Associations between the number of hysteroscopic surgeries and the risk of adverse obstetric outcomes
To some extent, the number of hysteroscopic surgeries a woman underwent reflected their severity of IUAs. We additionally examined the potential impacts of the number of hysteroscopic surgeries on obstetrical outcomes. Among the 780 women with a history of HA-treated IUAs, 371, 315 and 94 underwent 1, 2 and ≥ 3 hysteroscopic procedures before this pregnancy, respectively. There were graded relationships between the number of hysteroscopic surgeries and the risk of PE (Figure 2A ), placenta previa (Figure 2B ), placenta accreta spectrum (Figure 2C ), PPH (Figure 2D ) and iatrogenic preterm birth (Figure 2H ) .The monotonic increases in RRs were observed with an increasing number of hysteroscopic surgeries (p-value for trend <0.01). Additionally, women who underwent more surgeries were more likely to receive o receive hemostatic therapies (Figure 2E ) and cervical cerclage (Figure 2F ).