Abstract:

BACKGROUND: Sodium hyaluronate has precaution basin and celiac adhesion effects, but because of short residence time of uterine cavity of sodium hyaluronate, it is difficult to prevent intrauterine adhesious. The researches at abroad reported that sodium hyaluronate was chemically modified and then formed self-cross-linked sodium hyaluronate gel. It has a strong adhesion in impaired endometrium, and the residence time in the uterine cavity up to 72 hours.
OBJECTIVE: To evaluate the effect and safety of sodium hyaluronate gel on the prevention of intrauterine adhesious after uterine-incision delivery.
METHODS: Literatures related to sodium hyaluronate gel for prevention of intrauterine adhesious after uterine-incision delivery from PubMed database (http://www.ncbi.nlm.nih.gov/PubMed), VIP database (http://www.cqvip.com/) were retrieved, with the key words of “sodium hyaluronate, cesarean section, adhesion, intrauterine adhesions” in Chinese and English respectively. The retrieval time was limited to 1990-01/2009-12. Duplicated and reviewed researches were excluded.
RESULTS AND CONCLUSION: Totally more than 150 articles were obtained. After duplicated and reviewed researches were excluded, 16 of them were involved for evaluation (12 Chinese, 4 English). The results showed that sodium hyaluronate gel is high molecular polysaccharide biomaterial formed by iterative N-acetyl-glucuronide, which has a high degree of elasticity, plasticity, and good biocompatibility. Sodium hyaluronate gel has a significant effect in prevention of intrauterine adhesious after uterine-incision delivery, especially can effectively reduce the incidence of re-adhesion after separation. But one thing is important that sodium hyaluronate gel is absolutely cannot be used in vascular, in order to avoid complications caused by pulmonary embolism. Injection process should be slow, lest back into venous system.