Chronic deciduitis

Chronic Deciduitis is a pathological condition affecting the decidua, a layer of the endometrium (the lining of the uterus) that undergoes significant changes during pregnancy. This condition is characterized by the inflammation of the decidua, which can have implications for both maternal and fetal health. Chronic deciduitis is often diagnosed through histopathological examination of the endometrium, particularly in women who have experienced recurrent pregnancy loss or other pregnancy-related complications.

Etiology

The exact cause of chronic deciduitis remains unclear, but it is believed to be associated with various factors including infections, autoimmune responses, and possibly the presence of foreign materials in the uterus. Bacterial infection, especially by organisms such as Ureaplasma urealyticum and Mycoplasma hominis, has been frequently associated with this condition.

Pathophysiology

In chronic deciduitis, there is a persistent inflammatory response in the decidua. This inflammation can lead to the recruitment of immune cells, such as plasma cells and lymphocytes, into the endometrial tissue. The presence of plasma cells is particularly indicative of chronic deciduitis and is a key diagnostic criterion. This inflammatory environment can disrupt the normal function and structure of the decidua, potentially affecting implantation and placental development.

Clinical Features

Chronic deciduitis is often asymptomatic and may only be discovered incidentally during histological examination of the endometrium for other reasons. However, when symptoms do occur, they may include abnormal uterine bleeding, pelvic pain, and in some cases, impacts on fertility and pregnancy outcomes, such as recurrent pregnancy loss or preterm birth.

Diagnosis

The diagnosis of chronic deciduitis is primarily made through histopathological examination of endometrial biopsy specimens. Key features include the presence of plasma cells within the decidua, along with other signs of chronic inflammation. Immunohistochemistry may also be used to identify specific types of immune cells and inflammatory markers.

Treatment

Treatment for chronic deciduitis focuses on addressing the underlying cause of the inflammation. If an infectious etiology is identified, appropriate antimicrobial therapy may be administered. In cases where an autoimmune process is suspected, immunomodulatory treatments may be considered. Additionally, supportive care and monitoring during pregnancy may be recommended for women with chronic deciduitis to manage potential complications.

Prognosis

The prognosis for chronic deciduitis largely depends on the underlying cause and the presence of associated reproductive complications. With appropriate treatment and management, many women can achieve successful pregnancy outcomes. However, the condition may recur in subsequent pregnancies, necessitating ongoing monitoring and care.

See Also

• Endometritis
• Placenta
• Pregnancy
• Uterus