Investigating the Association Between Diagnostic and Therapeutic Management Models and Prognosis of Intrauterine Adhesions Based on a Large-Scale Prospective Cohort Study

Overview

This research plan aims to explore a new diagnosis and treatment management model for intrauterine adhesions and verify its efficacy and feasibility through a multicenter real-world study. Intrauterine adhesions are a common gynecological disease that may affect women's fertility. The study will focus on several key issues: 1. How do three-dimensional ultrasound image features reflect the diagnosis and prognosis of intrauterine adhesions; 2. The effect of new diagnostic and treatment technologies (such as cold knife plowing technology and patented intrauterine stents) in preventing the recurrence of intrauterine adhesions 3. The efficacy of traditional Chinese medicine prescriptions in promoting endometrial growth and preserving pregnancy; 4. How to construct a postoperative infertility risk prediction model that combines multidimensional risk factors of traditional Chinese and Western medicine. To achieve these goals, the study will: 1. Establish four-dimensional ultrasound diagnostic evaluation standards to improve the accuracy of diagnosis; 2. Build a large database and data cohort, standardize the diagnosis and treatment standards, and provide solid data support for the research; 3. Evaluate the efficacy of the new model through real-world research, and compare the clinical efficacy of the new diagnosis and treatment model with the traditional diagnosis and treatment model; 4. Construct and verify the postoperative infertility risk prediction model to provide clinicians with a visual display of risk prediction for clinical application. This study is expected to provide a scientific basis for improving the treatment effect of intrauterine adhesions and reducing the infertility rate, and promote the standardization and standardization of the diagnosis and treatment model of combining traditional Chinese and Western medicine, bringing good news to more patients with intrauterine adhesions.

Detailed description

Research purpose: This project intends to explore the efficacy of the new IUA diagnosis and treatment model through multi-center real-world research and prove that it is a high-quality medical service model, laying the foundation for its future promotion.

Experimental design: Based on previous research, our team proposed a "new model for the management and treatment of IUA throughout the entire course of disease": preoperative four-dimensional color ultrasound diagnosis and evaluation, intraoperative use of integrated hysteroscopy "immediate diagnosis and treatment" cold knife plowing adhesion separation, postoperative application of patented uterine cavity stent to prevent re-adhesion, postoperative use of famous doctors and famous prescriptions to promote endometrial repair, postoperative use of four-dimensional color ultrasound evaluation follow-up instead of multiple hysteroscopy, combined with intraoperative hysteroscopy endometrial gland opening AI counting gland density, multimodal data fusion prediction and evaluation of pregnancy prognosis after IUA treatment.

Experimental process: Prospective, observational real event study Inclusion criteria: Patients with intrauterine adhesions diagnosed and treated in our hospital and the sub-center units of this project: age 18-45 years old; collection began after the ethical review, a total of 5,000 cases were collected, and 2,000 cases were collected in this center.

Exclusion criteria: abnormal ovarian function, male infertility, and those who cannot cooperate with diagnosis, treatment and follow-up

Interventions

• Procedure Transcervical resection of adhesion
  During the operation, an integrated hysteroscopic "immediate diagnosis and immediate treatment" cold knife plowing type adhesion separation surgery was adopted
• Procedure Uterine cavity stent
  Made of medical-grade silicone rubber, it is non-irritating to human tissues, has no toxic side effects, is non-carcinogenic, has good biocompatibility, corrosion resistance, will not swell, soften or deteriorate due to water absorption, is easy to process and manufacture, convenient to use, and has good thermal stability. The uterine stent is mainly composed of the reinforcing ribs of the uterine ring, the membrane, the tail-shaped structure and the placement device. The placement device is com
• Drug Traditional Chinese medicine for tonifying the kidney
  Traditional Chinese medicines for tonifying the kidney can promote blood circulation in the internal reproductive organs, significantly increase blood supply to the uterus, improve the receptivity of the endometrium, enhance the affinity of estrogen receptors in target tissues, promote endometrial proliferation, and improve secretory function

Primary outcome measures

• Number of Participants with Pregnancy Outcome within 2 Years of Postoperative Pregnancy Preparation Following Intrauterine Adhesions Surgery [Time frame: From the start of postoperative pregnancy preparation up to 2 years]

Eligibility criteria

Inclusion criteria

• Patients with intrauterine adhesions diagnosed and treated in our hospital and the sub-central units of this project: aged 18-45 years old; The collection began after the ethical review was passed. A total of 5,000 cases were collected, and 2,000 cases were collected in this center.

Exclusion criteria

• Abnormal ovarian function, male infertility, inability to cooperate with diagnosis and treatment and follow-up visits

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

China · 1 center

• The Third Xiangya Hospital of Central South University — Changsha

Identifiers

NCT: NCT07421908 · xy3-IUA-Xu

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗