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 douched 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. (Am J Obstet Gynecol 2002;186:690-5.)
Keywords
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Article Info
Publication History
Accepted:
November 15,
2001
Received in revised form:
November 2,
2001
Received:
November 30,
2000
Footnotes
☆Supported by National Institutes of Health grant No. AI 12192 and training grant No. AI 07140.
☆☆Reprint requests: Linda O. Eckert, MD, Assistant Professor, Department of Obstetrics and Gynecology, University of Washington, Box 359865, 325 9th Ave, Seattle, WA 98104-2499.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
