Reproductive outcomes in women with mild intrauterine adhesions; a systematic review and meta-analysis.
| Autor: | Hooker AB; Department of Obstetrics and Gynecology, Zaans Medical Center, Zaandam, The Netherlands.; Department of Obstetrics and Gynecology, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands., Mansvelder FJ; Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Elbers RG; Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Frijmersum Z; Department of Obstetrics and Gynecology, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2022 Dec; Vol. 35 (25), pp. 6933-6941. Date of Electronic Publication: 2021 May 27. |
| DOI: | 10.1080/14767058.2021.1931103 |
| Abstrakt: | Background: Moderate to severe intrauterine adhesions (IUAs) may greatly impact fertility, predisposing to pregnancy and obstetric complications. The impact of mild IUAs on reproductive performance remains unclear. A systematic review and meta-analysis was performed to examine the long-term reproductive outcomes in women with hysteroscopic identified and treated mild IUAs mild intrauterine adhesions (IUAs). Methods: An electronic literature search was conducted using MEDLINE and EMBASE from inception to June 2019. All prospective cohort, cross-sectional studies or randomized controlled trials Clinical trials in which reproductive outcomes of women with mild IUAs, were reported were included. Results: Five studies, reporting on reproductive outcomes of 229 women with hysteroscopic identified and treated mild IUAs, were included. The pregnancy rate was 62.3% (142 of 228; 95% CI: 0.55-0.72, I 2 25%, p = .21) and in 86.6% (123 of 142) a live birth was encountered (95% CI: 0.71-0.97) with 83.1% (108 out of 130) term deliveries (95% CI: 0.53-0.95). A miscarriage was reported in 10% (13 of 130; 95% CI: 0.02-0.26). Due to the lack of a control group, reproductive outcomes were compared to a general population. Pregnancy and live birth rates were significantly lower in women with identified and treated mild IUAs, 90% versus 62.3% and respectively 99.5% versus 86.6%. The miscarriage rate was similar. Data on obstetric and neonatal outcomes are lacking. Conclusions: Women with hysteroscopic identified and treated mild IUAs seem to have lower pregnancy and live birth rate compared to the general population. Future studies consisting of a large cohort of women with hysteroscopic identified and treated IUAs with structural follow-up and a control group are needed to confirm our findings. |
| Databáze: | MEDLINE |
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