Prevalence of intrauterine adhesions before vacuum manual aspiration in woman abortion / PrevalÃncia de aderÃncias intra-uterinas apÃs aspiraÃÃo manual a vÃcuo em mulheres com abortamento

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

AIM: Our aim was to evaluate the prevalence of intrauterine adhesions (IUA) in women who underwent vacuum manual aspiration (VMA) for the treatment of abortion. PATIENTS AND METHODS: A prospective study was carried out in 80 women who had incomplete, inevitable, molar, septic or missed abortion. Between November 2000 and August 2001, the patients were submitted to MVA at Centro Integrado de SaÃde Amaury de Medeiros, in Recife – Pernambuco, Brazil. They were diagnosed by hysteroscopy (the gold standard method) after a period of between 40 and 60 days post-curettage. RESULTS: Hysteroscopy identified 13 patients with synechiae with a prevalence rate of 16,3%. IUA constituted by mucosal pattern was responsible for 11,2% of the cases, possibly due to a recent VMA. The average age of these women with the disease was 28,5 (Â 9,3) years, but no difference was found compared to those without adherence (p=0,12). IUA with mucosal constitution (69,2%) and minimal classification (84,6%) were the most prevalent characteristics, with no specific localization in the uterus. The previous menstrual pattern studied, evaluating two groups (amenorrheae/hipomenorrheae and eumenorrheae / hipermenorrheae), has not showed a statistical difference between them (p=0,20). There was a greater prevalence tendency of AIU among the women who had delivered at least once, but not statistically significant comparing to those who presented abortion only. Women with >8 weeks of pregnancy had a greater prevalence of IUA (p=0,01). Missed abortion was present in 41,7%. Compared to those with an incomplete/inevitable abortion, a missed abortion had a greater prevalence risk (PR=3,54; p=0,02). There was no significant difference (p=0,20), regarding the prevalence of IUA between the group of women with or without a surgical procedure in the past (cesarean, curettage and/or uterine suture). CONCLUSIONS: There was a prevalence rate of 16,3% of IUA in patients who underwent VMA and a greater chance of IUA in the women who had a missed abortion after eight weeks of pregnancy. Prospective and randomized studies should be undertaken comparing the prevalence of IUA between VMA and curettage.

ASSUNTO(S)

abortamento ginecologia e obstetricia aderÃncias intra-uterinas aspiraÃÃo manual a vÃcuo (amv) intrauterine adhesion aspiraÃÃo manual intra-uterina (amiu) vacuum manual aspiration (vma)

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