Efficacy analysis of sodium hyaluronate gel for preventing recurrence of moderate intrauterine adhesion

Abstract

Objective To explore the clinical effects of sodium hyaluronate gel for preventing recurrence of moderate intrauterine adhesion (IUA). Methods From January 2013 to January 2014, a total of 72 patients with moderate IUA who underwent transcervical resection of adhesion (TCRA) by hysteroscopy in Department of Gynecology, Guangdong Maternal and Child Health Hospital were selected as research subjects. According to the prevention methods of IUA recurrence after TCRA, they were divided into study group (n=32) and control group (n=40). Patients in study group were given sodium hyaluronate gel in uterine cavity, placement of intrauterine device (IUD) and oral estradiol valerate and dydrogesterone after TCRA. Patients in control group were given placement of IUD and oral estradiol valerate and dydrogesterone after TCRA. Three months after TCRA treatment, the menstruation recoveries of two groups were observed, and re-examinations of hysteroscopy were performed on all patients in two groups to assess the effective rate of measures taken after TCRA treatment for preventing recurrence of IUA. Six months after TCRA treatment, clinical pregnancies of two groups were observed. The effective rates of measures taken after TCRA treatment for preventing recurrence of IUA and clinical pregnancy of two groups were compared by chi-square test. This study was approved by the Ethics Committee of Human Beings in Guangdong Maternal and Child Health Hospital and every subject signed informed consent of clinical research. Results ①There were no statistical differences between two groups in the aspects of age, times of artificial termination and so on (P>0.05). ②The effective rate of measures taken after TCRA treatment for preventing recurrence of IUA in study group was 71.9% (23/32), which was statistically higher than that of control group 15.0% (6/40), and the difference was statistically significant (χ2=5.237, P=0.022). After 6-month of treatment by TCRA, the clinical pregnancy rate in study group was 34.4% (11/32), and 15.0% (6/40) in control group, but there was no statistical difference between two groups in the clinical pregnancy rate (χ2=3.700, P=0.054). Conclusions As to moderate IUA patients, the use of sodium hyaluronate gel in uterine cavity, placement of IUD and oral estrin after TCRA treatment can promote menstrual recovery and improve uterine morphology, and effectively prevent the recurrence of IUA. As the sample size in this study is relatively small, whether this method is worthy of clinical application in preventing recurrence of IUA after TCRA treatment in patients with moderate IUA, it remains to be confirmed by large sample, multicenter, and randomized controlled trials. Key words: Sodium hyaluronate; Intrauterine adhesion; Treatment outcome; Recurrence; Transcervical resection of adhesion; Women