University of British Columbia, Department of Obstetrics and Gynaecology, Vancouver, BC, V6Z 2K8, Canada.
University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, BC, V6T 2B5, Canada.
Placenta. 2020 Oct;100:60-65. doi: 10.1016/j.placenta.2020.07.032. Epub 2020 Aug 12.
the objective of this study was to evaluate the incidence of Chronic Intervillositis of Unknown Etiology (CIUE) at our institution and to report on the pregnancy outcomes based on severity of lesions.
retrospective cohort study including 29 889 perinatal specimens from 27 968 patients. The pathology database at our institution was queried for the keywords "intervillositis" and "CIUE" between February 2006 and April 2019. Histology was re-examined using a standardized diagnostic criterion to confirm diagnosis. Cases in which diagnosis was confirmed were categorized as low grade (5-49% intervillous space involvement) or high grade (≥50% involvement). Interventions and pregnancy outcomes were recorded.
The overall prevalence of CIUE is 0.17% (47 of 27 968 patients), with significantly higher prevalence in 1st trimester products of conception compared with 2nd and 3rd trimester specimens (0.38% vs 0.09%; p < 0.0001). A total of 97 specimens were initially diagnosed with chronic intervillositis. 56 out of 97 (57.7%) specimens met our diagnostic criteria for CIUE on review. Pregnancies with confirmed CIUE had significantly higher rates of pregnancy loss compared with pregnancies with chronic intervillositis not meeting our study criteria for CIUE (94% vs 71%; p = 0.003). Pregnancy loss between low grade (42.9%; 24 out of 56 cases of CIUE) and high grade (57.1%; 32 out of 56 cases) CIUE were not significantly different.
CIUE prevalence is low at 0.17%, but it is associated with pregnancy loss, particularly in the first trimester. High grade disease may be associated with worse pregnancy outcomes than low grade disease.
本研究旨在评估我院慢性病因不明性绒毛膜炎（CIUE）的发病率，并根据病变严重程度报告妊娠结局。
回顾性队列研究纳入了 27968 名患者的 29889 例围产儿标本。我院病理数据库于 2006 年 2 月至 2019 年 4 月间检索了“绒毛膜炎”和“CIUE”等关键词。使用标准化诊断标准重新检查组织学以确认诊断。确诊病例分为低级别（5-49%绒毛间隙受累）或高级别（≥50%受累）。记录干预措施和妊娠结局。
CIUE 的总患病率为 0.17%（27968 例患者中有 47 例），与 1 次妊娠流产标本相比，2 次和 3 次妊娠流产标本的患病率显著更高（0.38% vs 0.09%；p<0.0001）。共有 97 例最初被诊断为慢性绒毛膜炎。97 例中有 56 例（57.7%）经重新评估符合我们的 CIUE 诊断标准。与不符合本研究 CIUE 诊断标准的慢性绒毛膜炎相比，确诊为 CIUE 的妊娠流产率显著更高（94% vs 71%；p=0.003）。低级别（42.9%；56 例 CIUE 中有 24 例）和高级别（57.1%；56 例 CIUE 中有 32 例）CIUE 之间的妊娠丢失率无显著差异。
CIUE 的患病率较低（0.17%），但与妊娠丢失有关，特别是在早期妊娠。高级别疾病可能与较低级别疾病相比，妊娠结局更差。
