Role of Chronic Endometritis in Postoperative Recurrence of Severe Intrauterine Adhesions

Sun Yat-sen University

Status

Completed

Conditions

Chronic Endometritis

Intrauterine Adhesions

Treatments

Other: Chronic endometritis

Study type

Observational

Funder types

Other

Identifiers

NCT02744807

2013B021800237

Details and patient eligibility

About

This study is to evaluate the prevalence of chronic endometritis (CE) in women with severe intrauterine adhesions and compare recurrence of adhesion in women with and without CE.

Full description

Chronic endometritis (CE) is a persistent in endometrium that is characterized by the presence of plasma cells. Recently, there has been increasing interest in the role of CE in recurrent pregnancy loss (RPL). One of the most common uterine abnormalities for RPL is Intrauterine adhesion (IUA).Intrauterine adhesion, also known as Asherman's syndrome, is the partial or complete occlusion of the uterine cavity as a result of endometrium damage. Most intrauterine adhesions patients manifest amenorrhea, reduced menstrual pattern, infertility, and intrauterine growth restriction, which seriously affect their reproductive health.It is well established that the formation of IUA likely involves hypoxia, reduced neovascularization, and altered expression of adhesion-associated cytokines, but the exact mechanisms are not well understood. Although excessive curettage is considered the primary cause, intrauterine adhesion is known to be associated with diverse non-traumatic factors, such as postabortal sepsis, puerperal sepsis and infections. It is therefore possible to hypothesize that Intrauterine adhesion may be related to chronic endometritis. To the best of researchers knowledge,there have been no reports investigating this relationship. The aim of this study was to clarify the hypothesis by evaluating the prevalence of chronic endometritis (CE) in women with severe intrauterine adhesions and compare recurrence of adhesion in women with and without chronic endometritis (CE).

Enrollment

125 patients

Sex

Female

Ages

20 to 40 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Pre-operative adhesion score was ≥5
The prior menstrual cycle was regular, and the sex hormone was normal
with informed consent
absence of other uterine abnormality at transvaginal ultrasound
There were no severe systemic diseases, and no contradictions to aspirin, estrogen and surgery.

Exclusion criteria

Pre-operative adhesion score was <5
Prior menstrual cycle was irregular and sex hormone was abnormal, or patients had endocrine factors that caused amenorrhea, menstrual reduction and infertility
other uterine abnormality at transvaginal ultrasound
without informed consent
Patients had contradictions to estrogen and aspirin such as cancers (breast cancer and endometrial cancer), thrombotic diseases, allergy to antipyretic analgesics, severe liver injury, hypoprothrombinemia, vitamin K deficiency, hemophilia, thrombocytopenia, gastric or duodenal ulcer and asthma
refuse Endometrial biopsy
Vaginal discharge abnormal, or Suspected vaginitis or pelvic inflammatory disease, or using antibiotics.