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Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions.
JSLS. 2018 Oct-Dec; 22(4)JSLS

Abstract

Background and Objectives

The authors sought to assess the effect of the use of a new crosslinked hyaluronan (NCH) gel on the prevention of intrauterine adhesions (IUAs) in women underwent curettage in the second trimester.

Methods

Between June 2016 and September 2017, 60 patients who underwent curettage for retained placental tissue after medically induced or spontaneous pregnancy loss in the second trimester were enrolled in the study. The patients were randomly assigned to 1 of 2 groups: Group 1 patients received curettage plus NCH gel (intervention group), and group 2 patients received curettage alone (control group). The main outcomes were the rate and severity of IUA formation, which were assessed by follow-up hysteroscopy performed in the ensuing 2-6 months.

Results

The hysteroscopic findings were available for 20 patients in group 1 and 28 patients in group 2. IUAs were observed in 6 patients in group 2, while no IUAs was observed in group 1 (P = .007). IUAs were staged as mild in 4 patients (14.28%) and moderate in 2 patients (7.14%) in group 2 according to the American Fertility Society classification of IUAs.

Conclusions

Our study demonstrates that NCH gel appears to be able to reduce the formation of IUAs in women who undergo curettage in the second trimester, although larger controlled, randomized, multicenter studies are needed to confirm these results.

Authors+Show Affiliations

School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.School of Medicine, Istanbul University, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30524185

Citation

Can, Sultan, et al. "Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 22, no. 4, 2018.
Can S, Kirpinar G, Dural O, et al. Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions. JSLS. 2018;22(4).
Can, S., Kirpinar, G., Dural, O., Karamustafaoglu, B. B., Tas, I. S., Yasa, C., & Ugurlucan, F. G. (2018). Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 22(4). https://doi.org/10.4293/JSLS.2018.00036
Can S, et al. Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions. JSLS. 2018 Oct-Dec;22(4) PubMed PMID: 30524185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions. AU - Can,Sultan, AU - Kirpinar,Gamze, AU - Dural,Ozlem, AU - Karamustafaoglu,Burcin Balci, AU - Tas,Inci Sema, AU - Yasa,Cenk, AU - Ugurlucan,Funda Gungor, PY - 2018/12/8/entrez PY - 2018/12/14/pubmed PY - 2019/1/27/medline KW - Dilatation and curettage KW - Hyaluronic acid KW - Intrauterine adhesions KW - Miscarriage KW - Termination of pregnancy JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 22 IS - 4 N2 - Background and Objectives: The authors sought to assess the effect of the use of a new crosslinked hyaluronan (NCH) gel on the prevention of intrauterine adhesions (IUAs) in women underwent curettage in the second trimester. Methods: Between June 2016 and September 2017, 60 patients who underwent curettage for retained placental tissue after medically induced or spontaneous pregnancy loss in the second trimester were enrolled in the study. The patients were randomly assigned to 1 of 2 groups: Group 1 patients received curettage plus NCH gel (intervention group), and group 2 patients received curettage alone (control group). The main outcomes were the rate and severity of IUA formation, which were assessed by follow-up hysteroscopy performed in the ensuing 2-6 months. Results: The hysteroscopic findings were available for 20 patients in group 1 and 28 patients in group 2. IUAs were observed in 6 patients in group 2, while no IUAs was observed in group 1 (P = .007). IUAs were staged as mild in 4 patients (14.28%) and moderate in 2 patients (7.14%) in group 2 according to the American Fertility Society classification of IUAs. Conclusions: Our study demonstrates that NCH gel appears to be able to reduce the formation of IUAs in women who undergo curettage in the second trimester, although larger controlled, randomized, multicenter studies are needed to confirm these results. SN - 1938-3797 UR - https://www.unboundmedicine.com/medline/citation/30524185/Efficacy_of_a_New_Crosslinked_Hyaluronan_Gel_in_the_Prevention_of_Intrauterine_Adhesions_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30524185/ DB - PRIME DP - Unbound Medicine ER -