Application value of real-time ultrasonic guidance during hysteroscopic adhesiolysis of severe intrauterine adhesions

doi:10.3877/cma.j.issn.1672-6448.2020.05.010

Abstract

Abstract:

Objective

To explore the value of real-time transabdominal ultrasound monitoring in hysteroscopic surgery for severe intrauterine adhesion.

Method

Patients who received hysteroscopic adhesiolysis due to severe intrauterine adhesion at Nanjing Druw Tower Hospital from January 2017 to June 2019 were analyzed retrospectively. Transvaginal ultrasound and preoperative evaluation were performed routinely before the operation. Patients with complex surgery identified through clinical discussion and evaluation before surgery were given real-time monitoring by transabdominal ultrasound during the operation.

Result

A total of 236 cases of severe intrauterine adhesion were included, all of which underwent hysteroscopic adhesiolysis. After the operation, 108 cases were implanted with umbilical cord mesenchymal stem cells or bone marrow stem cells on collagen membrane scaffolds, 15 cases were implanted with biological membrane wrapped by contraceptive ring, 71 cases of thin endometrium were injected with growth factor under the endometrium. No uterine perforation or abnormal bleeding occurred during surgery.

Conclusion

Real-time transabdominal ultrasound monitoring in hysteroscopic surgery for severe intrauterine adhesion has advantages of increasing the safety and success rate of the operation, decreasing the risk of the operation, and reducing the complications, which is worthy of clinical promotion.

Key words: Ultrasonography, Intrauterine adhesion, Hysteroscopy

Chenyan Dai, Yali Hu, Xianghong Zhu, Xiaoqiu Tang, Huiyan Wang, Hui Zhu, Yaling Li. Application value of real-time ultrasonic guidance during hysteroscopic adhesiolysis of severe intrauterine adhesions[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(05): 447-450.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.05.010

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I05/447

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References 12

1	March CM. Management of Asherman′s syndrome [J]. Reprod Biomed Online, 2011, 23(1): 63-76.
2	Lemmers M, Verschoor MA, Hooker AB, et al. Dilatation and curettage increases the risk of subsequent preterm birth: a systematic review and meta-analysis [J]. Hum Reprod, 2016, 31(1): 34-45.
3	Zhao G, Cao Y, Zhu X, et al. Transplantation of collagen scaffold with autologous bone marrow mononuclear cells promotes functional endometrium reconstruction via downregulating ΔNp63 expression in Asherman′s syndrome [J]. Sci China Life Sci, 2017, 60(4): 404-416.
4	Jiang PP, Tang XQ, Wang HY, et al. Collagen-binding basic fibroblast growth factor improves functional remodeling of scarred endometrium in uterine infertile women: a pilot study [J]. Sci China Life Sci, 2019, 62(12): 1617-1629.
5	Santamaria X, Mas A, Cervelló I, et al. Uterine stem cells: from basic research to advanced cell therapies [J]. Hum Reprod Update, 2018, 24(6): 673-693.
6	Hooker AB, Lemmers M, Thurkow AL, et al. Systematic review and meta-analysis of intrauterine adhesions after miscarriag: prevalence, risk factors and long-term reproductive outcome [J]. Hum Reprod Update, 2014, 20(2): 262-278.
7	Cao Y, Sun H, Zhu H, et al. Allogeneic cell therapy using umbilical cord MSCs on collagen scaffolds for patients with recurrent uterine adhesion: a phase I clinical trial [J]. Stem Cell Res Ther, 2018, 9(1): 192.
8	Kumagai M, Marui A, Tabata Y, et al. Safety and efficacy of sustained release of basic fibroblast growth factor using gelatin hydrogel in patients with critical limb ischemia [J]. Heart Vessels, 2016, 31(5): 713-721.
9	中华医学会妇产科学分会. 宫腔粘连临床诊疗中国专家共识 [J]. 中华妇产科杂志, 2015, 50(12): 881-887.
10	Saravelos SH, Li TC. Ultrasound-guided treatment of intrauterine adhesions in the outpatient setting. Saravelos [J]. Ultrasound Obstet Gynecol, 2017, 50(2): 278-280.
11	戴晨燕, 茹彤, 胡娅莉, 等. 三维超声宫腔成像在宫腔粘连患者宫腔形态评估中的作用[J]. 现代医学, 2017, 12: 1734-1736.
12	鲁静洁, 朱慧, 朱湘虹, 等. 宫腔粘连分离术后复发为重度宫腔粘连的因素分析 [J]. 实用妇产科杂志, 2017, 10: 751-754.

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