| Objective: To explore a new index that may be effective in predicting the postoperative pregnancy of patients with intrauterine adhesions-the density of endometrial glandular openings(DEGO)under hysteroscopy and the currently relatively recognized intrauterine Predictive value of membrane thickness on postoperative pregnancy rate in patients with intrauterine adhesions.Methods: From October 2020 to September 2021,patients with intrauterine adhesions who were diagnosed and treated in Changsha Jiangwan Reproductive and Genetics Hospital of the Third Xiangya Hospital of Central South University were prospectively selected as the research subjects,and the basic information and research of the subjects were collected.Variables(endometrial thickness before and after surgery and postoperative endometrial gland opening density,endometrial gland opening density was identified by the intelligent endometrial gland opening automatic counting software);significant variables were screened out by statistical analysis(P<0.1 means statistical significance),establish a prediction model for postoperative pregnancy of patients with intrauterine adhesions,calculate the area under the curve of the prediction model with DEGO and endometrial thickness as the main variables,and compare the prediction accuracy(P<0.05).statistically significant).result:1.In this study,a total of 69 subjects were finally included.After six months of follow-up,3 were lost to follow-up.In the last DEGO classification,the pregnancy rates of G1-G3 were 60%,50%,and 21.4%,respectively.,the difference was statistically significant(P=0.029).Taking 7mm as the cut-off value,comparing the first endometrial thickness,the pregnancy rates of the two groups of <7mm and ≥7mm were 31.4% and 66.7%,respectively,and the difference was statistically significant(P=0.014),comparing the last endometrial thickness,the pregnancy rates of <7mm and ≥7mm groups were 26.1% and 48.8%,respectively,and the difference was statistically significant(P=0.076).2.To analyze the relationship between the last DEGO classification(during the last operation)and the decrease in AFS score of IUA patients after surgery,the difference in the mean value of AFS score decrease in different DEGO classifications was statistically significant(P<0.05).With the increase of DEGO classification The average value of AFS score decline showed a downward trend,and the G1 grade AFS score decreased most significantly.3.The relationship between the last DEGO grade and the EM change value(last EM-first EM)of patients with intrauterine adhesions was analyzed.The difference in the average value of the EM change value of different DEGO grades was statistically significant(P<0.05),among which the G2 grade The average value of the EM change values is the largest.4.Analyze the correlation between each variable and the pregnancy,and find that the parity,the number of abortions,the first endometrial thickness,the last endometrial thickness,the last adhesion area,and the last endometrial gland opening density are related to the pregnancy.The differences are as follows: Statistical significance(P<0.1).5.Finally,the significant variables were analyzed by binary multivariate Logistic regression,and the prediction model of postoperative pregnancy rate of patients with intrauterine adhesions was established with the last endometrial gland opening density or the first endometrial thickness as the main variables respectively.The areas under the curve(ROC)were 0.796 and 0.693,respectively.Conclusion: Endometrial gland opening density may be a potentially effective predictor of postoperative pregnancy in patients with intrauterine adhesions.It also seems to be used to assess adhesion recovery and endometrial thickness improvement in patients with intrauterine adhesions.And its predictive value for postoperative pregnancy in patients with intrauterine adhesions may be higher than the currently commonly used endometrial thickness.Figure 5,17 tables,51 references... |
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