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


METHODS
Observational cohort study using prospectively collected data.


METHODS
Recurrent pregnancy loss program in an academic medical center.


METHODS
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.


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


METHODS
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.
University of Chicago Recurrent Pregnancy Loss Program, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois.
Dana B
DB
McQueen
University of Chicago Recurrent Pregnancy Loss Program, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois; Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois.
Lia A
LA
Bernardi
University of Chicago Recurrent Pregnancy Loss Program, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois; Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois. Electronic address: msteph@uic.edu.
Mary D
MD
Stephenson
D000026:Abortion, Habitual / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D002641:Chicago / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D020964:Embryo Loss / Q000401:mortality*; D004716:Endometritis / Q000453:epidemiology*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D011247:Pregnancy; D015995:Prevalence; D018570:Risk Assessment; D055815:Young Adult
Chronic endometritis; fetal demise; pregnancy; recurrent miscarriage; recurrent pregnancy loss