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Asherman's syndrome is an intrauterine pathology, which is characterized by the formation of numerous synechiae, as a result of which the endometrium atrophies and scleroses. In order to avoid dangerous complications, it is very important to timely diagnose the pathology and undergo a course of treatment. You can make an appointment with the doctor by phone listed on the website, or by using the record button.

In connection with the syndrome, the patient's menstrual cycle is disrupted and infertility develops. Syndrome is one of the most common causes of the development of the uterine form of amenorrhea.

Causes of Asherman's Syndrome

The formation of adhesions in the uterine cavity can be due to several reasons:

  • Endometrial trauma due to curettage (during abortion, a frozen pregnancy or after childbirth, with myomectomy or removal of endometrial polyps, diagnostic manipulations in the uterine cavity)
  • Genital tuberculosis
  • Endometritis
  • Use of an intrauterine device
  • Pelvic Infections

In most cases, the basis of Asherman's syndrome is precisely the traumatic effect on the mucous membrane of the uterine cavity. According to statistics, pathology can develop in about one in three women with a missed pregnancy. Not only the quality of the intervention plays a role, but also their quantity. Already three procedures involving curettage of the uterine cavity increase the risk of developing pathology by more than 30%.

The main classification criterion is how closed the organ cavity is, how much pathological changes have affected it. It is customary to distinguish 3 degrees of intrauterine synechia:

  1. The easiest form, in which less than ¼ of the uterine cavity is wound, the adhesions are thin, the mouths of the fallopian tubes are free.
  2. It is diagnosed if 14 to 34 uterine cavities are involved, and the mouths of the tubes are blocked, although not completely.
  3. Involved in more than 34 uterine cavities, i.e. the uterine cavity is almost completely closed.

Diagnosis of Asherman's syndrome

The most informative diagnostic method is hysteroscopy, during which the doctor can determine the degree of development of the pathological process. In addition, an endometrial aspiration biopsy can be performed, after which the samples obtained are carefully examined. Hysterosalpingography makes it possible to assess the patency of the fallopian tubes.

To identify the causes of amenorrhea, a test with estrogens and progesterone can be used - with Asherman's syndrome, it gives a negative result, that is, menstrual bleeding does not occur after the use of hormones.

Treatment of Asherman's Syndrome

The only effective treatment is dissection of the intrauterine synechia. The operation is carried out under the control of a hysteroscope: this is a tube with a light source, a camera and a surgical instrument that allows you to display the image of the uterine cavity on the screen. It is preferable to use a mechanical separation of synechiae, but also for the intervention may require a hysteroresectoscope - "electron knife". The operation is safe, healthy tissues are almost not damaged, so the recovery period after it is short.

To prevent organ perforation, intrauterine synechia is dissected under the control of ultrasound equipment. And in order to prevent relapse, after the intervention, a course of hormone therapy is prescribed or an IUD is administered for 1-2 months. The prognosis is usually favorable, but it depends on the degree of damage. The easier the degree, the easier the operation and the lower the risk of complications. After dissection of synechia of the 2nd and 3rd degree after 2-3 months, it is desirable to perform a control hysteroscopy. Pregnancy can be planned after the restoration of menstrual function (usually after 3-4 months). But even with successful therapy, women who have a history of uterine adhesions require special attention from obstetrician-gynecologists during pregnancy.