Ultrasound monitoring of hysteroscopic laser ablation in case of intrauterine adhesions

Bortsvadze Sh.N.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Svidinskaya E.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Dzhibladze T.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-1540-5628

Zuev V.M.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Khokhlova I.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Ultrasound monitoring of hysteroscopic laser ablation in case of intrauterine adhesions

Authors:

Bortsvadze Sh.N., Svidinskaya E.A., Dzhibladze T.A., Zuev V.M., Khokhlova I.D.

More about the authors

Journal: Russian Bulletin of Obstetrician-Gynecologist. 2021;21(1): 69‑73

DOI: 10.17116/rosakush20212101169

Downloaded: 22

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Bortsvadze ShN, Svidinskaya EA, Dzhibladze TA, Zuev VM, Khokhlova ID. Ultrasound monitoring of hysteroscopic laser ablation in case of intrauterine adhesions. Russian Bulletin of Obstetrician-Gynecologist. 2021;21(1):69‑73. (In Russ.)
https://doi.org/10.17116/rosakush20212101169

Подписка 2025-2 (Russian Bulletin of Obstetrician-Gynecologist)

Close metadata

MATERIALS AND METHODS

The obstetrics and gynecology clinical department 2015 to 2020, 547 patients of 25 and 47 aged with diagnosed intrauterine adhesions and infertility were screened and tested. All patients were retrospectively divided into three groups according to the extent of intrauterine adhesions.

RESULTS

The first group of 162 patients with Asherman’s syndrome went through the laser hysteroscopic ablation of intrauterine synechiae under ultrasound control, after the operation ended, all patients were injected with anti-adhesive gel into the intrauterine cavity. The second group consisted of 212 patients with multiple fibrous fusions in lower third of the uterine cavity. Destruction of intrauterine synechiae was under ultrasound control. The third group presented 166 patients with dense single diagnosed synechiae usually in the middle or upper third of the cavity; we did not use an ultrasound control in that case. After 2-6 menstrual cycles 452 (82.6%) patients were up to hysteroscopy. 26 of 161 (22.4%) and 37 of 207 (17.8%) patients (the 1^st and the 2^nd groups respectively) presented a single intrauterine adhesion with further hysteroscopic re-intervention. None of the 84 patients in the third group were found throughout the control hysteroscopy of synechiae.

CONCLUSION

Ultrasonic monitoring in intrauterine laser surgery in patients with Asherman’s syndrome and multiple intrauterine synechiae allows the surgeon to act more confidently, avoid intraoperative complications, reduce the time of surgery and improve the quality of performing.

Keywords:

intrauterine adhesions

hysteroscopy

ultrasound scan

Authors:

Bortsvadze Sh.N.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Svidinskaya E.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Dzhibladze T.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-1540-5628

Zuev V.M.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Khokhlova I.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Received:

12.08.2020

Accepted:

20.09.2020

List of references:

Vikhlyaeva EM, Adamyan LV, Uvarova EV, Lopukhov DA, Kondrikov NI. Alternative solution to the issue of managing patients with a combination of benign pathology of endo- and myometrics. Akusherstvo i ginekologiya. 1990;8:45-48. (In Russ).
Anshina MB. The history and evolution of infertility treatments. Problemy reproduktsii. 1995;1:9-13. (In Russ.).
Serov VN, Prilepskaya VN, Ovsyannikova TV. Gynecological endocrinology. M.: MEDpress-inform; 2008. (In Russ.).
Kulakov VI, Korneeva IE. Diagnosis and treatment of female infertility. Practical gynecology. M.: MEDpress-inform; 2002. (In Russ.).
Korneeva IE. The general concept of diagnosing and classifying forms of infertility. An infertile marriage. Modern approaches to diagnosis and treatment. Ed Sukhikh G.T., Nazarenko T.A. M.: GEOTAR-Media; 2010. (In Russ.).
Nazarenko TA, Yarotskaya EL. Reproductive health of the Russian population. An infertile marriage. Modern approaches to diagnosis and treatment. Ed G.T. Sukhikh, T.A. Nazarenko. M.: GEOTAR-Media; 2010. (In Russ.).
An infertile marriage. Ed Pepperell R.Dzh., Hadson B., Vud K. 2-e izd.: Trans. from English. M.: Meditsina; 1986. (In Russ.).
Kravtsova EI, Kutsenko II, Kholina LA, Anikina GA. Efficacy of proteolytic therapy in the comprehensive management of patients with second-degree intrauterine synechia. Meditsinskii sovet. 2020;3:170-175. (In Russ.). https://doi.org/10.21518/2079-701X-2020-3-170-175
Dobrokhotova YuE, Grishin II, Grishin AI, Komagorov VI. Use of anti-adhesion gels for intrauterine surgery. RMZh. Mat’ i ditya. 2018;1:1:71-75. (In Russ.). https://doi.org/10.32364/2618-8430-2018-1-1-71-75
Khan Z, Goldberg JM. Hysteroscopic Management of Asherman’s Syndrome. J Minim Invasive Gynecol. 2018;25:2:218-228. https://doi.org/10.1016/j.jmig.2017.09.020
Attilio Di Spiezio Sardo, Gloria Calagna, Marianna Scognamiglio, Peter OʼDonovan, Rudi Campo, Rudy L. de Wilde. Prevention of intrauterine post-surgical adhesions in hysteroscopy. A systematic review. Eur J Obstet Gynecol Reprod Biol. 2016;203:182-192. https://doi.org/10.1016/j.ejogrb.2016.05.050
Angelo Hooker, Donachienne Feank, Hans Brolmann, Judith Huirne. Prevalence of intrauterine adhesions after termination of pregnancy: a systematic review. Eur J Contracept Reprod Health Care. 2016;21:4:329-335. https://doi.org/10.1080/13625187.2016.1199795
Makarenko TA, Nikiforova DE. Contemporary possibilities in treatment of Asherman’s syndrome. RMZh. 2016;15:1001-1004. (In Russ.).
Onlas AR, Dzhakupov DV, Barmanasheva ZE. Reproductive Medicine Institute, Almaty Evidence-based medicine’s look to the problem of the intrauterine adhesions (literature review). Vestnik KazNMU. 2016;3:30-36. (In Russ.).
Yuqing Chen, Lixiang Liu,Yuanna Luo, Minghui Chen, Yang Huan, Ruili Fang. Prevalence and impact of chronic endometritis in patients with intrauterine adhesions: a prospective cohort study. J Minim Invasive Gynecol. 2016;24:1:74-79. https://doi.org/10.1016/j.jmig.2016.09.022
Makarenko TA, Nikiforova DE, Ul’yanova IO. Experience of application anti adgesivebarrier in the treatment of patients with Asherman’s syndrome. Zhurnal akusherstva i zhenskikh boleznei. 2016;65:5:29-32. (In Russ.). https://doi.org/10.17816/JOWD65529-32
Molotkov AS, Popov EN, Sudakov DS, Aivazyan TA, Aleksandrova LA, Dymarskaya YuR. Experience of intrauterine application of anti-adhesive gel based on hyaluronic acid in the prevention of Asherman’s syndrome in patients with the pathology of the uterine cavity and severe forms of endometriosis. Zhurnal akusherstva i zhenskikh boleznei. 2017;66:6:12-19. (In Russ.). https://doi.org/10.17816/JOWD66612-19
Bortsvadze ShN, Svidinskaya EA, Dzhibladze TA, Khokhlova ID, Van Ya. Possibilities of ultrasonic monitoring of endometrium and ovaries in patients after cancellation of long-term reception of combined oral contraceptives when planning pregnancy. Arkhiv akusherstva i ginekologii im. V.F. Snegireva. 2019;6:4:215-220. (In Russ). https://doi.org/10.18821/2313-8726-2019-6-4-215-220
Song D, Liu Y, Xiao Y, Li TC, Zhou F, Xia E. A matched cohort study comparing the outcome of intrauterine adhesiolysis for Asherman’s syndrome after uterine artery embolization or surgical trauma. J Minim Invasive Gynecol. 2014;21:6:1022-1028. https://doi.org/10.1016/j.jmig.2014.04.015

Close metadata