The Effect Of Hysteroscopic Adhesiolysis On Pregnancy Outcomes

Objective: The study searched the effect of hysteroscopic adhesiolysis on pregnancy outcomes by using retrospective analysis on clinical data of 76 cases. And analysis the influence factors to seek the therapeutic method about improving fertility rate.Methods: The patients were diagnosed and treated in Huabei Petroleum General Hospital and Eastern Conference Of The Second Hospital Of Hebei Medical University from December, 2010 to December, 2012. Inclusion criteria:(1)The IUA were confirmed by the clinical diagnostic criteria,and were confirmed by endoscopy.(2)There were complete data of the patients.(3)There are surgical indications.(4)The patients without heart disease and lung disease can tolerate surgery.(5)The patients have the retquirements of fertility.Exclusion criteria:(1)Patients have absolutly contraindications to surgery.(2)Patients refused the treatment.(3).The data of the patients were not complete.(4)Lost to follow-up.(5)Patients of IUA are accompanied by cervix tumo or polyp,and so on.(6)Patients suffered from severe disease that can`t be pregnant.The complete data of the patients include name,sex, age,clinical feature,operation note,operation method,hysteroscopy,pathology report and contact information.Arrange follow-up by telephone,e-mail and regular return visist.Patients need hysteroscopy examination every three months.We need contact with patients that didn`t reture visist more than 6months especially.Patients are followed up 2 years to know menstrual blood volume and pregnancies.The SPSS17.0 software collected data entry, numeric variable application of T-test, categorical variables using chi-square test was used for statistical analysis. The level of statistical significance was set at P<0.05.Results: The are 76 cases up to standerd,age(26.2±3.4),68 cases of them accept uterine cavity operation before, accounting for 89.47%.There are 65 cases have menoxenia,42 cases of them are spanomenorrhea,23 cases of them are amenorrhea.There are 14 cases with mild intrauterine adhesion,55 cases with moderate intrauterine adhesion,7 cases with severe intrauterine adhesion. Follow-up results show that improvement rate of menstruation is 56.92%(37/65),rate of pregnancy is 48.68% after surgery.After analysis the influence factors,we find that the factors of age,menstrual conditions before or after surgery is not associate with the rate of pregnancy(P>0.05),on the contrary the number of intrauterine operation, aetiological agent,the degree of adhesion,operation result,pregnent time after surgery is closely related with the rate of pregnancy(P<0.05).There is significant difference(P<0.05)between moderate and severe intrauterine adhesion on operation result. Menstrual conditions before surgery is not associate with operation result(P>0.05).Aetiological agent and the number of uterine cavity operations have an effect on the degree of adhesion(P<0.05).Conclusions:1 Intrauterine operation is the main reason for intrauterine adhesion, especially artificial abortion, missed abortion, curettage after delivery.2 Aetiological agent, the number of uterine cavity operations, degree of adhesion, operation result, pregnent time after surgery are the main influence factors for the rate of pregnancy. On the contrary,age and menstrual conditions before or after surgery is not associate with it.3 Aetiological agent and the number of uterine cavity operations have an effect on the degree of adhesion, also the degree of adhesion is the main influence factor of operation result.