Department of Obstetrics and Gynecology, Zaans Medical Center, Zaandam, The Netherlands.
Department of Obstetrics and Gynecology, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6933-6941. doi: 10.1080/14767058.2021.1931103. Epub 2021 May 27.
Moderate to severe intrauterine adhesions (IUAs) may greatly impact fertility, predisposing to pregnancy and obstetric complications. The impact of mild IUAs on reproductive performance remains unclear. A systematic review and meta-analysis was performed to examine the long-term reproductive outcomes in women with hysteroscopic identified and treated mild IUAs mild intrauterine adhesions (IUAs).
An electronic literature search was conducted using MEDLINE and EMBASE from inception to June 2019. All prospective cohort, cross-sectional studies or randomized controlled trials Clinical trials in which reproductive outcomes of women with mild IUAs, were reported were included.
Five studies, reporting on reproductive outcomes of 229 women with hysteroscopic identified and treated mild IUAs, were included. The pregnancy rate was 62.3% (142 of 228; 95% CI: 0.55-0.72, 25%, = .21) and in 86.6% (123 of 142) a live birth was encountered (95% CI: 0.71-0.97) with 83.1% (108 out of 130) term deliveries (95% CI: 0.53-0.95). A miscarriage was reported in 10% (13 of 130; 95% CI: 0.02-0.26). Due to the lack of a control group, reproductive outcomes were compared to a general population. Pregnancy and live birth rates were significantly lower in women with identified and treated mild IUAs, 90% versus 62.3% and respectively 99.5% versus 86.6%. The miscarriage rate was similar. Data on obstetric and neonatal outcomes are lacking.
Women with hysteroscopic identified and treated mild IUAs seem to have lower pregnancy and live birth rate compared to the general population. Future studies consisting of a large cohort of women with hysteroscopic identified and treated IUAs with structural follow-up and a control group are needed to confirm our findings.
中度至重度宫腔粘连 (IUAs) 可能会极大地影响生育能力，导致妊娠和产科并发症。轻度 IUAs 对生殖性能的影响尚不清楚。系统评价和荟萃分析旨在检查宫腔镜识别和治疗轻度宫腔粘连 (mIUAs) 的女性的长期生殖结局。
使用 MEDLINE 和 EMBASE 从创建到 2019 年 6 月进行电子文献检索。所有前瞻性队列研究、横断面研究或随机对照试验均纳入报道了宫腔镜识别和治疗轻度 IUAs 的女性生殖结局的研究。
纳入了 5 项研究，共报道了 229 例宫腔镜识别和治疗轻度 IUAs 的女性的生殖结局。妊娠率为 62.3%（142/228；95%CI：0.55-0.72，25%，=0.21），活产率为 86.6%（123/142）（95%CI：0.71-0.97），83.1%（108/130）为足月分娩（95%CI：0.53-0.95）。报道了 10%（13/130；95%CI：0.02-0.26）的流产。由于缺乏对照组，将生殖结局与一般人群进行了比较。患有经宫腔镜识别和治疗的轻度 IUAs 的女性的妊娠率和活产率明显较低，分别为 90%和 62.3%，分别为 99.5%和 86.6%。流产率相似。缺乏产科和新生儿结局的数据。
与一般人群相比，经宫腔镜识别和治疗的轻度 IUAs 女性的妊娠率和活产率似乎较低。需要进行包含大量经宫腔镜识别和治疗 IUAs 的女性队列研究，包括结构随访和对照组，以证实我们的研究结果。
