The Comparison Of The Value Of Different IUA Classification Systems In Indicating Pregnancy Outcomes

PurposeTo observe the pregnancy rate and live birth rate in patients with intrauterine adhesions of different degrees. To find the significance of different intrauterine adhesion classification systems in indicating the pregnancy outcomes.MethodsChoose the patients who had been diagnosed of intrauterine adhesions and accepted surgery treatment in Sir Run Run Shaw Hospital College Of Medicine Zhejiang University from October2008to December2013. Choose the patients that we have known whether have been pregnant during the2years, and choose the patients we have known whether the pregnancy outcome is successful. All the patients chosen have accpetd hystroscopic adhesiolysis, and according to what we saw in the surgery, scored by AFS, ESGE, March and Nasr classification. Thus to compare the correlation of different classification systems of intrauterine adhesions and pregnancy outcome. Results(1) Comparisons among different classification systems in predicting pregnancy rate of IUA patients after sugery.:A total of148cases are chosen. The correlation between AFS or ESGE classification and pregnancy rate has no statistics significance (P>0.05). The correlation coefficient of March classification and pregnancy rate is0.348, P<0.05, which has statistics significance. The correlation coefficient of Nasr classification and pregnancy rate is0.282, P<0.05, which has statistics significance. March Classification is better than the others in correlation test. In Logistic regression analysis, both AFS classification and ESGE classification have95%confidence intervals which cover1, suggesting poor efficacy of predict outcome. March classification’s regression coefficient B is1.723, P is0.000, OR is5.603,95%confidence interval is from2.361to13.297, the coefficient has statistics significance. Nasr classification’s regression coefficient B is1.338, P is0.000, OR is3.810,95%confidence interval is from2.233to6.503, the coefficient has statistics significance. Comparing the four criterion’s efficacy in evaluating pregnancy rate, they are all effient (P<0.05), but March classification is the best, which has the biggest AUCROC (0.707).(2) Comparisons among different classification systems in predicting live birth rate of IUA patients after sugery.:Choose129cases which have the results of whether have acquired live birth. The correlation coefficient of AFS, ESGE and March classification is0.218,0.261,0.422,0.294. The correlation all have statistics significance (P<0.05). March classification has the greatest correlation with live birth rate. In Logistic regression analysis, AFS classification suggest the regression coefficient B is0.837, P is0.014, OR is2.31,95%confidence interval is from1.186to4.497. ESGE classification suggest the regression coefficient B is0.673, P is0.004, OR is1.961,95%confidence interval is from1.238to3.105, the two coefficient above both have statistics significance. March classification’s regression coefficient B is1.615, P is0.000, OR is5.030,95%confidence interval is from2.465to10.265, the coefficient has statistics significance. Nasr classification’s regression coefficient B is1.048, P is0.000, OR is3.810,95%confidence interval is from1.802to4.504, the coefficient has statistics significance. Comparing the four criterion’s efficacy in evaluating pregnancy rate, they are all effient (P<0.05), but March classification is the best, which has the biggest AUCROC (0.709).ConclusionThe AFS, ESGE, March and Nasr classification do have differences in indicating pregnancy outcomes. Of the ability of predicting pregnancy rate and live birth rate postoperatively, March classification is better than the others.