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Comparison of Treatment Strategies on Pregnancy Outcomes in Women with Persistent Chronic Endometritis: A Retrospective Study

gynecology-and-obstetrics
womens-health

Abstract

Objective

This study aims to evaluate the effects of different treatment regimens on pregnancy outcomes, histological cure rates of chronic endometritis (CE), adverse reactions, and adverse events in patients with persistent CE and pregnancy failure.

Methods

Methods: This retrospective study included 125 patients diagnosed with CE, of which 90 were diagnosed with persistent CE. Based on the treatment regimen, the patients were divided into three groups: Group A (antibiotic therapy only), Group B (antibiotic therapy + intrauterine infusion of rhG-CSF), and Group C (antibiotic therapy + intrauterine infusion and subcutaneous injection of rhG-CSF). The primary outcome measures were pregnancy outcomes (overall pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, and preterm birth rate), while the secondary outcome measures included histological cure rate of CE, adverse reactions, and adverse events.

Results

1. Pregnancy outcomes: The overall pregnancy rate in Group C (83.9%) was significantly higher than that in Group A, but there was no statistical difference between Group B and Group C (P>0.05). Regarding biochemical pregnancy rate, Group B was significantly higher than Group C, while there were no significant differences between Group A and Group B, or Group A and Group C (P>0.05). In terms of clinical pregnancy rate, Group C was significantly higher than Group A, while there was no statistical difference between Group A and Group B, or Group B and Group C (P>0.05). Group C had the lowest rates of natural miscarriage and preterm birth, and the highest live birth rate, all significantly better than Groups A and B (P<0.05).

2. Risk analysis of natural miscarriage: Multivariate analysis revealed that the risk of natural miscarriage was significantly higher in Groups A and B than in Group C (P<0.05), and increasing age significantly elevated the risk (P<0.05).

3. Histological cure rate of CE: After treatment, the histological cure rate of CE was significantly higher in Group B (78.6%) and Group C (77.4%) than in Group A (32.3%, P<0.05), with no significant difference between Group B and Group C.

4. Adverse reactions and adverse events: The incidence of subchorionic hematoma (71.4%) and placenta accreta (75.0%) in Group A was significantly higher than in Group C (12.5% and 9.1%, P<0.05), but there was no statistical difference between Group A and Group B (P>0.05). No significant differences were observed between Groups B and C (P>0.05). Ectopic pregnancy and neonatal malformations were not observed in any group.

Conclusion

rhG-CSF combination therapy significantly improved pregnancy outcomes in persistent CE patients, increasing pregnancy, clinical pregnancy, and live birth rates, while reducing miscarriage and preterm birth risks. Continuous use of rhG-CSF may further enhance treatment, but its efficacy and safety require validation through larger studies.

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