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Int J Gynaecol Obstet. 2018 Nov;143(2):145-149. doi: 10.1002/ijgo.12635. Epub 2018 Aug 29.

Meta-analysis of the use of amniotic membrane to prevent recurrence of intrauterine adhesion after hysteroscopic adhesiolysis.

Author information

1
Department of Obstetrics and Gynecology, Yiwu Maternity and Children Hospital, Jinhua, China.
2
Department of Public Health, Southwest Medical University, Lu Zhou, China.
3
Department of Human Health and Human Services, Yiwu Maternity and Children Hospital, Jinhua, China.

Abstract

BACKGROUND:

Various adjuvant therapies have failed to improve clinical symptoms and pregnancy rates among patients with moderate-to-severe intrauterine adhesion.

OBJECTIVES:

To evaluate the ability of amniotic membrane to prevent the recurrence of intrauterine adhesion after hysteroscopic adhesiolysis.

SEARCH STRATEGY:

The Cochrane Library, Embase, and PubMed databases were searched for articles published before December 31, 2017, using the terms: ("amnion") and ("intrauterine adhesions" or "Asherman syndrome" or "IUA" or "endometrial injury" or "uterine adhesion" or "hysteroscopic" or "hysteroscopic adhesiolysis").

SELECTION CRITERIA:

Randomized controlled trials of amniotic membrane therapy after hysteroscopic adhesiolysis.

DATA COLLECTION AND ANALYSIS:

Four studies were included in the meta-analysis (300 patients in total). Dichotomous outcomes were expressed as relative risk (RR) with 95% confidence intervals (CIs). Continuous variables were expressed as mean difference.

MAIN RESULTS:

Amniotic membrane increased menstrual blood volume after hysteroscopic adhesiolysis (mean difference 6.15, 95% CI 4.20-8.11; P<0.001). By contrast, this treatment did not affect the rates of intrauterine adhesion recurrence (RR 0.84, 95% CI 0.61-1.16; P=0.290); pregnancy (RR 1.40, 95% CI 0.78-2.50; P=0.260); or spontaneous abortion (RR 0.88, 95% CI 0.38-1.99; P=0.750).

CONCLUSIONS:

The use of amniotic membrane increased menstrual blood volume but failed to improve other measures assessed in the current meta-analysis.

KEYWORDS:

Amniotic membrane; Hysteroscopic adhesiolysis; Meta-analysis; Pregnancy; Prevent; Recurrence

PMID:
30073656
DOI:
10.1002/ijgo.12635
[Indexed for MEDLINE]

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