Quantitative Evaluation Of Endometrial Repair After Different Treatments For Intrauterine Adhesions By Transvaginal Three-dimensional Ultrasound

Objective :To investigate the significance of transvaginal three-dimensional ultrasound(3D-TVS)in quantitative analysis of endometrial repair in patients with intrauterine adhesions after different estrogen regimens.Methods :A total of 62 patients with moderate intrauterine adhesions admitted to Ganzhou People ’s Hospital were selected.All patients underwent transcervical resection of adhesions(TCRA).According to different postoperative estrogen treatment regimens,they were divided into two groups with 30 patients in the estrogen and progesterone sequential group who were treated with estradiol valerate and dydrogesterone sequential therapy after operation and 32 patients in the estrogen group who were treated with estradiol valerate alone after operation.All patients took estrogen orally after operation.Endometrial thickness,endometrial volume,vascular index(VI),blood flow index(FI)and vascular blood flow index(VFI)were measured by 3D-TVS before and after drug treatment.Intrauterine adhesion score was performed according to the international standard.Endometrial repair and intrauterine adhesions were compared between the two groups after treatment.Results :The mean endometrial thickness,endometrial volume,VI,FI and VFI were 7.11 mm,2.99 cm3,4.86,30.28 and 1.16,respectively,after three cycles of TCRA surgery.Compared with the single estrogen group,these indicators were significantly increased after treatment,and the difference between the two groups was statistically significant(p < 0.05).The score of hysteroscopic intrauterine adhesions was 1.94 ±1.16 in the estrogen and progesterone sequential group,which was lower than that in the estrogen group(p< 0.05).The number of the patients with menstrual improvement in the estrogen and progesterone sequential group was 23(76.7 %),which was higher than that in the estrogen group,and the difference was statistically significant(p < 0.05).Postoperative hysteroscopy showed that there were 12 cases(40.0 %)of intrauterine adhesions in the estrogen and progesterone sequential group,which was lower than that in the single estrogen group(p< 0.05).After treatment,the correlation coefficient between hysteroscopic review of intrauterine adhesion score and endometrial thickness,endometrial volume,VI,FI,VFI was-0.625,-0.624,-0.678,-0.637,-0.696(p < 0.01),showing a strong negative correlation.Conclusion :Compared with estrogen alone,estrogen and progesterone sequential therapy can better improve the endometrial repair status of patients with intrauterine adhesions after TCRA,and 3D-TVS technology can effectively evaluate the therapeutic effect of patients with intrauterine adhesions.