Prevalence and Impact of Chronic Endometritis in Patients With Intrauterine Adhesions: A Prospective Cohort Study

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• 作者：Yuqing Chen ; MD ; ^{fangchenyq@163.com} ; Lixiang Liu ; MD ; Yuanna Luo ; MD ; Minghui Chen ; PhD ; Yang Huan ; MD ; Ruili Fang ; MD
• 关键词：Adhesion recurrence ; American Fertility Society classification ; Endometrial biopsy ; Transcervical resection of adhesions
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2017
• 出版时间：1 January 2017
• 年：2017
• 卷：24
• 期：1
• 页码：74-79
• 全文大小：866 K
• 卷排序：24

文摘

To evaluate the prevalence and impact of chronic endometritis (CE) in patients with intrauterine adhesions (IUAs).DesignProspective cohort study (Canadian Task Force classification II-2).SettingUniversity-affiliated hospital.PatientsEighty-two women with moderate to severe IUAs.InterventionsTranscervical resection of adhesions (TCRA) and endometrial biopsy were performed in all patients. According to results of the endometrial biopsy, participants were classified into 2 groups: 29 patients with CE (CE group) and 53 women without CE (NCE group). Second-look hysteroscopy assessed the impact of TCRA using the American Fertility Society classification system.Measurements and Main ResultsPrevalence of CE, reformation of adhesions, and reduction of adhesion score were studied. Thirty-one women (37.8%) presented with visual signs of CE at hysteroscopy, confirmed by histology in 29 of 82 patients (35.4%). In hysteroscopic diagnosis of CE, sensitivity and specificity were 79.3% (23/29) and 84.9% (45/53), respectively. At second-look hysteroscopy, the recurrence of adhesions in the CE group was significantly higher than in the NCE group (44.8% vs 20.8%, respectively; p = .022). The median reduction of adhesion score was significantly greater in the NCE group (median, 8; range, 0–12) than in the CE group (median, 5; range, 0–10).ConclusionCE in women with IUAs may be a contributing factor in higher adhesion recurrence, indicating chronic inflammation may play a role in IUA recurrence. (Clinical Trial Registration No.: NCT02744807.)