There is a tendency for the condition to develop soon after pregnancy usually within four months 9. The incidence is thought to be increasing probably as a result of increased use of intrauterine interventions. Patients may present with infertility, pregnancy loss, menstrual abnormalities e. Intrauterine adhesions result secondary to trauma to the basal layer of the endometrium with subsequent scarring 1. This may be from a previous pregnancy, dilation, and curettage, surgery, or infection e. The adhesions are composed of fibromuscular-connective tissue bands with or without surrounding superficial epithelial cells or glandular tissue.
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Asherman syndrome is the formation of scar tissue in the uterine cavity. The problem most often develops after uterine surgery. Asherman syndrome is a rare condition. Adhesions in the uterine cavity can also form after infection with tuberculosis or schistosomiasis. These infections are rare in the United States. Uterine complications related to these infections are even less common. However, such symptoms could be related to several conditions. Treatment involves surgery to cut and remove the adhesions or scar tissue.
This can most often be done with hysteroscopy. This uses small instruments and a camera placed into the uterus through the cervix. After scar tissue is removed, the uterine cavity must be kept open while it heals to prevent adhesions from returning. Your health care provider may place a small balloon inside the uterus for several days.
You may also need to take estrogen while the uterine lining heals. The stress of illness can often be helped by joining a support group. In such groups, members share common experiences and problems. Asherman syndrome can often be cured with surgery. Sometimes more than one procedure will be necessary. Women who are infertile because of Asherman syndrome may be able to have a baby after treatment. Successful pregnancy depends on the severity of Asherman syndrome and the difficulty of the treatment.
Other factors that affect fertility and pregnancy may also be involved. Complications of hysteroscopic surgery are uncommon. When they occur, they may include bleeding, perforation of the uterus, and pelvic infection. Scarred uterus and Asherman's syndrome. Philadelphia, PA: Elsevier Saunders; Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. Comprehensive Gynecology. Philadelphia, PA: Elsevier; chap Spontaneous abortion and recurrent pregnancy loss: etiology, diagnosis, treatment.
Early pregnancy loss and stillbirth. Obstetrics: Normal and Problem Pregnancies. Smith RP. Asherman syndrome uterine synechia. In: Smith RP, ed. Netter's Obstetrics and Gynecology. Updated by: John D. Editorial team. Asherman syndrome.
A severe pelvic infection unrelated to surgery may also lead to Asherman syndrome. The adhesions may cause: Amenorrhea lack of menstrual periods Repeated miscarriages Infertility However, such symptoms could be related to several conditions. Exams and Tests. A pelvic exam does not reveal problems in most cases. Tests may include: Hysterosalpingography Hysterosonogram Transvaginal ultrasound examination Blood tests to detect tuberculosis or schistosomiasis.
You may need to take antibiotics if there is an infection. Outlook Prognosis. Possible Complications. In some cases, treatment of Asherman syndrome will not cure infertility. When to Contact a Medical Professional. Call your provider if: Your menstrual periods do not return after a gynecologic or obstetrical surgery. You cannot get pregnant after 6 to 12 months of trying See a specialist for an infertility evaluation. Most cases of Asherman syndrome cannot be predicted or prevented.
Alternative Names. Uterine synechiae; Intrauterine adhesions; Infertility - Asherman. Uterus Normal uterine anatomy cut section. Uterine Diseases Read more. Health Topics A-Z Read more.
What Is Asherman Syndrome?
The older obstetric patient. Obstet Gynaecol Reprod Med ; Trends in Europe and North America. The statistical yearbook of the Economic Commission for Europe Consultado: septiembre 2, Childbearing among older women-the message is cautiously optimistic.
NCBI Bookshelf. Collin Smikle ; Shailesh Khetarpal. It may occur with or without hemorrhage after delivery or elective termination of pregnancy. Less often, it results after a dilation and curettage for a non-obstetrical procedure for excessive bleeding, sampling for endometrial cancer, or removal of endometrial polyps.
The management of Asherman syndrome: a review of literature
Asherman syndrome is the formation of scar tissue in the uterine cavity. The problem most often develops after uterine surgery. Asherman syndrome is a rare condition. Adhesions in the uterine cavity can also form after infection with tuberculosis or schistosomiasis. These infections are rare in the United States. Uterine complications related to these infections are even less common.
2015, Número 3
Asherman syndrome is a rare, acquired condition of the uterus. In women with this condition, scar tissue or adhesions form in the uterus due to some form of trauma. In severe cases, the entire front and back walls of the uterus can fuse together. In milder cases, the adhesions can appear in smaller areas of the uterus.