The value of hysteroscopy in diagnosis of chronic endometritis in patients with unexplained recurrent spontaneous abortion

Zolghadri, J. and Momtahan, M. and Aminian, K. and Ghaffarpasand, F. and Tavana, Z. (2011) The value of hysteroscopy in diagnosis of chronic endometritis in patients with unexplained recurrent spontaneous abortion. European Journal of Obstetrics Gynecology and Reproductive Biology, 155 (2). pp. 217-220.

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Abstract

Objectives: We performed this study in order to investigate the role of chronic endometritis (CE) in unexplained recurrent spontaneous abortion (RSA) and to determine the correlation between hysteroscopic and histologic findings of CE in patients with unexplained RSA. We also tried to find out the relation between CE and primary vs. secondary RSA. Study design: One hundred and forty-two consecutive patients with unexplained RSA and 154 fertile women were enrolled in this study. All the patients and controls underwent hysteroscopy and, at the same time, endometrial biopsy. CE was suspected when hysteroscopy revealed signs of focal or diffuse endometrial hyperemia or endometrial endopolyps (less than 1 mm in size). Histopathologic diagnosis of CE was based on superficial stromal edema, increased stromal density, and pleomorphic stromal inflammatory infiltrate dominated by lymphocytes and plasma cells. Results were compared between cases and controls as well as those with primary (n = 61) and secondary (n = 81) RSA. Results: Patients with RSA had a significantly higher incidence of CE both hysteroscopically (67.6 vs. 27.3; p < 0.0001) and pathologically (42.9 vs. 18.2; p < 0.0001). The sensitivity, specificity, positive predictive value and negative predictive value of hysteroscopy in the diagnosis of CE were found to be 98.4, 56.23, 63.5 and 97.82 respectively. Patients with secondary RSA had a higher prevalence of CE both pathologically (83.9 vs. 45.9; p < 0.0001) and hysteroscopically (58.1 vs. 24.6; p < 0.0001). Conclusion: CE is associated with unexplained RSA. Hysteroscopy, with high sensitivity and acceptable specificity, is suitable for the diagnosis of CE in those with unexplained RSA. CE should be taken into consideration in those with secondary unexplained RSA. © 2010 Elsevier Ireland Ltd.

Item Type: Article
Additional Information: cited By 21
Uncontrolled Keywords: adult; article; controlled study; diagnostic test accuracy study; endometritis; endometrium biopsy; female; histopathology; human; human tissue; hyperemia; hysteroscopy; incidence; intermethod comparison; lymphocyte; major clinical study; plasma cell; predictive value; prevalence; priority journal; sensitivity and specificity; spontaneous abortion; unexplained recurrent spontaneous abortion, Abortion, Habitual; Adolescent; Adult; Biopsy; Case-Control Studies; Cell Count; Endometritis; Endometrium; Female; Humans; Hyperemia; Hysteroscopy; Middle Aged; Polyps; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Stromal Cells; Uterine Diseases; Young Adult
Divisions: School of Medicine
Depositing User: Unnamed user with email eprints@fums.ac.ir
Date Deposited: 09 Mar 2017 21:36
Last Modified: 09 Mar 2017 21:36
URI: http://eprints.fums.ac.ir/id/eprint/258

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