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Endometritis: The clinical-pathologic syndrome

Eckert, LO ; Hawes, SE ; Wölner-Hanssen, Pål LU ; Kiviat, NB ; Wasserheit, JN ; Paavonen, JA ; Eschenbach, DA and Holmes, KK (2002) In American Journal of Obstetrics and Gynecology 186(4). p.690-695
Abstract
OBJECTIVE: The purpose of this study was to evaluate histologically proved endometritis as a clinical syndrome that is distinct from laparoscopically confirmed salpingitis. STUDY DESIGN: This was a cross-sectional study of 152 women in an urban hospital with a suspected pelvic inflammatory disease. All women provided a standardized medical history and underwent physical examination, endometrial biopsy, and laparoscopy. We defined endometritis by the presence of plasma cells in endometrial stroma and neutrophils in the endometrial epithelium. RESULTS: Of 152 women who were enrolled, 43 women had neither endometritis nor salpingitis; 26 women had endometritis alone without salpingitis, and 83 women had salpingitis. Those women with... (More)
OBJECTIVE: The purpose of this study was to evaluate histologically proved endometritis as a clinical syndrome that is distinct from laparoscopically confirmed salpingitis. STUDY DESIGN: This was a cross-sectional study of 152 women in an urban hospital with a suspected pelvic inflammatory disease. All women provided a standardized medical history and underwent physical examination, endometrial biopsy, and laparoscopy. We defined endometritis by the presence of plasma cells in endometrial stroma and neutrophils in the endometrial epithelium. RESULTS: Of 152 women who were enrolled, 43 women had neither endometritis nor salpingitis; 26 women had endometritis alone without salpingitis, and 83 women had salpingitis. Those women with endometritis alone more often had couched recently, had a current intrauterine device, and were in menstrual cycle day 1 to 7, compared with women with no endometritis or salpingitis (P = .007, .04, .005, respectively) or women with acute salpingitis (P = .03, .01, .02, respectively). Infection with Neisseria gonorrhoeae and/or Chlamydia trachomatis was found more frequently in women with endometritis alone than in women with no endometritis or salpingitis (P < .001) and less frequently than in women with salpingitis (P = .05). Lower quadrant, adnexal, cervical motion, rebound tenderness, peritonitis, tenderness score, fever, and laboratory abnormalities that indicated inflammation and detection of gonorrheal or chlamydial infection were significantly less common in women with endometritis alone than in women with salpingitis but were somewhat more common in women with endometritis alone than among women with no salpingitis or endometritis. CONCLUSION: Among women with suspected pelvic inflammatory disease, the histopathologic manifestations of endometritis were associated with clinical manifestations, infection, and specific risk factors that were intermediate in frequency between women with salpingitis and women with neither endometritis nor salpingitis. (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
risk factors, laparoscopy, endometritis, salpingitis
in
American Journal of Obstetrics and Gynecology
volume
186
issue
4
pages
690 - 695
publisher
Elsevier
external identifiers
  • wos:000175545300014
  • pmid:11967492
  • scopus:0036257738
ISSN
1097-6868
DOI
10.1067/mob.2002.121728
language
English
LU publication?
yes
id
d9087e0c-5c29-488d-b530-740f660e1079 (old id 338461)
date added to LUP
2016-04-01 12:20:09
date last changed
2022-01-27 02:12:52
@article{d9087e0c-5c29-488d-b530-740f660e1079,
  abstract     = {{OBJECTIVE: The purpose of this study was to evaluate histologically proved endometritis as a clinical syndrome that is distinct from laparoscopically confirmed salpingitis. STUDY DESIGN: This was a cross-sectional study of 152 women in an urban hospital with a suspected pelvic inflammatory disease. All women provided a standardized medical history and underwent physical examination, endometrial biopsy, and laparoscopy. We defined endometritis by the presence of plasma cells in endometrial stroma and neutrophils in the endometrial epithelium. RESULTS: Of 152 women who were enrolled, 43 women had neither endometritis nor salpingitis; 26 women had endometritis alone without salpingitis, and 83 women had salpingitis. Those women with endometritis alone more often had couched recently, had a current intrauterine device, and were in menstrual cycle day 1 to 7, compared with women with no endometritis or salpingitis (P = .007, .04, .005, respectively) or women with acute salpingitis (P = .03, .01, .02, respectively). Infection with Neisseria gonorrhoeae and/or Chlamydia trachomatis was found more frequently in women with endometritis alone than in women with no endometritis or salpingitis (P &lt; .001) and less frequently than in women with salpingitis (P = .05). Lower quadrant, adnexal, cervical motion, rebound tenderness, peritonitis, tenderness score, fever, and laboratory abnormalities that indicated inflammation and detection of gonorrheal or chlamydial infection were significantly less common in women with endometritis alone than in women with salpingitis but were somewhat more common in women with endometritis alone than among women with no salpingitis or endometritis. CONCLUSION: Among women with suspected pelvic inflammatory disease, the histopathologic manifestations of endometritis were associated with clinical manifestations, infection, and specific risk factors that were intermediate in frequency between women with salpingitis and women with neither endometritis nor salpingitis.}},
  author       = {{Eckert, LO and Hawes, SE and Wölner-Hanssen, Pål and Kiviat, NB and Wasserheit, JN and Paavonen, JA and Eschenbach, DA and Holmes, KK}},
  issn         = {{1097-6868}},
  keywords     = {{risk factors; laparoscopy; endometritis; salpingitis}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{690--695}},
  publisher    = {{Elsevier}},
  series       = {{American Journal of Obstetrics and Gynecology}},
  title        = {{Endometritis: The clinical-pathologic syndrome}},
  url          = {{http://dx.doi.org/10.1067/mob.2002.121728}},
  doi          = {{10.1067/mob.2002.121728}},
  volume       = {{186}},
  year         = {{2002}},
}