人工流产术后宫腔粘连误诊为子宫腺肌病、异位妊娠原因分析OA

Objective To analyze the cause of misdiagnosis of intrauterine adhesions(IUA)after induced abortion as uterine adenomyosis or ectopic pregnancy.Methods A retrospective analysis was conducted on the clinical data of 2 patients who were admitted to Shijiazhuang People's Hospital from January 2024 to December 2025 due to misdiagnosis of IUA after induced abortion as uterine adenomyosis or ectopic pregnancy.Results One patient presented with reduced menstrual flow and progressively worsening dysmenorrhea one year after induced abortion.She was misdiagnosed as having uterine adenomyosis and received treatment with Leuprorelin,which was ineffective and the symptoms worsened after discontinuation of the medication.Further hysteroscopy revealed right IUA with fluid accumulation.Pathological examination ruled out adenomyosis.Eventually,she was diagnosed with IUA after induced abortion.The misdiagnosis lasted for one year.After diagnosis,a hysteroscopic adhesiolysis was performed,followed by the placement of an intrauterine device and sequential administration of estrogen and progesterone,with marked improvement.The other patient had no menstrual flow at 38 d after induced abortion and was misdiagnosed as having ectopic pregnancy due to persistent lower abdominal pain.During laparotomy exploration,intra-abdominal bleeding was found,and a partial resection of the left ovary(removing the bleeding area)was performed.However,the pathology confirmed it as luteal tissue,ruling out ectopic pregnancy.The patient still had amenorrhea after the operation,and a hysteroscopic examination finally confirmed IUA after induced abortion.The misdiagnosis lasted for approximately one month.Subsequently,a hysteroscopic adhesiolysis was performed,followed by the placement of an intrauterine device and sequential administration of estrogen and progesterone,with significant improvement.Two patients showed that the uterine cavity morphology and endometrial thickness returned to normal after secondary hysteroscopy and long-term follow-up after the surgery.The menstrual cycle was regular,and there was no recurrence of adhesions.Conclusion The clinical manifestations of IUA after artificial abortion overlap with those of uterine adenomyosis and ectopic pregnancy,with no specific diagnostic indicators.Clinicians should pay attention to the patient's history of induced abortion and integrate hysteroscopic findings with pathological results to improve the diagnostic accuracy and avoid improper treatment due to misdiagnosis.