Endometrial Ossification Associated with Repeated Abortions

Degani, S.; Gonen, Ron; Vries, Karl de; Шарф, М

doi:10.3109/00016348309155810

Cited by 23 publications

(21 citation statements)

References 4 publications

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“…It has been reported that the time interval between the abortion and osseous metaplasia can range from 8 weeks to 23 years [5,6]. Hysteroscopic or resectoscopic excision of the bones is the mainstay of the treatment [2][3][4][5][6][7][8][9][10][11]. Ultrasonographic or laparoscopic guidance may be applied in extensive osseous metaplasias at which there may be deep myometrial invasion.…”

Section: Discussionmentioning

confidence: 99%

Osteoid Metaplasia of the Endometrium: A Case Report and Literature Review

Bouzid¹,

Ayachi²,

Mourali³

2016

Gynecol Obstet

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Endometrial ossification is a rare condition. Most cases reported had a history of abortion. Clinical presentation may include abnormal vaginal bleeding or discharge, dysmenorrhea, pelvic pain and secondary infertility. Hysteroscopy appears to be the gold standard method to both diagnosis and treatment. We report a case of endometrial ossification in a woman who presented with pelvic pain. The patient had a pregnancy voluntarily terminated at an unknown gestational age. The diagnosis was suspected at Sonography. We insist on the fact that diagnosis must be considerate in a symptomatic or infertile woman with a history of both early and late abortion and illustrate the feasibility and safety of a hysteroscopic treatment for this condition.

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Section: Discussionmentioning

confidence: 99%

Osteoid Metaplasia of the Endometrium: A Case Report and Literature Review

Bouzid¹,

Ayachi²,

Mourali³

2016

Gynecol Obstet

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“…Sin embargo, a pesar de los pocos reportes que ponen énfasis en el tejido óseo residual en el útero, se cree que si no existe tejido óseo en la cavidad endometrial, el tejido óseo residual incrustado en el miometrio no tendría un significado clínico relevante [3][4][5][6][7][15][16][17][18][19][20][21] .…”

Section: Discussionunclassified

Extensa metaplasia ósea endometrial y exitoso embarazo espontáneo post tratamiento

2010

Rev. méd. Chile

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Bony metaplasia of the endometrium. Report of two casesWe report a 28-year-old female consulting for infertility and a 26-year-old woman consulting for severe dysmenorrhea. In both patients a osseous metaplasia of the endometrium was found. Both patients were subjected to a hysteroscopic resection of the osseous material and both achieved spontaneous pregnancies and term deliveries following the procedures. If the bony material is removed, normal pregnancies and deliveries are feasible afterwards, no matter how extensive is the the osseus metaplasia. (Rev Med Chile 2010; 138: 1004-1007 a metaplasia ósea endometrial corresponde a la presencia de tejido óseo en el interior de la cavidad uterina. Es una patología de baja incidencia (0,3 x 1.000 mujeres) y en 80% de los casos existe el antecedente de abortos espontáneos o inducidos, generalmente de 12 semanas o más de gestación. No existe una teoría con respecto a su etiología, sin embargo, se han formulado múltiples hipótesis al respecto .Clínicamente se presenta con metrorragia, dismenorrea, algia pélvica y flujo vaginal en ocasiones con restos óseos. También se ha asociado a infertilidad primaria y secundaria, especulándose que el tejido óseo podría ejercer una acción similar a un dispositivo intrauterino 4-10 .Comunicamos el caso de dos pacientes con diagnóstico de metaplasia ósea extensa endometrial, dado el compromiso completo de la cavidad, que fueron sometidas a resectoscopía, logrando posteriormente un embarazo espontáneo. Caso clínico 1Paciente de 28 años, multípara de uno, con antecedente de parto vaginal a término con resultado de mortineonato por sepsis (Staphylococcus aureus). Consultó el año 1999 por deseo de embarazo luego de tres años de exposición. Dentro del estudio, destacaba una ecografía transvaginal que sugería el diagnóstico de metaplasia ósea al visualizarse una intensa ecorrefringencia de toda la zona endometrial.Se programó una resección histeroscópica en la cual se extrajo abundante tejido osificado, cuya anatomía patológica confirmó el diagnóstico de metaplasia, sin embargo, no fue posible extraer todos los fragmentos en una primera instancia por motivos de seguridad para la paciente (prolongado procedimiento con mayor exposición peritoneal a glicina, sangrado miometrial, riesgo de perforación, etc.). Recibió estrógenos conjugados 3,75 mg diarios por un mes, seguido de anticonceptivos orales cíclicos con 50 µg de etinilestradiol. Se realizó una segunda resectoscopía seis meses más tarde para extraer el tejido metaplásico remanente, realizándose exitosamente.Se embarazó espontáneamente al año de exposición, evolucionando sin incidentes. A las 38 semanas de gestación se obtuvo un recién nacido sano de 3.560 g por cesárea tras prueba de trabajo de parto fracasada (Figura 1).

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“…Sporadic cases without antecedent pregnancy support this theory [9,10,11,12]. Over the past few decades there have been several case reports describing endometrial ossification [13,14,15,16,17]. It is most commonly believed to be due to retained fetal bone fragments, but some cases may be due to metaplasia of mature endometrial stromal cells in response to chronic inflammation or trauma [9].…”

Section: Etiopathologymentioning

confidence: 95%

Hysteroscopic removal of intrauterine retained fetal bones

et al. 2004

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Fetus papyraceus is a well-recognized complication of missed abortion or intrauterine fetal death. However, prolonged intrauterine retention of parts of the fetal skeleton is not adequately reported in the literature. Prolonged retention of intrauterine bone is a recognized cause of secondary infertility. Literature regarding endometrial ossification contains more than 80 cases, with 80% occurring after pregnancy. Common symptoms include menorrhagia, menometrorraghia, pelvic pain and infertility. Several theories have been proposed to explain osseous tissue within the uterine cavity. The most widely accepted is that ossification represents retained fetal bones following spontaneous, missed, incomplete or therapeutic abortion, suggesting that the fetus achieved at least 12 weeks gestation in order for endochondral ossification to occur. In contemporary gynecology, transvaginal sonographic diagnosis of retained fetal bones is made and the bones removed with the help of a resectoscope. Hysteroscopy is invaluable in achieving a cure for these patients without resorting to more aggressive surgery. Gonadotropin-releasing hormone analogues (GnRHa) have many new uses in gynecology. Several clinical studies have demonstrated a mean decrease in uterine volume after about 3-6 months of therapy. These patients might be candidates for GnRHa therapy so that a smaller corpus with an atrophic endometrium might aid in hysteroscopic retrieval of the retained bony fragments.

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Endometrial Ossification Associated with Repeated Abortions

Abstract: Abstract. A patient with repeated abortions and a finding of endometrial ossification is reported. The etiology and pathogenesis of endometrial ossification are discussed.

Cited by 23 publications

References 4 publications

Osteoid Metaplasia of the Endometrium: A Case Report and Literature Review

Osteoid Metaplasia of the Endometrium: A Case Report and Literature Review

Extensa metaplasia ósea endometrial y exitoso embarazo espontáneo post tratamiento

Hysteroscopic removal of intrauterine retained fetal bones

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