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- Title
Incidence of intrauterine adhesion after ultrasound-guided manual vacuum aspiration (USG-MVA) for first-trimester miscarriages: a prospective cohort study.
- Authors
Chung, Jacqueline Pui Wah; Chau, Olivia See Yung; Law, Tracy Sze Man; Ng, Karen; Ip, Patricia Nga Ping; Ng, Elaine Yee Lee; Tso, Tracy Kwan Yi; Sahota, Daljit Singh; Li, Tin Chiu
- Abstract
Purpose: Ultrasound-guided manual vacuum aspiration (USG-MVA) is a feasible and effective outpatient treatment to treat early pregnancy loss. Methods: This was a prospective observational study at a university-affiliated hospital. All women undergoing either a USG-MVA or electric vacuum aspiration (EVA) were invited to return 3–6 months later for follow-up at which women completed a questionnaire to document their post-evacuation menstrual and reproductive history, and underwent a hysteroscopy if they were not pregnant. The severity of intrauterine adhesion (IUA), if present, was graded (Stage I-III) according to the American fertility society classification. Results: A total of 292 women had a hysteroscopy after their initial surgical evacuation, USG-MVA 169(57.9%) versus EVA 123(42.1%). Women undergoing EVA as opposed to a USG-MVA had a 12.9% higher incidence of IUA (24.1% vs. 37.0%, p = 0.042) equivalent to 1.84 times higher risk (95% CI 1.01–3.34; p = 0.048). Women having EVA continued to show an increased but not statistically significant trend towards an increased risk of IUA after adjusting for the type of miscarriage (aOR = 1.3; 95% CI 0.66–2.50; p = 0.46). Conclusion: There were no significant differences in their reproductive outcomes and fewer women post-USG-MVA complained of hypomenorrhea. IUA may still occur in women undergoing USG-MVA but it is lower than the rate in women undergoing EVA. Clinical trials registry The trial was registered with the Centre for Clinical Research and Biostatistics – Clinical Trials Registry (CCRBCTR), a partner registry of the WHO Primary Registry-Chinese Clinical Trials Registry (ChiCTR) with a Unique Trial Number: CUHK_CCRB00541 on 22 Dec 2016.
- Subjects
VACUUM curettage; TISSUE adhesions; MISCARRIAGE; LONGITUDINAL method; COHORT analysis; RECURRENT miscarriage
- Publication
Archives of Gynecology & Obstetrics, 2024, Vol 309, Issue 2, p669
- ISSN
0932-0067
- Publication type
Article
- DOI
10.1007/s00404-023-07280-6