Reviewer ’s report  
 
Title: Relationship of chronic endometritis with chronic deciduitis in cases of miscarriage.  
 
Version: 0 Date: 30 Apr 2020  
 
Reviewer's report:  
 
Dear Respectable Editor  
Thank you to give me the opportunity to review the manuscrip t entitled (Relationship of chronic 
endometritis with chronic deciduitis (CD) in cases of miscarriage).  
The study was designed to study the effect of chronic endometritis (CE) on decidua in cases of 
miscarriage.  
Authors obtained decidual tissue from the p atients who miscarried at the first pregnancy within a 
year after the diagnosis of the presence or absence of chronic endometritis. The number and 
distribution pattern of plasma cells stained with CD138 in decidual tissue in 10 high -power fields 
(HPFs) exa mined. The prevalence of CD diagnosed with four different grade; grade 0, no plasma 
cell in 10 HPFs, thus Non -CD ;grade 1, rare single plasma cells; grade 2, rare clusters or more 
than 5 single cells total; and grade 3, many plasma cells with more than 5 c lusters, examined and 
compared between Non -CE and CE.  
Authors found the incidence rate of CD of grade2+3 was significantly higher in CE than Non -CE 
(53.8%; 7/13 vs. 0%; 0/13, P &lt;0.01). Presence of clusters or a number of plasma cells in 10 
HPFs of decidua showed a sensitivity of 53.8%, a specificity of 100%, a positive predictive value 
of 100%, and a negative predictive value of 68.4% for the diagnosis of chronic endometritis.  
Authors concluded that the presence of clusters of plasma cells or five or more of plasma cells in 
decidua was found in more than half of chronic endometritis, but not found in Non -CE. When 
CD with cluster or five or more of plasma cells is confirmed histolo gically in miscarriage 
decidual tissue, the presence of CE before the pregnancy should be suspected.  
Authors presented the manuscript with clear informative title with clear structured abstract.  
In the introduction, they specify the magnitude of the proble m and relation of chronic 
endometritis to infertility, implantation failure, and habitual abortion and why their study 
designed.  
The authors presented in their manuscript clear methodology and clear results supported by the 
table and immunobiological image s.  
In the discussion they compared their results with others finding and they used relevant 
references.  
Finally, the manuscript discussing unique and important subject and can be accepted after minor 
corrections and/or revision  
1. Correction of minor typi ng errors (please, see the highlighted areas in the attached reviewed 
manuscript file).  
2. Authors should specify the sample size software used to specify the sample size needed to 
reach statistically accepted figure.  
3. Last paragraph of the discussion n eeds revision to highlight the strength, limitations of the 
study and the future suggested recommendations or studies  
4. Last two references in the references section not published yet and should be replace by 
published articles.  
5. The meaning of the ab breviations in the table or figure should be mentioned below the table of 
the figure.  
Please, see the attached PDF file of the reviewed manuscript.  
Regards  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you receiv ed reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests i n relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no conflict of interest  
 
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