Added administration of estradiol valerate tosurgical treatment for missed abortion in early pregnancy

Abstract

Objective: To explore the clinical effect of different surgical methods for missed abortion in early pregnancy.

Methods: In this retrospective study 100 patients diagnosed with early missed abortion were assigned to two groups based on the treatment modality. The operation group (n=50) underwent dilatation and curettage (D&C), while the combination group (n=50) received oral estradiol valerate prior to D&C. Clinical outcomes were compared between the two groups, including operative indexes, postoperative adverse events, cervical dilation effect, abortion outcomes, estrogen levels, endometria-related indexes, inflammatory markers, and levels of pregnancy associated protein A (PAPP-A).

Results: Compared to the operation group, the combination group showed significantly reduced intraoperative blood loss, shorter durations of vaginal bleeding and operation time, greater postoperative endometrial thickness, and a lower incidence of postoperative intrauterine adhesions and total adverse events (all P<0.05). The total effective rate (χ²=4.320) and total abortion rate (Z=-3.525; χ²=5.020) were also significantly higher in the combination group. Moreover, the combination group exhibited higher postoperative levels of estradiol (E₂), progesterone (P), β-human chorionic gonadotropin (β-hCG), and follicle-stimulating hormone (FSH), while levels of luteinizing hormone (LH), P, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and PAPP-A were lower (all P<0.05).

Conclusion: Oral administration of estradiol valerate followed by D&C demonstrates superior clinical efficacy in the management of missed abortion during early pregnancy. This can enhance cervical dilation, facilitate abortion, modulate estrogen levels, promote endometrial repair, and relieve inflammation.

Keywords: Dilatation and curettage; early pregnancy; estradiol valerate; inflammation; intrauterine adhesion; missed abortion.

Figure 1

Surgical-related indicators in women with early pregnancy missed abortion undergoing different treatment methods. Note: A. Number of uterine aspirations; B. Peroperative bleeding; C. Duration of vaginal bleeding; D. Postoperative endometrial thickness; E. Time of operation. *means comparison between groups, P<0.05.

Figure 2

Estrogen-related hormone level in women with early pregnancy missed abortion undergoing different surgical treatments (preoperative and postoperative). Note: A. Estradiol (E₂); B. Progesterone; C. β-human chorionic gonadotropin (β-hCG). *means comparison between groups, P<0.05.

Figure 3

Endometrium-related hormones in women with early pregnancy missed abortion undergoing different surgical treatments (preoperative and postoperative). Note: A. Luteinizing hormone (LH); B. Follicle-stimulating hormone (FSH). *means comparison between groups, P<0.05.

Figure 4

Inflammatory factors and PAPP-A levels in women with early pregnancy missed abortion undergoing different surgical treatments (preoperative and postoperative). Note: A. High-sensitivity C-reactive protein (hs-CRP); B. Tumor necrosis factor-α (TNF-α); C. Interleukin-6 (IL-6); D. Pregnancy associated protein A (PAPP-A). *means comparison between groups, P<0.05.