Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention

Qiao Peng,1,2 Chao-xia Cao,3 Yi-nan Chen,4 Wei-chu Liu,5 Rui-kun Zhao,5 Quan-jia Jiang,6 Qin Zhou5 1Reproductive Medicine Center, Suining Central Hospital, Suining, Sichuan, 629000, People’s Republic of China; 2Prenatal Diagnosis Center, Suining Central Hospital, Suining, 629000, People’s Republic o...

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Main Authors: Peng Q, Cao CX, Chen YN, Liu WC, Zhao RK, Jiang QJ, Zhou Q
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:Therapeutics and Clinical Risk Management
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Online Access:https://www.dovepress.com/retrospective-analysis-of-prognostic-factors-and-pregnancy-outcomes-in-peer-reviewed-fulltext-article-TCRM
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author Peng Q
Cao CX
Chen YN
Liu WC
Zhao RK
Jiang QJ
Zhou Q
author_facet Peng Q
Cao CX
Chen YN
Liu WC
Zhao RK
Jiang QJ
Zhou Q
author_sort Peng Q
collection DOAJ
description Qiao Peng,1,2 Chao-xia Cao,3 Yi-nan Chen,4 Wei-chu Liu,5 Rui-kun Zhao,5 Quan-jia Jiang,6 Qin Zhou5 1Reproductive Medicine Center, Suining Central Hospital, Suining, Sichuan, 629000, People’s Republic of China; 2Prenatal Diagnosis Center, Suining Central Hospital, Suining, 629000, People’s Republic of China; 3Department of Gynecology, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Chongqing, 401147, People’s Republic of China; 4Department of Mathematics, University College London, London, WC1E 6BT, UK; 5Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 6Department of Obstetrics and Gynecology, Chongqing Shapingba Maternity & Child Healthcare Hospital, Chongqing, 401331, People’s Republic of ChinaCorrespondence: Qin Zhou, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 of Youyi Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Tel +8613101383367, Fax +86023-89011082, Email zhqinou@hospital.cqmu.edu.cnObjective: To assess the clinical prognosis and reproductive outcomes in individuals presenting with moderate-to-severe intrauterine adhesion (IUA) following the administration of hysteroscopic adhesiolysis (HA) in conjunction with modified intrauterine stents.Methods: A cohort comprising 156 individuals diagnosed with IUA (105 with moderate severity and 51 with severe severity) was enrolled. Subsequent to hysteroscopic intervention, all participants received intrauterine stent placement during the immediate postoperative phase. A comprehensive follow-up period of 2 years post-stent removal was instituted.Results: The occurrence of adhesion recurrence increased progressively, demonstrating a recurrence rate of 11.54% at hysteroscopic reevaluation administrated in 3 months after surgery and surging to 32.69% during the 2-year follow-up period. Comparative analysis indicated a statistically significant reduction in recurrence rates among patients with moderate IUA compared to severe IUA (P < 0.05). The median duration of stent placement was determined to be 4 months. Postoperatively, patients exhibited a cumulative pregnancy rate of 71.79%, with a live birth rate of 79.28%. Significantly, patients with moderate IUA exhibited a significantly elevated pregnancy rate in comparison to those with severe IUA (P = 0.004). Multifactorial logistic regression analysis revealed that the severity of IUA was an independent risk factor for recurrence risk. Furthermore, the severity of IUA and postoperative re-adhesion emerged as contributory factors to the infertility observed in these patients.Conclusion: The combination of HA with a modified intrauterine stent demonstrates efficacy in the treatment of IUA; however, outcomes remain suboptimal for cases characterized by severity. The prognostic assessment of patients and the suggested criteria for the removal of intrauterine stents, as delineated in the study, are considered both feasible and recommendable for clinical practice. Furthermore, conscientious and attentive management is imperative for the mitigation of adverse pregnancy such as early pregnancy loss in individuals afflicted with IUA during pregnancy.Keywords: hysteroscopic adhesiolysis, hysteroscopy, intrauterine adhesion, intrauterine stent, pregnancy outcome
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spelling doaj-art-3fb30be7b56642c6bcd92b377a9ace212025-08-20T03:29:52ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2025-06-01Volume 21Issue 1929939104081Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent InterventionPeng Q0Cao CX1Chen YN2Liu WC3Zhao RK4Jiang QJ5Zhou Q6Reproductive Medicine CenterDepartment of GynecologyFaculty of mathematics and statisticsDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyQiao Peng,1,2 Chao-xia Cao,3 Yi-nan Chen,4 Wei-chu Liu,5 Rui-kun Zhao,5 Quan-jia Jiang,6 Qin Zhou5 1Reproductive Medicine Center, Suining Central Hospital, Suining, Sichuan, 629000, People’s Republic of China; 2Prenatal Diagnosis Center, Suining Central Hospital, Suining, 629000, People’s Republic of China; 3Department of Gynecology, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Chongqing, 401147, People’s Republic of China; 4Department of Mathematics, University College London, London, WC1E 6BT, UK; 5Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 6Department of Obstetrics and Gynecology, Chongqing Shapingba Maternity & Child Healthcare Hospital, Chongqing, 401331, People’s Republic of ChinaCorrespondence: Qin Zhou, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 of Youyi Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Tel +8613101383367, Fax +86023-89011082, Email zhqinou@hospital.cqmu.edu.cnObjective: To assess the clinical prognosis and reproductive outcomes in individuals presenting with moderate-to-severe intrauterine adhesion (IUA) following the administration of hysteroscopic adhesiolysis (HA) in conjunction with modified intrauterine stents.Methods: A cohort comprising 156 individuals diagnosed with IUA (105 with moderate severity and 51 with severe severity) was enrolled. Subsequent to hysteroscopic intervention, all participants received intrauterine stent placement during the immediate postoperative phase. A comprehensive follow-up period of 2 years post-stent removal was instituted.Results: The occurrence of adhesion recurrence increased progressively, demonstrating a recurrence rate of 11.54% at hysteroscopic reevaluation administrated in 3 months after surgery and surging to 32.69% during the 2-year follow-up period. Comparative analysis indicated a statistically significant reduction in recurrence rates among patients with moderate IUA compared to severe IUA (P < 0.05). The median duration of stent placement was determined to be 4 months. Postoperatively, patients exhibited a cumulative pregnancy rate of 71.79%, with a live birth rate of 79.28%. Significantly, patients with moderate IUA exhibited a significantly elevated pregnancy rate in comparison to those with severe IUA (P = 0.004). Multifactorial logistic regression analysis revealed that the severity of IUA was an independent risk factor for recurrence risk. Furthermore, the severity of IUA and postoperative re-adhesion emerged as contributory factors to the infertility observed in these patients.Conclusion: The combination of HA with a modified intrauterine stent demonstrates efficacy in the treatment of IUA; however, outcomes remain suboptimal for cases characterized by severity. The prognostic assessment of patients and the suggested criteria for the removal of intrauterine stents, as delineated in the study, are considered both feasible and recommendable for clinical practice. Furthermore, conscientious and attentive management is imperative for the mitigation of adverse pregnancy such as early pregnancy loss in individuals afflicted with IUA during pregnancy.Keywords: hysteroscopic adhesiolysis, hysteroscopy, intrauterine adhesion, intrauterine stent, pregnancy outcomehttps://www.dovepress.com/retrospective-analysis-of-prognostic-factors-and-pregnancy-outcomes-in-peer-reviewed-fulltext-article-TCRMHysteroscopic adhesiolysishysteroscopyintrauterine adhesionintrauterine stentpregnancy outcome
spellingShingle Peng Q
Cao CX
Chen YN
Liu WC
Zhao RK
Jiang QJ
Zhou Q
Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention
Therapeutics and Clinical Risk Management
Hysteroscopic adhesiolysis
hysteroscopy
intrauterine adhesion
intrauterine stent
pregnancy outcome
title Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention
title_full Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention
title_fullStr Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention
title_full_unstemmed Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention
title_short Retrospective Analysis of Prognostic Factors and Pregnancy Outcomes in Patients with Moderate-to-Severe Intrauterine Adhesions Following Hysteroscopic Adhesiolysis and Modified Intrauterine Stent Intervention
title_sort retrospective analysis of prognostic factors and pregnancy outcomes in patients with moderate to severe intrauterine adhesions following hysteroscopic adhesiolysis and modified intrauterine stent intervention
topic Hysteroscopic adhesiolysis
hysteroscopy
intrauterine adhesion
intrauterine stent
pregnancy outcome
url https://www.dovepress.com/retrospective-analysis-of-prognostic-factors-and-pregnancy-outcomes-in-peer-reviewed-fulltext-article-TCRM
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