{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:46:56Z","timestamp":1782798416512,"version":"3.54.5"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intrauterine adhesions (IUAs) are a common complication following hysteroscopic submucosal myomectomy and are closely linked to impaired endometrial healing. The role of perioperative inflammatory biomarkers in predicting adhesion formation remains incompletely defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study included 140 women undergoing hysteroscopic submucosal myomectomy at a tertiary care center between April 2024 and October 2025. Serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      ) were measured preoperatively, at 48\u202fh, and at 12\u202fweeks postoperatively. IUAs were assessed by second-look hysteroscopy and graded according to American Fertility Society criteria. Multivariable logistic regression and correlation analyses were performed to identify predictors of adhesion formation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      IUAs developed in 42 patients (30.0%). Baseline characteristics were comparable between groups; however, FIGO type II fibroids and longer operative time were significantly associated with adhesion formation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). At 48\u202fh postoperatively, IL-6 and CRP levels were significantly higher in the IUA group compared to the non-IUA group (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), while TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      showed a smaller increase. IL-6 demonstrated the strongest correlation with adhesion severity (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u202f=\u202f0.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), followed by CRP (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u202f=\u202f0.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). In multivariable analysis, IL-6 (adjusted OR\u202f=\u202f1.24, 95% CI: 1.10\u20131.40) and CRP (adjusted OR\u202f=\u202f1.31, 95% CI: 1.07\u20131.60) were independent predictors of moderate-to-severe IUAs, whereas TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      was not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Perioperative inflammatory response, particularly elevated IL-6 and CRP levels, is strongly associated with intrauterine adhesion formation following hysteroscopic myomectomy. Early postoperative biomarker assessment may provide a valuable strategy for risk stratification and targeted prevention of IUAs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1847179","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:39:39Z","timestamp":1782797979000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic perioperative inflammatory biomarkers predict intrauterine adhesion formation following hysteroscopic myomectomy: a prospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Mei","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Gynecology, The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"955","DOI":"10.3390\/diagnostics15080955","article-title":"Intrauterine adhesions and asherman syndrome: a retrospective dive into predictive risk factors, diagnosis, and surgical perspectives","volume":"15","author":"Toma","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1055\/s-0028-1082393","article-title":"Intrauterine adhesions","volume":"26","author":"Berman","year":"2008","journal-title":"Semin Reprod Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1093\/humupd\/dmaf019","article-title":"Women\u2019s Health Research Collaborative\u2019s endometrial trauma group. 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