International Journal of Obstetrics and Gynecology

Objective To explore surgical approach-related risk factors for intrauterine adhesions (IUA) following curettage in patients with missed abortion. Methods A retrospective analysis was conducted on 150 patients who underwent one of four different curettage procedures between January 2022 and December 2023. All patients received hysteroscopic follow-up at 6 months to assess adhesion incidence and collect intraoperative parameters. Results The overall adhesion rate was 25.33%, with the highest rate in the traditional sharp curettage group (42.86%) and the lowest in the hysteroscopy-guided group (5.71%). Logistic regression analysis identified blind curettage, repeated curettage, suction time ≥7 minutes, and vacuum pressure ≥300 mmHg as independent risk factors (P<0.05). Conclusion The type of curettage and intraoperative technique significantly affect the risk of IUA, emphasizing the importance of surgical optimization and procedural precision.

Missed abortion; Curettage; Intrauterine adhesion; Surgical method; Vacuum aspiration