Evaluation Of Intrauterine Adhesions And Risk Factors After The Artificial Abortion By Superb Microvascular Imaging

Objective: Using superb microvascular imaging(SMI)to observe endometrial blood perfusion at different stages after induced abortion and to assess the occurrence of postoperative intrauterine adhesions and the risk factors that lead to its formation.Methods: Fifty-four women who underwent the abortion at the First Affiliated Hospital of Guangxi Medical University from February 2017 to August 2017 were enrolled.Transvaginal Ultrasound(TVS)was performed to observe the growth of endometrial thickness,and SMI was performed to observe the endometrial perfusion,at 10-15 days,3 months,and 6 months after the abortion,respectively.The general information of the study subjects was collected using a unified survey collection form,including age,gestational age,surgical methods,postoperative bleeding time,postoperative medication,postoperative menstrual relapse time and so on.According to the postoperative outcome was divided into intrauterine adhesion group and non-adhesion group.Results:(1)The difference of endometrial thickness between 10-15 days after operation,3 months after operation and 6 months after operation was statistically significant(P<0.05);(2)Postoperative abortion 10-15 days,3months after operation,and 6 months after operation showed significant differences in SMI-based Ader classification of endometrial blood flow(P<0.05).2.Univariate analysis: Among 11 single factors at 3 months postoperatively,the difference of postoperative menopausal relapse(P=0.011)and endometrial thickness(P=0.001)at postoperative 10-15 days showed statistically significant.Among 11 single factors at 6 months postoperatively,the difference of gestational age(P=0.038),endometrial thickness(P=0.001),and postoperative use of Umbilical treatment(P=0.006)showed statistically significant.3.Multivariate analysis: Endometrial thickness was thin(P=0.045)after 10-15 days of surgery,and no postoperative use of Umbilical(P=0.037)were the independent risk factor for intrauterine adhesions.Conclusions: 1.With the prolonged time after the abortion,the thickness of the endometrium gradually increases.SMI shows that the Adler grade of endometrial blood flow changes from grade 0 to grade III,and the intimal hemorrhage becomes more and more abundant.2.The use of Yasmin for treatment after abortion and thin endometrial thickness at 10-15 days after surgery are the independent risk factor for intrauterine adhesions.3.Applicationof SIM technology to show endometrial blood perfusion to assess postoperative abortion outcomes needs further study.