Hysteroscopy Center, Fu Xing Hospital, Capital Medical University, Beijing, China.
Center for Reproductive Medicine, Dalian Obstetrics and Gynecology Hospital, Dalian, China.
Arch Gynecol Obstet. 2021 Nov;304(5):1345-1351. doi: 10.1007/s00404-021-06029-3. Epub 2021 Apr 3.
To examine the association of chronic endometritis (CE) with cervical incompetence (CI) in Chinese women with mid-trimester loss, and the impact of the presence of CE on the outcome of laparoscopic cervical cerclage (LCC).
This retrospective cohort study included a study group of 293 women with mid-trimester loss due to CI (group I) and a comparison group of 332 women with recurrent first-trimester miscarriage (group II). Immunohistochemical study using CD138 epitope for the diagnosis of CE was completed in all subjects. Pre-conception LCC was undertaken in 247 women in the study group (group I). The study was approved by Institutional Review Board (IRB) (number 2015FXHEC-KY005).
The prevalence of CE in group I was 42%, significantly (P < 0.001) higher than that of 23.5% in group II. Among 247 women in group I, there were no significant difference in mid-trimester loss rate, preterm delivery rate and term delivery rate in women with and without CE (2.2, 12.0, 85.8% vs. 1.8, 10.1, 88.1% respectively) and between women with CE treated and not treated with antibiotics prior to conception (2.3, 9.3, 88.4% vs. 2.0, 14.3, 83.7% respectively).
Mid-trimester loss due to cervical incompetence is associated with chronic endometritis; However, the presence or not of CE and whether it was treated with antibiotics prior to conception did not appear to significantly influence the obstetric outcomes of women with CI after LCC.
探讨慢性子宫内膜炎（CE）与中国中期流产宫颈机能不全（CI）的相关性，以及 CE 的存在对腹腔镜宫颈环扎术（LCC）结局的影响。
本回顾性队列研究纳入了因 CI 导致中期流产的 293 名女性（I 组）和 332 名反复发生早期流产的女性（II 组）。所有受试者均进行 CD138 表位免疫组织化学法诊断 CE。在研究组中，247 名患者在妊娠前接受了 LCC（I 组）。本研究经机构审查委员会（IRB）批准（编号 2015FXHEC-KY005）。
I 组 CE 的患病率为 42%，明显高于 II 组的 23.5%（P<0.001）。在 I 组的 247 名女性中，CE 患者与非 CE 患者的中期流产率、早产率和足月产率无显著差异（分别为 2.2%、12.0%、85.8%和 1.8%、10.1%、88.1%），以及在妊娠前接受抗生素治疗与未接受抗生素治疗的 CE 患者之间无显著差异（分别为 2.3%、9.3%、88.4%和 2.0%、14.3%、83.7%）。
宫颈机能不全导致的中期流产与慢性子宫内膜炎相关；然而，CE 的存在与否以及妊娠前是否使用抗生素治疗似乎并未显著影响 CI 患者接受 LCC 后的产科结局。
