Progress and Correlation inDiagnosis and Treatment of Embryo Residue and Intrauterine Adhesions/ ZHANG Jiayi，YANG Xue，HUANG Xiaowu.//Medical Innovation of China，2025，22（19）： 162-166

[Abstract]Retained products of conception refers to part of the embryo or placental tissue remaining in the uterine cavityafter abortion，inductionoflaborordelivery，whichcan lead to long-term iregularvaginal bleeding， abnormalsecretions and other symptoms.Intrauterine adhesion is a gynecological disease in which the basal layer of endometriumisdamageddue to infectionand intrauterinemechanicaloperation，andtherepair siteoffibrous scartissue isadherentandblocked.Inrecent years，the diagnosisand treatment technology hasbeen improved，the incidence of these twodiseases has gradualyincreased，and moreandmore evidenceshowsthatretainedproducts of conception can beone oftherisk factors，leading to theoccurrence of uterine adhesions.Thisarticlereviewed the relevant literature at home andabroad，summarized the research progress and correlation of the diagnosis and treatment of retained products ofconception and intrauterine adhesions，and provided guidance for prevention and diagnosis.

[Key Words] Retained products of conception Intrauterine adhesion Pregnancy complication Uteroscope

First-author'saddress： The Eighth Clinical School of Medicine，Capital Medical University，Beijing 100038， China

doi：10.3969/j.issn.1674-4985.2025.19.037

胚物残留（retained products of conception，RPOC）是指在人工流产、引产和足月分娩后，部分胎盘绒毛组织、胎膜、胚芽及骨骼碎片残留于子宫腔内[，是一种妊娠相关并发症，临床上并不罕见，发病率为 1%～6%^[2] 。宫腔粘连（intrauterineadhesion，IUA）是其长期并发症之一。IUA是指各种因素导致子宫内膜基底层损伤后，宫腔肌壁、宫颈管、输卵管相互粘连，继而导致不孕、复发性流产等[3]，严重危害育龄期女性的生育功能及心理健康。两种疾病间的并发风险与联系越来越受到社会的重视，现就RPOC、IUA的治疗研究进展及相关性展开综述。

1胚物残留

1.1 临床概述

RPOC在临床上并不罕见，近年来发病率逐步升高，是妇科常见疾病之一。人工或药物流产、引产、葡萄胎清宫不全都是造成胚物组织残留在子宫腔内的主要原因，造成人为稽留流产[4]。研究发现，胚物残留发病率占全部妊娠并发症的 1% ，在自然流产或人工流产中较常见，发生率达 6% ，而在药物流产中更为常见，发生率高达 15%^[5] 。此外，RPOC的发病率与终正妊娠时间有一定相关性，孕中期流产后高发。

临床表现为术后数日乃至数月仍有暗红或咖啡色不规则阴道出血，甚至出现危及生命的大量出血；月经少甚至闭经；阴道分泌物可为伴有臭味的脓性液体；伴子宫内膜炎时可有发热；偶有下腹坠痛不适、子宫压痛、盆腔疼痛等[；血清人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）下降不理想甚至升高。

随子宫内膜的周期性脱落，少许无活性的胚物组织可自行排出，而有活性的胚物或直径较大的无活性胚物组织则易滞留于宫腔内，长时间滞留可导致宫腔感染、胚物植人甚至后天性子宫动静脉畸形等并发症，长远来看，甚至与复发性流产、胎儿发育异常相关。……