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Value of intrauterine platelet-rich concentrates in patients with intrauterine adhesions after hysteroscopy: A systematic review and meta-analysis of randomized controlled trials

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Department of Obstetrics and Gynecology, Maternity and Children Hospital, Makkah, Saudi Arabia. Department of Obstetrics and Gynecology, Faculty of Medicine at Rabigh, King Abdulaziz University, Saudi Arabia. Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia. Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia. Department of Obstetrics and Gynecology, New Jeddah Clinic Hospital, Jeddah, Saudi Arabia. Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. Faculty of Medicine, Al-Quds University, Jerusalem, Palestine. Kasralainy, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: ahmed.m.rohei@students.kasralainy.edu.eg.

European journal of obstetrics, gynecology, and reproductive biology. 2022;271:63-70
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Abstract
OBJECTIVE To evaluate the value of intrauterine platelet-rich concentrates among patients with intrauterine adhesions (IUAs) after hysteroscopic adhesiolysis. METHODS Four different databases (PubMed, Cochrane Library, Scopus, and ISI web of science) were searched for the available studies from inception to November 2021. We selected randomized clinical trials (RCTs) that compared platelet-rich concentrates in the intervention group versus no injection of platelet-rich concentrates in the control group among women with intrauterine adhesions after operative hysteroscopy. Revman software was utilized for performing our meta-analysis. Our primary outcomes were the adhesion score and incidence of recurrence of severe intrauterine adhesions postoperatively. Our secondary outcomes were the clinical pregnancy rate, menstrual flow duration in days, and menstrual flow amount (number of pads). RESULTS Five RCTs met our inclusion criteria with a total number of 329 patients. We found that platelet-rich concentrates were linked to a significant reduction in the postoperative adhesion score (MD = -1.00, 95% CI [-1.68, -0.32], p = 0.004). Moreover, there was a significant reduction in the incidence of severe IUAs recurrence among the platelet-rich concentrates group (7.6%) compared to the control group (23.4%) after hysteroscopy (p = 0.001). The clinical pregnancy rate was significantly increased among the platelet-rich concentrates group (37.1%) in comparison with the control group (20.7%) after hysteroscopic adhesiolysis (p = 0.008). There were significant improvements in the menstrual flow duration and amount among the platelet-rich concentrates group (p < 0.001). CONCLUSIONS Intrauterine placement of platelet-rich concentrates is an effective method for the treatment of intrauterine adhesions after hysteroscopy.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine