重度宫腔黏连手术治疗后的妊娠情况分析

目的：评估宫腔镜黏连松解术治疗重度宫腔黏连患者不孕的效果。方法：用宫腔镜剪或单极电切割进行黏连松解术治疗86例重度宫腔黏连患者,所有患者术后均行宫腔镜检查宫腔修复情况。结果：术后85例（98.8%）患者均恢复月经。术后平均随访37个月,8例患者失访（9.3%）。78例随访者中,48例（61.5%）患者怀孕,其中3例患者妊娠时合并前置胎盘,3例合并胎盘植入。结论：宫腔镜黏连松解术是治疗重度宫腔黏连所致不孕症的有效手段,术后妊娠合并胎盘异常的发生率增加。

Fertility after Treatment of Severe Intrauterine Adhesion

Objective：To evaluate the efficacy of hysteroscopic adhesiolysis and subsequent fertility in patients with severe intrauterine adhesion.Methods： Eighty-six patients were followed after hysteroscopic adhesiolysis with hysteroscopic scissors or monopolar energy.Evalunation of the uterine cavity after surgery has been performed by hysteroscopy for all patients.Results： Eight-five patients（98.8%） had resumption of menses.The mean follow-up time was 37 months,8 patients（9.8%） bost follow-up.Among the patients who were followed successfully the pregnancy rate after the procedure was 55.8%（48 of 86）,and 3 patients had placenta previa and 3 patient had placenta accreta with uneventful postoperative course.Conclusions： Hysteroscopic adhesiolysis can be performed for severe adhesions with safety and efficacy,the pregnancies were at risk of abnormal placentation.