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What is Asherman’s Syndrome – Causes, Symptoms, Diagnosis and Treatment

A rarely carried out gynecological procedure for abortion in the first trimester is dilation and curettage. After carrying out this process, in 5 percent cases, a complication arises in women known as Asherman’s syndrome. It cannot be predicted or prevented in most of the cases.

Doctors cannot diagnose this condition early owing to the lack of knowledge of its signs. Some statistics mention that the chances of developing this condition after miscarriage are between 5-39 percent. This article tries to gain further insight on this topic.

Hysteroscopy of Asherman's_Syndrome

Causes: The uterus cavity has inner linings known as endometrium. There are two layers of this lining, namely, the functional and basal layer. The former layer is shed during menstruation. During dilation and curettage procedure the inner basal layer can receive injury. This can lead to formation of fibrous bands between the tissues and organs. They are scar tissues which connect tissues which normally remain unconnected. This undesirable development is called adhesion. It can wipe the cavity of the uterus to varying degrees.

The risks are high when D and C is performed on recently pregnant uterus which either had incomplete birth, miscarriage or abortion while the retained matter of conception is removed by surgery from it. Others causes of this syndrome are:

  • Removal of fibroid tumors technically known as myomectomy
  • Cesarean sections
  • Pelvic irradiation
  • Genital tuberculosis
  • Schistosomiasis
  • Placing pregnancy preventing intrauterine device

Symptoms of Asherman’s Syndrome:

  • Absence of menstruation
  • Reduced menstrual flow
  • Uterine adhesion
  • Cramping
  • Scarring of the Uterine
  • Pain in the Abdomen
  • Pain from trapped blood
  • Impaired fertility
  • Amenorrhea
  • Repeated abortions
  • Occluded cervix uteri

Diagnosis: Techniques like Hysteroscopy and sonohysteroscopy are used to find the signs of this condition. Blood test is carried out to confirm tuberculosis or schistosomiasis. Infertility evaluation is carried out. Transvaginal ultrasound examination is also performed.

Treatment of Asherman’s Syndrome:
Surgery is performed to remove the scarred tissues. A small flexible tube is inserted through the cervix containing a camera into the uterus. It provides a view of the organ while the surgery is performed.

The uterus should be kept open so as to prevent adhesion recurrence and ensure faster healing. A small balloon like structure is inserted by the doctor post surgery for this purpose. Anti-biotics are prescribed to avoid infection in the region. Most of the infertile women conceive successfully post surgery.

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