Yuqing Chen1, Lixiang Liu2, Yuanna Luo2, Minghui Chen2, Yang Huan2, Ruili Fang2. 1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China. Electronic address: fangchenyq@163.com. 2. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
Abstract
STUDY OBJECTIVE: To evaluate the prevalence and impact of chronic endometritis (CE) in patients with intrauterine adhesions (IUAs). DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: Eighty-two women with moderate to severe IUAs. INTERVENTIONS: Transcervical 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 RESULTS: Prevalence 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). CONCLUSION: CE 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.).
STUDY OBJECTIVE: To evaluate the prevalence and impact of chronic endometritis (CE) in patients with intrauterine adhesions (IUAs). DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: Eighty-two women with moderate to severe IUAs. INTERVENTIONS: Transcervical 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 RESULTS: Prevalence 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). CONCLUSION: CE 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.).
Authors: Stephanie E McLaughlin; Surabhi B Vora; E Chandler Church; Christopher Spitters; Angela Thyer; Sylvia LaCourse; Christopher N Herndon Journal: F S Rep Date: 2022-08-05