Chronic endometritis in women with recurrent early pregnancy loss and/or fetal demise

Dana B McQueen; Lia A Bernardi; Mary D Stephenson

doi:10.1016/j.fertnstert.2013.12.031

Infections and the Reproductive Microbiome Chronic Endometritis

Chronic endometritis in women with recurrent early pregnancy loss and/or fetal demise

McQueen DB, Bernardi LA, Stephenson MD

Published April 2014 Fertility and sterility, 101(4), 1026-30

DOI 10.1016/j.fertnstert.2013.12.031 PMID 24462055

Abstract

Objective

To assess the prevalence of chronic endometritis in women with a history of recurrent early pregnancy loss (REPL) and/or fetal demise (FD).

Design

Observational cohort study using prospectively collected data.

Setting

Recurrent pregnancy loss program in an academic medical center.

Patients

Three hundred ninety-five women with a history of two or more pregnancy losses of less than 10 weeks' size or a fetal demise of 10 or more weeks' size.

Interventions

All women had an endometrial biopsy. Chronic endometritis was treated with antibiotics, and a second endometrial biopsy was recommended as a "test of cure."

Main Outcome Measures

Subsequent live-birth rate (LBR).

Results

The overall prevalence of chronic endometritis was 9% (35/395) in this cohort; 7% (21/285) in the REPL group, 14% (8/57) in the FD group, and 11% (6/53) in the combined REPL/FD group. The cure rate was 100% after a course(s) of antibiotics. The subsequent cumulative LBR was 88% (21/24) for the treated chronic endometritis group versus 74% (180/244) for the group without chronic endometritis. The per-pregnancy LBR for the treated chronic endometritis group was 7% (7/98) before treatment versus 56% (28/50) after treatment.

Conclusions

There was a high prevalence of chronic endometritis in this cohort. The test of cure was 100% with antibiotics. Subsequent LBRs after treatment were encouraging.

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Topics

Infections and the Reproductive Microbiome › Chronic Endometritis › Endometritis and Reproductive Outcomes · Diagnostics › Endometrial Assessment › Endometrial Infection · Infertility › Recurrent Pregnancy Loss › Anatomic Causes

Dana B McQueen, Lia A Bernardi, Mary D Stephenson

D McQueen, L Bernardi, M Stephenson

PMID 24462055 24462055 DOI 10.1016/j.fertnstert.2013.12.031 10.1016/j.fertnstert.2013.12.031 McQueen et al. 2014, McQueen 2014

Keywords

Chronic endometritis, fetal demise, pregnancy, recurrent miscarriage, recurrent pregnancy loss

Chronic endometritis in women with recurrent early pregnancy loss and/or fetal demise

Abstract

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