Background: Intrauterine adhesions are a difficult clinical problem for reproductive infertility. The most common cause is uterine cavity surgery and post-abortion (including abortion and spontaneous abortion). After the abortion, the uterine cavity adhesion, when is the key point, the literature is not much ink, early literature has mentioned that after the abortion, the uterus scraping action is scraped in four days and the uterine adhesion will be smaller than one to four weeks. Much more, it seems that the sooner the uterine adhesion factor is excluded, the more it can reduce uterine adhesion, but the uterine curettage itself is a risk factor for uterine adhesion. This early practice, the current clinical application, is not used, Instead, it is a hysteroscopy. Our past clinical observations, as soon as possible after the abortion, outpatient hysteroscopy, can find the tissue factors that may cause adhesion in the uterine cavity as soon as possible, and immediately remove it with an outpatient hysteroscope. Objective: To verify the early outpatient hysteroscopy and reduce the occurrence of intrauterine adhesion after abortion. Expected benefits to patients: Abortion is likely to cause intrauterine adhesions, which may further cause the incidence of reproductive infertility, should be involved before the formation of permanent injury, reduce the adhesion of the uterine cavity. Outpatient hysteroscopy is a simple and easy-to-use examination procedure that is painless and does not require anesthesia. Although it is invasive but has few complications, it is expected to reduce the occurrence of intrauterine adhesion after abortion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
70
outpatient hysteroscopy after the first menstrual cycle in the follicular phase (9-12 days).
Chang Gung Memorial Hospital
Kaohsiung City, Taiwan
Incidence rate of intrauterine adhesions
assess with hysteroscopy
Time frame: 6 months later after induced abortion
The American Fertility Society (AFS) intrauterine adhesion (IUA) score
Assess by hysteroscopy and measure with IUA score. Score scaling from 1 to 12 with the higher scores mean a worse outcome. Stage I (mild, 1-4), stage II (moderate, 5-8); stage III (severe, 9-12).
Time frame: 6 months later after induced abortion
Menstrual cycle condition: Menstrual amount
Normal/Hypo/Hyper by Pictorial blood loss assessment charts (PBACs): self-reported by patients and questionnaire. Normal amount: 10 to 100 points. Hypermenorrhea: over 100 points. Hypomenorrhea: less than 10 points.
Time frame: 6 months later after induced abortion
Menstrual cycle condition: Menstrual duration
days: by questionnaire
Time frame: 6 months later after induced abortion
Menstrual cycle condition: Menstrual symptoms
dysmenorrhea/no dysmenorrhea: by questionnaire
Time frame: 6 months later after induced abortion
Sonography findings:endometrial thickness
centimeters
Time frame: 6 months later after induced abortion
Sonography findings: morphology
Normal. Abnormal (hyperechogenic lesion/hypoechogenic lesion/other irregular endometrial line)
Time frame: 6 months later after induced abortion
Fertility outcome
Pregnancy outcome: no pregnancy/ abortion/ gestational age/ live birth
Time frame: 2 years later after induced abortion
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.