title: Prevalence and Impact of Chronic Endometritis in Patients With Intrauterine Adhesions: A Prospective Cohort Study.
abstract: To evaluate the prevalence and impact of chronic endometritis (CE) in patients with intrauterine adhesions (IUAs).
  
  
  
  Prospective cohort study (Canadian Task Force classification II-2).
  
  
  
  University-affiliated hospital.
  
  
  
  Eighty-two women with moderate to severe IUAs.
  
  
  
  Transcervical resection of adhesions (TCRA) and endometrial biopsy were performed in all patients. According to results of the endometrial biopsy, participants were classified into 2 groups: 29 patients with CE (CE group) and 53 women without CE (NCE group). Second-look hysteroscopy assessed the impact of TCRA using the American Fertility Society classification system.
  
  
  
  Prevalence of CE, reformation of adhesions, and reduction of adhesion score were studied. Thirty-one women (37.8%) presented with visual signs of CE at hysteroscopy, confirmed by histology in 29 of 82 patients (35.4%). In hysteroscopic diagnosis of CE, sensitivity and specificity were 79.3% (23/29) and 84.9% (45/53), respectively. At second-look hysteroscopy, the recurrence of adhesions in the CE group was significantly higher than in the NCE group (44.8% vs 20.8%, respectively; p = .022). The median reduction of adhesion score was significantly greater in the NCE group (median, 8; range, 0-12) than in the CE group (median, 5; range, 0-10).
  
  
  
  CE in women with IUAs may be a contributing factor in higher adhesion recurrence, indicating chronic inflammation may play a role in IUA recurrence. (Clinical Trial Registration No.: NCT02744807.).
authors: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China. Electronic address: fangchenyq@163.com.
authors: Yuqing
authors: Y
authors: Chen
authors: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
authors: Lixiang
authors: L
authors: Liu
authors: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
authors: Yuanna
authors: Y
authors: Luo
authors: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
authors: Minghui
authors: M
authors: Chen
authors: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
authors: Yang
authors: Y
authors: Huan
authors: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
authors: Ruili
authors: R
authors: Fang
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D004716:Endometritis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D015995:Prevalence; D012008:Recurrence; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000150:complications* / Q000601:surgery
keywords: Adhesion recurrence; American Fertility Society classification; Endometrial biopsy; Transcervical resection of adhesions