Observation in clinical effects of different intervention schemes after electrotomy of intrauterine adhesion

  Objective   To observe the clinical effects of different intervention methods after transcervical resection of intrauterine adhesion in patients with moderate to severe intrauterine adhesion.

  Methods   A total of 174 patients with moderate to severe intrauterine adhesion were selected as study objects, including 121 cases with moderate adhesion, and 53 cases with severe adhesion, all of them accepted electrosurgical treatment of intrauterine adhesion. According to the method of preventing re-adhesion after operation, they were divided into gel group (self-crosslinked sodium hyaluronate gel regimen), balloon group (Foley balloon regimen) and combination group (self-crosslinked sodium hyaluronate gel regimen combined with Foley balloon regimen). The recurrence conditions of postoperative adhesion and changes of menstrual pattern were observed and compared among the three groups, and the pregnancy outcomes and obstetric complications of the patients with fertility requirements were followed up. Logistic regression analysis was used to analyze the effects of the degree of intrauterine adhesions, the number of intrauterine operation, menstrual pattern and age on pregnancy outcomes.

  Results   The incidence of postoperative re-adhesion in the combination group was lower than that in the gel group and the balloon group (P < 0.05). There were no statistical significances in the change of menstrual pattern and pregnancy rate among the three groups (P>0.05). Logistic regression analysis showed that the degree of intrauterine adhesions before operation and postoperative menstrual patterns after operation were independent factors affecting pregnancy(P < 0.05).

  Results   Conclusion Self-crosslinking sodium hyaluronate gel combined with Foley balloon has better efficacy than self-crosslinking sodium hyaluronate gel or Foley balloon alone in preventing intrauterine readhesion. The recovery of patients with severe adhesions is relatively poor. The preoperative degree of intrauterine adhesions and postoperative menstrual patterns will affect the pregnancy outcomes of patients with intrauterine adhesions.