Reproductive prognosis in patients with moderate and severe intrauterine adhesions after transcervical resection of adhesions

Ding Ye; Qi Yaqin; Gu Xiaoyan; Yang Dazhen; Zhai Yongning; Hua Xiangdong; Sun Pingping; Wang Sumin

doi:10.13406/j.cnki.cyxb.001240

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Reproductive prognosis in patients with moderate and severe intrauterine adhesions after transcervical resection of adhesions

更新时间：2024-01-17

- Reproductive prognosis in patients with moderate and severe intrauterine adhesions after transcervical resection of adhesions
- Journal of Chongqing Medical University Vol. 42, Issue 4, Pages: 406-410(2017)
- 作者机构：
  
  1. 南京医科大学附属妇产医院腔镜科
  2. 浙江大学医学院附属妇产科医院
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001240
  CLC： R713.4
- Published：2017，
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Ding Ye, Qi Yaqin, Gu Xiaoyan, et al. Reproductive prognosis in patients with moderate and severe intrauterine adhesions after transcervical resection of adhesions. [J]. Journal of Chongqing Medical University 42(4):406-410(2017)
DOI：

Ding Ye, Qi Yaqin, Gu Xiaoyan, et al. Reproductive prognosis in patients with moderate and severe intrauterine adhesions after transcervical resection of adhesions. [J]. Journal of Chongqing Medical University 42(4):406-410(2017) DOI： 10.13406/j.cnki.cyxb.001240.

摘要

目的:分析506例中重度宫腔粘连(intrauterine adhesion

IUA)患者TCRA术后生殖预后现状。方法:收集从2011年1月至2014年12月首次在本院腔镜科行宫腔镜下宫腔粘连电切手术的506例中重度宫腔粘连患者的临床资料

分别统计中度、重度组患者术后妊娠率和活产率

成功妊娠者足月产、流产和早产比例

以及产时并发症发生情况。结果:(1)506例宫腔粘连患者(中度274例

重度232例)

90.51%的患者出现月经量减少甚至闭经

重度组月经量减少、继发性不孕的发生率显著高于中度组

差异有统计学意义(P=0.000)。(2)共随访患者433例

随访率85.57%

有生育要求者406例(93.76%)

总妊娠率57.64%(234/406)、总活产率34.98%(142/406)。其中中度组妊娠率67.11%(151/225)、活产率42.22%(95/225);重度组妊娠率45.86%(83/181)、活产率25.97%(47/181)

重度组妊娠率和活产率均较中度组明显降低

差异有统计学意义(P=0.000

P=0.01)。(3)所有妊娠患者中足月产构成比46.58%

流产构成比32.05%

重度组足月产构成比低于中度组

流产构成比高于中度组

但统计学上无差异(P=0.466

P=0.198)。妊娠患者中出现产后出血、胎盘粘连、前置胎盘、胎盘植入共178例次

产后出血和胎盘粘连发生率高于前置胎盘和胎盘植入

重度组胎盘植入的发生明显高于中度组

差异有统计学意义(P=0.045)。结论:中度宫腔粘连术后生殖预后优于重度宫腔粘连。

Abstract

Objective:To analyze the reproductive outcomes of moderate and severe intrauterine adhesions after transcervical resection of adhesions（TCRA）. Methods:A retrospective analysis was carried out to explore the clinical data of 506 patients with moderate or severe intrauterine adhesions who were hospitalized in Nanjing Maternity and Child Care Center from January 2011 to December2014. And they all underwent the TCRA surgery successfully for the first time. The pregnancy and live birth rates

the ratio of term birth

abortion

and premature birth

and the intrapartum complications of patients with two different adhesions degrees were separately calculated. Results:（1）This study contained 506 patients of IUA

274 moderate cases and 232 severe cases;90.51% of all cases had experienced hypomenorrhea even amenorrhea. The incidence of hypomenorrhea and secondary infertility in severe group was significantly higher than that of moderate group（P=0.000）.（2）A total of 433 cases were followed up and the follow-up rate was 85.57%.406 of them had fertility requirements（93.76%）;the total pregnancy rate was 57.64%（234/406）

and the total live birth rate was34.98%（142/406）. The pregnancy rate of 67.11%（151/225）in moderate group was significantly higher than that of 45.86%（83/181）in severe group（P=0.000）. The live birth rate of 25.97%（47/181）in severe group was significantly lower than that of 42.22%（95/225）in moderate group（P=0.01）.（3）Among all the pregnant patients

the constituent ratio of full-term birth and abortion was 46.58%and 32.05%

respectively. In severe group

the constituent ratio of full-term birth was lower than that in the moderate group

and the abortion constitution ratio was higher than that in the moderate group

but there was no statistically significant difference（P=0.466

P=0.198）. There were 178 cases of postpartum hemorrhage

placenta adhesion

placenta praevia and placenta implantation. The placenta implantation was significantly higher in severe group than in moderate group

the difference was statistically significant（P=0.045）.Conclusion:The reproductive outcome of moderate IUA is better than that of severe intrauterine adhesions.

关键词

宫腔粘连妊娠率生殖预后

Keywords

intrauterine adhesionpregnancy ratereproductive prognosis

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