Chronic endometritis in women with suspected retained products of conception and their reproductive outcomes.

OBJECTIVE

To determine whether women who underwent operative hysteroscopy for suspected retained products of conception (rPOC) have histopathologic evidence of chronic endometritis (CE).

DESIGN

Retrospective cohort.

SETTING

Academic center.

PATIENT(S): One hundred and eleven women who underwent operative hysteroscopy for suspected rPOC between 2016 and 2018.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Evidence of CE on histopathology and subsequent reproductive outcomes.

RESULT(S): One hundred and eleven women with retained products of conception were included in our study of which 26 (23.4%) were diagnosed with CE. Women without CE had a higher median gravidity (1 vs. 2, p = .021) and a higher median number of prior pregnancy losses (1 vs. 2 prior losses, p = .005) compared to those with CE. Subsequent pregnancy data were available for 63 women. There was no difference in the subsequent pregnancy rate (61.5 vs. 54%, p = .626) between those with and without CE. Once pregnant, miscarriage (37.5 vs. 25.9%, p = .524) and live birth rates (50 vs. 44.4%, p = .782) were similar between the groups. Women with CE received antibiotics 57.7% of the time, the most common of which was doxycycline (46.6%). Of the women with CE who received antibiotics (n = 10), 8 became pregnant, and 4 of whom went on to have a live birth.

CONCLUSION(S): Nearly 1 in 4 women undergoing hysteroscopy for rPOC was incidentally diagnosed with CE. It is not clear whether CE is a causative agent for retained products or a response to the pregnancy loss. In this cohort, a diagnosis of CE did not negatively impact subsequent reproductive outcomes.