New Crosslinked Hyaluronan Gel for the Prevention of Intrauterine Adhesions after Dilation and Curettage in Patients with Delayed Miscarriage: A Prospective, Multicenter, Randomized, Controlled Trial

Li, Xueying; Wu, Ling; Zhou, Yufan; Fan, Xing; Huang, Jufang; Wu, Jiyuan; Yu, Renxiu; Lou, Jianying; Yang, Mengjie; Yao, Zhihong; Xue, Min

doi:10.1016/j.jmig.2018.03.032

Cited by 34 publications

(27 citation statements)

References 21 publications

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“…A total of seven were included in the final analysis after screening ( Fig. 1) (10,(13)(14)(15)(16)(17)(18). All 7 studies compared the efficacies of using hyaluronic acid gel as an adjuvant therapy (treatment group) against a control group (without the use of hyaluronic acid gel) after an intrauterine operation.…”

Section: Resultsmentioning

confidence: 99%

“…From these patients, 455 had been treated with hyaluronic acid gel postoperatively and 497 were controls. Among the 7 studies, 3 used common abortive procedures such as intrauterine operations (14,15,17) and 4 were performed using hysteroscopy (10,13,16,18). A total of six studies were performed using direct injection with the gel (10,16,18) and one used a temporary adhesion barrier, which hydrated into a gel within 24-48 h of administration into the patient (17).…”

Section: Resultsmentioning

confidence: 99%

“…A total of six studies were performed using direct injection with the gel (10,16,18) and one used a temporary adhesion barrier, which hydrated into a gel within 24-48 h of administration into the patient (17). There were no statistically significant differences in baseline parameters between the treatment and control groups, as presented in Table I (10,(13)(14)(15)(16)(17)(18). The results of the quality assessment of the included studies are presented in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis results. All seven studies reported the incidence rate of IUAs; however, only 4 reported the IUA score after the intrauterine operation (14)(15)(16)18). As indicated in Figs.…”

Section: Resultsmentioning

confidence: 99%

“…A total of seven studies were included in the present meta-analysis; all reported the incidence of IUA after intrauterine operation (10,(13)(14)(15)(16)(17)(18), but only four reported the IUA score (14)(15)(16)18). The results of the current study demonstrated that hyaluronic acid gel reduced IUA incidence and its score following an intrauterine operation.…”

Section: Discussionmentioning

confidence: 99%

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Meta‑analysis on the use of hyaluronic acid gel to prevent intrauterine adhesion after intrauterine operations

Zheng¹,

Xin

He³

et al. 2020

Exp Ther Med

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Intrauterine adhesion (IUA) is a severe complication that occurs following abortion, and hyaluronic acid gel has been used to prevent IUA following intrauterine operation. The present study aimed to systematically evaluate the efficacy of hyaluronic acid gel in preventing IUA following intrauterine operation. In the current study, a literature search was performed using PubMed, Cochrane Library and EMbase databases for randomized controlled clinical trials that used hyaluronic acid gel as an adjuvant therapy following intrauterine operation. The terms 'hyaluronic acid', 'intrauterine adhesions', 'Asherman's syndrome', 'IUA', 'dilatation and curettage', 'abortion' and 'hysteroscopic' were used to search for articles published online before July 31, 2018. RevMan 5.3 software was used to analyze the indicators of uterine cavity adhesion formation and pregnancy rates following intrauterine operation. A total of seven randomized controlled clinical studies were included, consisting of 952 patients who underwent intrauterine operation. The meta-analysis indicated that the use of hyaluronic acid gel reduced the incidence of IUA [relative risk (RR)=0.42; 95% confidence interval (CI)=0.30-0.57; P<0.001] and the score for IUA after an intrauterine operation (mean difference=-1.29; 95%=-1.73 to-0.84; P<0.001). A subgroup analysis revealed that the preventive effect of hyaluronic acid gel on IUA was not affected by the type of intrauterine operation, namely abortion (RR=0.40; 95% CI=0.26-0.62; P<0.001) and hysteroscopy (RR=0.44; 95% CI=0.28-0.68; P<0.001). The preventive effect of hyaluronic acid gel on IUA was also not affected by primary disorders/diseases including the following: Abortion (RR=0.48; 95% CI=0.29-0.78; P=0.003); IUA (RR=0.38; 95% CI=0.21-0.67; P<0.001) and submucosal myoma of the uterus, endometrial polyps or mediastinum uterus (RR=0.40; 95% CI=0.18-0.90; P=0.03). Hyaluronic acid gel improved pregnancy rates after intrauterine operations (RR=1.94; 95% CI=1.46-2.60; P<0.001). In conclusion, hyaluronic acid gel was indicated to significantly reduce the incidence of IUA following intrauterine operation, regardless of the type of intrauterine operation or the presence of primary diseases. Treatment with hyaluronic acid gel was also revealed to increase pregnancy rates following intrauterine operation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Meta‑analysis on the use of hyaluronic acid gel to prevent intrauterine adhesion after intrauterine operations

Zheng¹,

Xin

He³

et al. 2020

Exp Ther Med

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Methods for managing miscarriage: a network meta-analysis

Ghosh

Papadopoulou

Devall

et al. 2021

Cochrane Database of Systematic Reviews

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Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document.When citing, please reference the published version. Take down policyWhile the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

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Cyclical endometrial repair and regeneration: Molecular mechanisms, diseases, and therapeutic interventions

Hu,

Wu,

Yong

et al. 2023

MedComm

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The endometrium is a unique human tissue with an extraordinary ability to undergo a hormone‐regulated cycle encompassing shedding, bleeding, scarless repair, and regeneration throughout the female reproductive cycle. The cyclical repair and regeneration of the endometrium manifest as changes in endometrial epithelialization, glandular regeneration, and vascularization. The mechanisms encompass inflammation, coagulation, and fibrinolytic system balance. However, specific conditions such as endometriosis or TCRA treatment can disrupt the process of cyclical endometrial repair and regeneration. There is uncertainty about traditional clinical treatments' efficacy and side effects, and finding new therapeutic interventions is essential. Researchers have made substantial progress in the perspective of regenerative medicine toward maintaining cyclical endometrial repair and regeneration in recent years. Such progress encompasses the integration of biomaterials, tissue‐engineered scaffolds, stem cell therapies, and 3D printing. This review analyzes the mechanisms, diseases, and interventions associated with cyclical endometrial repair and regeneration. The review discusses the advantages and disadvantages of the regenerative interventions currently employed in clinical practice. Additionally, it highlights the significant advantages of regenerative medicine in this domain. Finally, we review stem cells and biologics among the available interventions in regenerative medicine, providing insights into future therapeutic strategies.

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New Crosslinked Hyaluronan Gel for the Prevention of Intrauterine Adhesions after Dilation and Curettage in Patients with Delayed Miscarriage: A Prospective, Multicenter, Randomized, Controlled Trial

Cited by 34 publications

References 21 publications

Meta‑analysis on the use of hyaluronic acid gel to prevent intrauterine adhesion after intrauterine operations

Meta‑analysis on the use of hyaluronic acid gel to prevent intrauterine adhesion after intrauterine operations

Methods for managing miscarriage: a network meta-analysis

Cyclical endometrial repair and regeneration: Molecular mechanisms, diseases, and therapeutic interventions

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