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. 2021 Nov;304(5):1345-1351.
doi: 10.1007/s00404-021-06029-3. Epub 2021 Apr 3.

The association of chronic endometritis with mid-trimester loss due to cervical incompetence and the outcome of laparoscopic cervical cerclage

Jian Li  1   2 , Dongmei Song  1 , Xiangdong Feng  1 , Xiaowu Huang  1 , Enlan Xia  1 , Tinchiu Li  3   4
Affiliations

The association of chronic endometritis with mid-trimester loss due to cervical incompetence and the outcome of laparoscopic cervical cerclage

Jian Li et al. Arch Gynecol Obstet. 2021 Nov.

Abstract

Purpose: 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).

Methods: 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).

Results: 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).

Conclusions: 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.

Keywords: Cervical incompetence; Chronic endometritis; Mid-trimester loss; Pre-conception laparoscopic cervical cerclage.

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Conflict of interest statement

The authors declare that they have no conflicts of interest and nothing to disclose.

Figures

Fig. 1
Fig. 1
Flow chart of the study
Fig. 2
Fig. 2
A comparison of the prevalence of chronic endometritis in three groups of subjects. Group Ia-women with a classical history of cervical incompetence. Group Ib-women with atypical history of cervical incompetence. Group II-Women with recurrent first trimester loss (the comparison group)
See this image and copyright information in PMC

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