Izhar Rubina, Husain Samia, Tahir Muhammad Ahmad, Husain Sonia
Department of Gynaecology And Obstetrics, Aziz Medical Center , Karachi , Pakistan.
Aziz Medical Center , Karachi , Pakistan.
J Ultrason. 2020;20(81):e116-e121. doi: 10.15557/JoU.2020.0019. Epub 2020 Jun 15.
To assess the effect of ultrasound-guided cervical dilation on clinical pregnancy rates in women with cervical stenosis. A prospective case control study was conducted in women with unexplained infertility. These women underwent saline infusion sonography and were suspected of having cervical stenosis if a 7 French Foley's catheter could not be introduced into the cervical canal. Women with suspected stenosis who agreed to undergo ultrasound guided dilation were included as cases. Those with suspected stenosis who refused dilation were used as controls. Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heart beat present on transvaginal scan during the follow up period. During the study period, 1097 women who underwent SIS were included. A total of 117 (10.7%) patients had cervical stenosis. No statistically significant difference was there in both groups in terms of mean age ( = 0.617), mean body mass index ( = 0.598), duration of infertility ( = 0.588) and type of infertility ( = 0.167). However, both groups were significantly different in terms of history for risk factors i.e. endometriosis ( <0.001), prior surgery ( <0.001), polyps ( = 0.004) and pelvic inflammatory disease ( = 0.001). Eighty-nine women agreed to have dilation and were used as cases and 28 women refused and were used as controls. Of the cases, 70.45% conceived as compared to 18.5% of controls. The mean time to conception in months was also significantly lower in cases (8.10 ± 3.43 vs. 11.39 ± 1.97, <0.001). Our study shows that ultrasound-guided cervical dilation in women with cervical stenosis can lead to improved conception rates. To assess the effect of ultrasound-guided cervical dilation on clinical pregnancy rates in women with cervical stenosis. A prospective case control study was conducted in women with unexplained infertility. These women underwent saline infusion sonography and were suspected of having cervical stenosis if a 7 French Foley’s catheter could not be introduced into the cervical canal. Women with suspected stenosis who agreed to undergo ultrasound guided dilation were included as cases. Those with suspected stenosis who refused dilation were used as controls. Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heart beat present on transvaginal scan during the follow up period. During the study period, 1097 women who underwent SIS were included. A total of 117 (10.7%) patients had cervical stenosis. No statistically significant difference was there in both groups in terms of mean age ( = 0.617), mean body mass index ( = 0.598), duration of infertility ( = 0.588) and type of infertility ( = 0.167). However, both groups were significantly different in terms of history for risk factors i.e. endometriosis ( <0.001), prior surgery ( <0.001), polyps ( = 0.004) and pelvic inflammatory disease ( = 0.001). Eighty-nine women agreed to have dilation and were used as cases and 28 women refused and were used as controls. Of the cases, 70.45% conceived as compared to 18.5% of controls. The mean time to conception in months was also significantly lower in cases (8.10 ± 3.43 vs. 11.39 ± 1.97, <0.001). Our study shows that ultrasound-guided cervical dilation in women with cervical stenosis can lead to improved conception rates.
评估超声引导下宫颈扩张术对宫颈狭窄女性临床妊娠率的影响。对不明原因不孕的女性进行了一项前瞻性病例对照研究。这些女性接受了盐水灌注超声检查,如果无法将7号法国福勒氏导尿管插入宫颈管,则怀疑患有宫颈狭窄。同意接受超声引导下扩张术的疑似狭窄女性被纳入病例组。拒绝扩张术的疑似狭窄女性被用作对照组。两组均随访一年。主要结局指标是在随访期间经阴道扫描发现有胎心搏动即临床妊娠的女性。在研究期间,纳入了1097例接受盐水灌注超声检查的女性。共有117例(10.7%)患者存在宫颈狭窄。两组在平均年龄(P = 0.617)、平均体重指数(P = 0.598)、不孕持续时间(P = 0.588)和不孕类型(P = 0.167)方面无统计学显著差异。然而,两组在危险因素病史方面存在显著差异,即子宫内膜异位症(P <0.001)、既往手术史(P <0.001)、息肉(P = 0.004)和盆腔炎(P = 0.001)。89名女性同意进行扩张术并被用作病例组,28名女性拒绝并被用作对照组。病例组中有70.45%怀孕,而对照组为18.5%。病例组的平均受孕时间(月)也显著低于对照组(8.10±3.43 vs. 11.39±1.97,P <0.001)。我们的研究表明,超声引导下对宫颈狭窄女性进行宫颈扩张术可提高受孕率。评估超声引导下宫颈扩张术对宫颈狭窄女性临床妊娠率的影响。对不明原因不孕的女性进行了一项前瞻性病例对照研究。这些女性接受了盐水灌注超声检查,如果无法将7号法国福勒氏导尿管插入宫颈管,则怀疑患有宫颈狭窄。同意接受超声引导下扩张术的疑似狭窄女性被纳入病例组。拒绝扩张术的疑似狭窄女性被用作对照组。两组均随访一年。主要结局指标是在随访期间经阴道扫描发现有胎心搏动即临床妊娠的女性。在研究期间,纳入了1097例接受盐水灌注超声检查的女性。共有117例(10.7%)患者存在宫颈狭窄。两组在平均年龄(P = 0.617)、平均体重指数(P = 0.598)、不孕持续时间(P = 0.588)和不孕类型(P = 0.167)方面无统计学显著差异。然而,两组在危险因素病史方面存在显著差异,即子宫内膜异位症(P <0.001)、既往手术史(P <0.001)、息肉(P = 0.004)和盆腔炎(P = 0.001)。89名女性同意进行扩张术并被用作病例组,28名女性拒绝并被用作对照组。病例组中有70.45%怀孕,而对照组为18.5%。病例组的平均受孕时间(月)也显著低于对照组(8.10±3.43 vs. 11.39±1.97,P <0.001)。我们的研究表明,超声引导下对宫颈狭窄女性进行宫颈扩张术可提高受孕率。