Hysteroscopy, Intrauterine Adhesion
Conditions
Keywords
Induced abortion, Uterine adhesions, Reproductive infertility, Hysteroscopy
Brief summary
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.
Interventions
outpatient hysteroscopy after the first menstrual cycle in the follicular phase (9-12 days).
Sponsors
Study design
Eligibility
Inclusion criteria
* female age 20 to 45 years-old * undergo induced abortion * desire future fertility * agree with the trial and sign the consent form
Exclusion criteria
* previous intrauterine surgery * previous intrauterine adhesion * previous having over(and/or equal to) 3 times of induced abortion * infection condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence rate of intrauterine adhesions | 6 months later after induced abortion | assess with hysteroscopy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Menstrual cycle condition: Menstrual amount | 6 months later after induced abortion | 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. |
| Menstrual cycle condition: Menstrual duration | 6 months later after induced abortion | days: by questionnaire |
| Menstrual cycle condition: Menstrual symptoms | 6 months later after induced abortion | dysmenorrhea/no dysmenorrhea: by questionnaire |
| The American Fertility Society (AFS) intrauterine adhesion (IUA) score | 6 months later after induced abortion | 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). |
| Sonography findings: morphology | 6 months later after induced abortion | Normal. Abnormal (hyperechogenic lesion/hypoechogenic lesion/other irregular endometrial line) |
| Fertility outcome | 2 years later after induced abortion | Pregnancy outcome: no pregnancy/ abortion/ gestational age/ live birth |
| Sonography findings:endometrial thickness | 6 months later after induced abortion | centimeters |
Countries
Taiwan