Does hyaluronic acid gel reduce intrauterine adhesions after surgery in women with miscarriage?

This study evaluated whether hyaluronic acid gel (HAG) reduces intrauterine adhesions (IUAs) after curettage in women with a miscarriage. The data showed that HAG reduces the rate of IUAs in these women.

Up to a third of women who have a miscarriage need a dilation and curettage procedure for a miscarriage. A dilation and curettage involve the scraping of the uterus (womb) to ensure the embryo tissue is completely removed. Intrauterine adhesions (IUAs) are common after a miscarriage. IUAs involve the forming of scar tissue in the uterus. This scar tissue can cause the uterus walls to stick together. This can make it difficult to become pregnant again. Surgery can be used to remove the scar tissue. 

Non-invasive methods may be better at preventing scar tissue buildup. One option is hyaluronic acid gels (HAG). Hyaluronic acid is naturally found in the body. It is broken down very quickly by the body. A HAG lasts longer because the gel formula slowly releases it into the body. HAG is used in general surgery to prevent body tissues from sticking together. HAG has been used to treat IUAs. However, whether HAG reduces IUAs formation after dilation and curettage in women with miscarriage is still unknown.

This study analyzed 343 women who had a miscarriage between weeks 7 and 14 of pregnancy. Patients were randomly assigned into two groups. Group 1 included 169 patients who received surgery alone (dilation and curettage). Group 2 included 174 patients who received surgery plus intrauterine instillation of HAG.

The rate of IUAs was 9.1% in group 2 versus 18.4% in group 1. 12 months after surgery, the pregnancy rate was 69.8% in group 2 versus 57.4% in group 1.

This study concluded that HAG reduced the rate of IUAs in women treated with dilation and curettage for miscarriage.

The sample size was very small. This study only included patients treated at institutions in France.