A Matched Cohort Study Comparing the Outcome of Intrauterine Adhesiolysis for Asherman's Syndrome After Uterine Artery Embolization or Surgical Trauma

被引:27
|
作者
Song, Dongmei [1 ,2 ]
Liu, Yuhuan [1 ]
Xiao, Yu [1 ]
Li, Tin-Chiu [2 ,3 ]
Zhou, Fengqiong [1 ]
Xia, Enlan [1 ]
机构
[1] Capital Med Univ, Fuxing Hosp, Dept Hysteroscop Ctr, Beijing, Peoples R China
[2] Univ Sheffield, Royal Hallamshire Hosp, Dept Reprod Med & Surg, Sheffield S10 2TN, S Yorkshire, England
[3] Chinese Univ Hong Kong, Dept Obstet & Gynaecol, Hong Kong, Hong Kong, Peoples R China
关键词
Asherman's syndrome; Hysteroscopic adhesiolysis; Pregnancy outcome; Uterine artery embolization; FIBROID EMBOLIZATION; SYMPTOMATIC FIBROIDS; PREGNANCY; HYSTEROSCOPY; ADENOMYOSIS; LEIOMYOMATA; EFFICACY; IMPACT; WOMEN;
D O I
10.1016/j.jmig.2014.04.015
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective: To compare the outcome of hysteroscopic adhesiolysis in women who had Asherman's syndrome after uterine artery embolization (UAE) with those who had Asherman's syndrome caused by surgical trauma. Design: A retrospective cohort study matched for age and intrauterine adhesion score (Canadian Task Force classification II-2). Setting: A tertiary hysteroscopic center in a teaching hospital. Patients: Nineteen women with Asherman's syndrome after UAE and 57 women with Asherman's syndrome caused by surgical trauma. Interventions: Hysteroscopic adhesiolysis was followed by a second-look hysteroscopy 1 month later. The scoring system proposed by the American Fertility Society was used to evaluate intrauterine adhesion during hysteroscopy. Measurements and Main Results: In the UAE group, only 42.1% of women experienced improvement in menstruation defined as a subjective increase in menstrual flow after surgery, which was significantly lower than that of 86.0% observed in the non-UAE group. In the UAE group, the reduction of the American Fertility Society (AFS) score after intrauterine adhesiolysis was 30%, which was significantly lower than that of 80% in the non-UAE group. The pregnancy rate and live birth rate in the UAE group (5% and 0%, respectively) were significantly lower than the corresponding rates in the non-UAE group (33% and 25%, respectively). Conclusion: The outcome of hysteroscopic adhesiolysis in women with Asherman's syndrome after UAE was worse than in women with Asherman's syndrome caused by surgical trauma. (C) 2014 AAGL. All rights reserved.
引用
收藏
页码:1022 / 1028
页数:7
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