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.
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页码:1022 / 1028
页数:7
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