Objective To explore the clinical value of transvaginal three-dimensional ultrasound(3D-TVS)in evaluating endometrial hemodynamic changes and predicting pregnancy outcome in patients with intrauterine adhesions(IUA)of different severity.Methods Totally 90 patients with IUA who visited our hospital were included,they were divided into a mild group of 10 cases,a moderate group of 43 cases,and a severe group of 37 cases.The endometrial volume(EV)and hemodynamic parameters in each group were obtained by 3D-TVS,including vascular index(VI),flow index(FI)and vascular flow index(VFI),the differences among the groups were compared.The patients were followed up for two years,there were 42 cases of poor pregnancy and 22 cases of good pregnancy,the differences of EV and hemodynamic parameters between the two were compared.Logistic regression was used to analyze the independent influencing factors for predicting the pregnancy outcome in patients with IUA.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of EV,VI,FI and VFI alone and in combination for predicting pregnancy outcome in patients with IUA.Results The differences in EV,VI,FI and VFI among mild,moderate,severe groups were statistically significant(all P<0.05),there were significant differences in pairwise comparison(all P<0.05).The EV,VI,FI and VFI of the poor pregnancy cases were lower than those of the good pregnancy cases,the differences were statistically significant(all P<0.05).Multivariate Logistic regression analysis showed that EV,VI,FI and VFI were independent protective factors for predicting pregnancy outcome in patients with IUA(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of EV,VI,FI,VFI and their combination for predicting pregnancy outcome in patients with IUA were 0.808,0.864,0.877,0.852,0.975,respectively.The AUC of combined applied was higher than that of applied alone(Z=2.837,2.403,2.082,2.507,all P<0.05).Conclusion 3D-TVS can evaluate the endometrial hemodynamic changes and have a certain value for predicting pregnancy outcome in patients with IUA of different severity.
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