4.2 Article

Retained pregnancy tissue after miscarriage is associated with high rate of chronic endometritis

Journal

JOURNAL OF OBSTETRICS AND GYNAECOLOGY
Volume 42, Issue 7, Pages 3101-3105

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/01443615.2022.2100693

Keywords

Chronic endometritis; recurrent pregnancy loss; retained pregnancy tissue; miscarriage; pregnancy loss

Funding

  1. Friends of Prentice

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The study aimed to evaluate the prevalence of chronic endometritis in patients with retained pregnancy tissue (RPT) following miscarriage. The results showed a significantly higher prevalence of chronic endometritis in patients with RPT, suggesting that RPT could be a risk factor for this disorder.
The objective of this study was to evaluate prevalence of chronic endometritis in a cohort of patients with retained pregnancy tissue (RPT) following miscarriage, with and without a history of recurrent pregnancy loss (RPL). In a cohort of our single academic fertility centre, we evaluated women with unexplained RPL (two or more losses) without evidence of RPT and women undergoing hysteroscopic resection of RPT following miscarriage. Endometrial samples underwent staining with H and E and CD138. A pathologist blinded to patient history recorded the number of plasma cells per 10 high power fields (HPF) and the presence or absence of endometrial stromal changes. Our main outcome measure was to measure the prevalence of chronic endometritis. Endometrial samples from 50 women with RPT following miscarriage and 50 women with unexplained RPL without evidence of RPT were reviewed. The prevalence of chronic endometritis was significantly higher in the RPT cohort (62% versus 30%). A multivariable regression demonstrated significantly higher odds of chronic endometritis in the RPT cohort, aOR 7.3 (95% CI 2.1, 25.5). We conclude that women with RPT following pregnancy loss have a high rate of chronic endometritis, suggesting that RPT is a risk factor for this disorder.

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