宫腔粘连分离术治疗阿谢曼综合征后患者报告的月经和产科结局
Patient-reported menstrual and obstetric outcomes following hysteroscopic adhesiolysis for Asherman syndrome.
作者信息
Morales Blanca, Movilla Peter, Wang Joyce, Wang Jennifer, Williams Alexandria, Chen Tammy, Reddy Himabindu, Tavcar Jovana, Loring Megan, Morris Stephanie, Isaacson Keith
机构信息
Newton Wellesley Hospital, Center for Minimally Invasive Gynecologic Surgery, Newton, Massachusetts.
出版信息
F S Rep. 2021 Jan 11;2(1):118-125. doi: 10.1016/j.xfre.2021.01.002. eCollection 2021 Mar.
OBJECTIVE
Review the menstrual and obstetric outcomes among Asherman syndrome patients when stratified by disease severity.
DESIGN
Retrospective cohort study.
SETTING
A community teaching hospital affiliated with a large academic medical center.
PATIENTS
A total of 355 Asherman syndrome patients stratified by March classification who underwent hysteroscopic adhesiolysis.
INTERVENTIONS
Telephone survey, analyzed with multivariable analysis.
MAIN OUTCOME MEASURES
Return of menstruation. Pregnancy, miscarriage, and live birth rate.
RESULTS
A total of 355 patients underwent hysteroscopic adhesiolysis. Of these, 150 (42.3%) patients completed the telephone survey with a mean follow-up of 2.21 years. Additionally, 40.7% had mild, 52.7% had moderate, and 6.6% had severe disease. Furthermore, 25.3% of patients reported amenorrhea at presentation, with mild disease patients having the highest rate of returning menstruation (93.8%) following treatment. The cumulative pregnancy rate was 81.9%, and the cumulative live birth rate was 51.2%, with no statistical differences identified by the classification group.
CONCLUSION
Asherman syndrome disease severity predicted returning menstruation but not pregnancy or live birth rate.
目的
按疾病严重程度对宫腔粘连综合征患者的月经和产科结局进行回顾性分析。
设计
回顾性队列研究。
地点
一所隶属于大型学术医疗中心的社区教学医院。
患者
共有355例根据March分类进行分层的宫腔粘连综合征患者接受了宫腔镜粘连松解术。
干预措施
电话调查，并采用多变量分析。
主要观察指标
月经恢复情况、妊娠率、流产率和活产率。
结果
共有355例患者接受了宫腔镜粘连松解术。其中，150例（42.3%）患者完成了电话调查，平均随访时间为2.21年。此外，40.7%为轻度疾病，52.7%为中度疾病，6.6%为重度疾病。此外，25.3%的患者就诊时出现闭经，轻度疾病患者治疗后月经恢复率最高（93.8%）。累积妊娠率为81.9%，累积活产率为51.2%，各分类组之间未发现统计学差异。
结论
宫腔粘连综合征的疾病严重程度可预测月经恢复情况，但不能预测妊娠率或活产率。
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