Efficacy of a New Crosslinked Hyaluronan Gel in the Prevention of Intrauterine Adhesions

• Published in: Journal of the Society of Laparoendoscopic Surgeons Vol. 22; no. 4; p. e2018.00036
• Main Authors: Can, Sultan, Kirpinar, Gamze, Dural, Ozlem, Karamustafaoglu, Burcin Balci, Tas, Inci Sema, Yasa, Cenk, Ugurlucan, Funda Gungor
• Format: Journal Article
• Language: English
• Published: United States Society of Laparoendoscopic Surgeons 01.10.2018
• Subjects: Abortion, Induced - adverse effects; Abortion, Induced - methods; Abortion, Spontaneous - surgery; Adult; Anti-Inflammatory Agents - administration & dosage; Dilatation and Curettage - adverse effects; Female; Gels - administration & dosage; Humans; Hyaluronic Acid - administration & dosage; Hysteroscopy; Pregnancy; Pregnancy Trimester, Second; Scientific Paper; Tissue Adhesions - diagnosis; Tissue Adhesions - etiology; Tissue Adhesions - prevention & control; Uterine Diseases - etiology; Uterine Diseases - prevention & control; Young Adult; Intrauterine adhesions; Termination of pregnancy; Hyaluronic acid; Miscarriage; Dilatation and curettage
• ISSN: 1086-8089; 1938-3797
• DOI: 10.4293/JSLS.2018.00036

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. 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. 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 ( = .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. 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.