Analysis of risk factors and prognosis for intrauterine adhesion after hysteroscopic submucosal myoma / 中国基层医药

ABSTRACT

Objective To explore the risk factors of intrauterine adhesions after abortion and the effect of hysteroscopic surgery.Methods Through retrospective analysis method,from January 2014 to October 2016,80 artificial abortion patients with intrauterine adhesions were collected as adhesion group.During the same period,80 patients without adhesion after artificial abortion were selected as non-adhesion group.The general data of the two groups were compared.By logistic multivariate analysis,the influencing factors of intrauterine adhesions were analyzed.And the effect of surgical treatment of hysteroscopic adhesion was analyzed.Results The adhesion group and the non-adhesion group had statistically significant differences in the times of pregnancy (t =6.848,P ＜ 0.001),missed abortion (t =12.004,P ＜ 0.001),painless curettage times (t =7.24,P ＜ 0.001),painless abortion history (x2 =5.079,P =0.024).Multivariate logistic regression analysis indicated that number of missed abortion(OR7.083,95 ％ CI2.406-17.392;P =0.002),curettage times (OR9.147,95 ％ CI2.875-32.068;P =0.014),painless abortion of history(OR5.276,95％ CI1.973-13.492;P =0.029) were the independent risk factors for uterine cavity adhesions (P ＜ 0.05).The total effective rate of the mild-to-moderate uterine cavity adhesions was significantly higher than that of the severe uterine cavity adhesions (x2 =16.449,P ＜ 0.001).Conclusion The number of missed abortion,curettage,painless history are independent risk factors for intrauterine adhesion,the effect of treatment is related to the degree of adhesion,hysteroscopic intrauterine adhesions after treated with the combination therapy of estrogen and Foley balloon catheter,IUD and absorbable membrane can help reduce the risk of readhesion,it is worthy of clinical attention.