术前雌激素、孕激素水平与稽留流产清宫术后宫腔粘连发生的关系及其预测价值OACSTPCD

Objective To investigate the relationship between estrogen and progesterone levels and intrau-terine adhesions(IUA)after uterine evacuation in patients with missed abortion(MA)and its predictive val-ue.Methods A total of 128 patients with MA who underwent uterine clearance in the department of Gynecol-ogy of the hospital from January 2019 to January 2022 were selected as the research objects.According to the uterine examination within 6 months after surgery,they were divided into non-IUA group(MA group,97 ca-ses)and IUA group(31 cases),and the IUA group was divided into mild,moderate and severe IUA groups according to the severity.The preoperative estradiol(E2)and progesterone(P)levels were compared between the IUA group and the MA group,and between the IUA groups with different severity of IUA.Multivariate Logistic regression was used to analyze the independent influencing factors of IUA occurrence.The correlation between E2,P and IUA was analyzed,and the receiver operating characteristic(ROC)curve was used to ana-lyze the predictive value of E2 and P levels for the occurrence and severity of IUA.Results The levels of E2 and P in IUA group were significantly lower than those in MA group(P＜0.05).Multivariate Logistic regres-sion analysis showed that preoperative E2 was an independent influencing factor for the occurrence of IUA af-ter MA curettage surgery(P＜0.05).The area under the curve of preoperative E2 and P levels for predicting IUA after MA curettage surgery was 0.714 and 0.702 respectively.The levels of E2 and P in the severe IUA group were significantly lower than those in the mild and moderate IUA groups,and the differences were sta-tistically significant(P＜0.05).The levels of E2 and P were negatively correlated with the severity of IUA(P＜0.05).The areas under the curve of preoperative E2 and P levels for predicting mild/moderate and severe IUA were 0.845 and 0.923 respectively.Conclusion The levels of E2 and P are correlated with the occurrence and severity of postoperative IUA in patients with MA curettage surgery,which have certain reference value for clinical prediction of the occurrence and progression of postoperative IUA in patients with MA curettage surgery.