The Way Of Placing Amniotic Membrane After Transcervical Resection Of Intrauterine Adhesion In Moderate-severe Intrauterine Adhesion

Objective: To compare the epithelial layer attaching towards the uterus cavity Vs the stroma layer attaching towards the uterine cavity in amniotic membrane transplantation for prevention of intrauterine adhesion(IUA)reformation after transcervical resection of adhesion(TCRA).Methods: 46 persons diagnosed with moderate to severe intrauterine adhesion(IUA)were divided into 2 groups randomly and each of these patients had a Foley's catheter placed into the uterine cavity after hysteroscopic adhesiolysis.Amniotic membrane covered the balloon of the catheter with the epithelial layer towards the uterine cavity(n=25)in the epithelial group;and the stroma layer was towards the uterine cavity in the stroma group(n=21).AFS scores and endometrium trickiness were recorded preoperative and postoperative.Results:(1)All the 2 groups scored a lower AFS scores,the epithelial group scored lower AFS scores than the stroma group(p<0.05);(2)The endometrial thickness increased in both of the groups,but no significant difference between the two;(3)There was no significant difference between the two groups in the pregnancy rate.Conclusion: Placing the epithelial layer towards the uterine cavity could improve the AFS scores compared with placing the stroma layer towards the uterine cavity in amniotic membrane transplantation.The way of placing the amniotic membrane had little effect on the endometrium trickiness and pregnancy rate as so far and further follow-ups were needed.