Department of Obstetrics and Gynecology, Yiwu Maternity and Children Hospital, Jinhua, China.
Department of Public Health, Southwest Medical University, Lu Zhou, China.
Int J Gynaecol Obstet. 2018 Nov;143(2):145-149. doi: 10.1002/ijgo.12635. Epub 2018 Aug 29.
Various adjuvant therapies have failed to improve clinical symptoms and pregnancy rates among patients with moderate-to-severe intrauterine adhesion.
To evaluate the ability of amniotic membrane to prevent the recurrence of intrauterine adhesion after hysteroscopic adhesiolysis.
The Cochrane Library, Embase, and PubMed databases were searched for articles published before December 31, 2017, using the terms: ("amnion") and ("intrauterine adhesions" or "Asherman syndrome" or "IUA" or "endometrial injury" or "uterine adhesion" or "hysteroscopic" or "hysteroscopic adhesiolysis").
Randomized controlled trials of amniotic membrane therapy after hysteroscopic adhesiolysis.
Four studies were included in the meta-analysis (300 patients in total). Dichotomous outcomes were expressed as relative risk (RR) with 95% confidence intervals (CIs). Continuous variables were expressed as mean difference.
Amniotic membrane increased menstrual blood volume after hysteroscopic adhesiolysis (mean difference 6.15, 95% CI 4.20-8.11; P<0.001). By contrast, this treatment did not affect the rates of intrauterine adhesion recurrence (RR 0.84, 95% CI 0.61-1.16; P=0.290); pregnancy (RR 1.40, 95% CI 0.78-2.50; P=0.260); or spontaneous abortion (RR 0.88, 95% CI 0.38-1.99; P=0.750).
The use of amniotic membrane increased menstrual blood volume but failed to improve other measures assessed in the current meta-analysis.
各种辅助疗法未能改善中重度宫腔粘连患者的临床症状和妊娠率。
评估羊膜预防宫腔镜粘连分解术后宫腔粘连复发的能力。
检索 Cochrane 图书馆、Embase 和 PubMed 数据库，检索词为：("羊膜")和("宫腔粘连"或"Asherman 综合征"或"IUA"或"子宫内膜损伤"或"子宫粘连"或"宫腔镜"或"宫腔镜粘连分解术")。
宫腔镜粘连分解术后羊膜治疗的随机对照试验。
共有 4 项研究纳入荟萃分析（共 300 例患者）。二分类结局采用相对危险度（RR）表示，95%置信区间（CI）。连续变量表示为均数差。
羊膜增加了宫腔镜粘连分解术后的月经量（平均差异 6.15，95%CI 4.20-8.11；P<0.001）。然而，这种治疗方法并不影响宫腔粘连复发率（RR 0.84，95%CI 0.61-1.16；P=0.290）；妊娠率（RR 1.40，95%CI 0.78-2.50；P=0.260）；或自然流产率（RR 0.88，95%CI 0.38-1.99；P=0.750）。
使用羊膜增加了月经量，但未能改善当前荟萃分析评估的其他指标。
