Analysis of Hysteroscopic Imaging Characteristics of Endometrial Tuberculosis Patients with Successful Pregnancy

LIU Lin-lin; HUANG Xiao-wu; XIA En-lan

doi:10.12280/gjfckx.20250527

Abstract：Objective:To summarize the hysteroscopic imaging characteristics of endometrial tuberculosis(ETB)patients with successful pregnancy,and provide references for clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on 111 ETB patients who visited the Hysteroscopy Center of Fuxing Hospital Affiliated to Capital Medical University from May 2012 to January 2020.Follow-up was carried out until March 2025.Among them,36 patients(32.4％,36/111)who finally achieved successful pregnancy were selected.Their medical records,hysteroscopic images and pregnancy outcome data were collected,and the characteristics of hysteroscopic manifestations were summarized.Results:Among the 36 patients with successful pregnancy,83.3％(30/36)were primary infertile.The conception methods included 29 cases of in vitro fertilization-embryo transfer(IVF-ET)and 7 cases of natural conception.Hysteroscopic manifestations included normal uterine cavity morphology in 8 cases(3 of them had endometrial hyperemia),tuberculous nodules in 2 cases,and tuberculous polyps in 8 cases.In addition,18 cases had different degrees of intrauterine adhesions(IUA),including 1 case of mild IUA,11 cases of moderate IUA and 6 cases of severe IUA,among which 3 cases were complicated with caseous necrosis.All patients received standardized anti-tuberculosis therapy.Among the 18 patients with IUA,all achieved successful pregnancy after hysteroscopic adhesiolysis.Conclusions:The hysteroscopic findings in ETB patients with successful pregnancy are diverse,including endometrial hyperemia,tuberculous nodules,tuberculous polyps,caseous necrosis and different degrees of IUA,and multiple lesions coexist in some cases.These manifestations constitute the hysteroscopic imaging of ETB in the context of pregnancy,which can provided references for preoperative assessment of fertility and individualized management.