Asherman's syndrome causes
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Editor(s)-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Canan S Fornusek, Ph.D.; Associate Editor-In-Chief: M.Umer Tariq [2]
Overview
Causes
Asherman's syndrome occurs most frequently after a D&C is performed on a recently pregnant uterus, following a missed or incomplete miscarriage, birth, or elective termination (abortion) to remove retained products of conception/placental remains. As the same procedure is used in all three situations, Asherman's can result in all of the above circumstances. It affects women of all races and ages as there is no underlying predisposition or genetic basis to its development. According to a study on 1900 patients with Asherman’s syndrome, over 90% of the cases occurred following pregnancy-related curettage [1]. It is estimated that up to 5% of D&Cs result in Asherman's. More conservative estimates put this rate at 1%. Asherman's results from 25% of D&Cs performed 1-4 weeks post-partum [2][3][4], 30.9% of D&Cs performed for missed miscarriages and 6.4% of D&Cs performed for incomplete miscarriages. [5] In the case of missed miscarriages, the time period between fetal demise and curettage increases the likelihood of adhesion formation to over 30.9% [1][6]
References
- ↑ 1.0 1.1 Schenker JG, Margalioth EJ. (1982). "Intra-uterine adhesions: an updated appraisal". Fertility Sterility. 37 (5): 593–610. PMID 6281085.
- ↑ Parent B, Barbot J, Dubuisson JB. Uterine synechiae (in French). Encyl Med Chir Gynecol 1988; 140A (Suppl): 10-12.
- ↑ Rochet Y, Dargent D, Bremond A, Priou G, Rudigoz RC (1979). "The obstetrical outcome of women with surgically treated uterine synechiae (in French)". J Gynecol Obstet Biol Reprod. 8 (8): 723–726. PMID 553931.
- ↑ Buttram UC, Turati G. (1977). "Uterine synechiae: variation in severity and some conditions which may be conductive to severe adhesions". Int J Fertil. 22 (2): 98–103. PMID 20418.
- ↑ Adoni A, Palti Z, Milwidsky A, Dolberg M. (1982). "The incidence of intrauterine adhesions following spontaneous abortion". Int J Fertil. 27 (2): 117–118. PMID 6126446.
- ↑ Fedele L, Bianchi S, Frontino G. Septums and synechiae: approaches to surgical correction. Clin Obstet Gynecol 2006; 49:767-788.