ABSTRACT
Objective:Uterine adhesion is mainly caused by endometrial injury,leading to poor postoperative pregnancy outcome.Therefore,preoperative evaluation on uterine cavity,especially endometrial condition,is very necessary.This study aims to explore the correlation between preoperative three-dimensional transvaginal ultrasound(3D-TVS)imaging characteristics and postoperative pregnancy outcomes after hysteroscopic adhesiolysis(HA). Methods:A total of 401 patients,who underwent HA surgery from February 22,2018 to October 31,2018 at the Third Xiangya Hospital of Central South University or Changsha Jiangwan Hospital,were enrolled,and we collected data regarding the preoperative 3D-TVS imaging characteristics and followed up their postoperative pregnancy outcomes.Correlation analysis and univariate and multivariate logistic regression analysis were performed between imaging features and pregnancy outcomes(live and non-live birth outcomes)in patients with intrauterine adhesion. Results:The results of correlation analysis showed that endometrial thickness,endometrial echo,visible tubal openings,endometrial blood flow,intercornual distance,and endometrial peristalsis were correlated with the live birth rate(all P<0.05).Logistic regression analysis revealed that in the HA patients with the live birth,the endometrial thickness was thicker(P<0.001),endometrial echo was more homogeneous(P<0.001),the number of tubal openings was more(P<0.001),the intercornual distance was wider(P<0.05),the endometrial blood flow,and irregular cases of endometrial peristaltic waves were more and cases of deficiency were fewer(both P<0.01)than those in the non-live birth group. Conclusion:Preoperative 3D-TVS imaging performance is closely related to pregnancy outcomes of HA patients,and preoperative 3D-TVS can be used to predict pregnancy outcomes after HA.
ABSTRACT
OBJECTIVES: To evaluate the causes of intrauterine adhesion (IUA) and the efficacy of hysteroscopic adhesiolysis in patients with IUA METHODS: From January 1995 to June 1999, a total of 63 patients with IUA were underwent hysteroscopic adhesiolysis. The patients with IUA only were trying to be pregnant spontaneous whereas, intrauterine insemination (IUI) or in vitro fertilization and embryo transfer (IVF-ET) were performed in the patients who have other infertility factors and IUA as well. The data such as the changes of menstrual amount and pattern, fertility, and full-term live birth rate were analyzed. RESULTS: The most common cause of IUA was curettage related problems; after incomplete abortion 20.6%, postpartum bleeding 9.5%, elective abortion 47.6%, missed abortion 11.1%, and for treatment of hydatidiform mole 1.6%. All patients with amenorrhea or oligomenorrhea had improvement of their menstrual patterns. Forty seven patients wanted pregnancy and 31 patients achieved pregnancy (68.4%). Full-term live birth rate 38.3% and there was one placenta accreta in full-term live birth case, which was resolved by postpartum curettage. CONCLUSION: Hysteroscopic adhesiolysis of IUA could be effective for restoring the normal menstrual pattern and fertility.