregnancy (in future pregnancies).

Lifestyle & Prevention

• Practice safe sex to reduce the risk of sexually transmitted infections.
• Maintain good genital hygiene.
• Seek prompt treatment for any genital tract infections.
• Avoid invasive procedures unless medically necessary.
• Follow prenatal care guidelines to monitor for infections.

When to Seek Professional Help

Seek immediate medical attention if experiencing severe pelvic pain, fever, abnormal vaginal discharge, or signs of preterm labor. Prompt evaluation is critical to prevent complications for both the mother and fetus.

Tips for Medical Coders

When coding O23.523, ensure documentation specifies the condition occurred in the third trimester of pregnancy. Verify that the diagnosis aligns with clinical findings and that any associated complications or treatments are appropriately documented. Accurate coding requires clear documentation of the trimester and the presence of salpingo-oophoritis to support the code assignment.