Asherman's syndrome , also called uterine synechiae, presents a condition characterized by the presence of scars within the uterine cavity.

Features

The cavity of the uterus is lined by the endometrium. This lining can be traumatized, typically after a dilation and curettage (D&C) done after a miscarriage, abortion, or delivery, and then develops intrauterine scars which can obliterate the cavity to a varying degree. In the extreme, the whole cavity has been scarred and occluded. Even with relatively few scars, the endometrium may fail to respond to estrogens and rests. The patient experiences secondary amenorrhea and becomes infertile. An artificial form of Ashermans's Syndrome can be surgically induced by uterine ablation in women with uterine bleeding problems in lieu of hysterectomy. Female internal reproductive anatomy The uterus or womb is the major female reproductive organ of most mammals, including humans. ... The endometrium is the uterine membrane in mammals which is thickened in preparation for fertilization, and into which a fertilized egg is implanted upon its arrival into the uterus. ... Dilation and curettage is a gynaecological procedure performed on the female reproductive system. ... Miscarriage is the lay term for the natural or accidental termination of a pregnancy at a stage where the embryo or the fetus is incapable of surviving. ... Newborn with suctioning and umbilical cord Childbirth (also called labour, birth, or parturition) is the culmination of pregnancy, the emergence of a child from its mothers uterus. ... Estrogens (or oestrogens) are a group of steroid compounds that function as the primary female sex hormone. ... Amenorrhoea (BE) or amenorrhea (AmE) is the absence of a menstrual period in a woman of reproductive age. ... Ablation is defined as the removal of material from the surface of an object by vaporization, chipping, or other erosive processes. ... A hysterectomy is the surgical removal of the uterus, usually done by a gynecologist. ...

Diagnosis

The history of a pregnancy event followed by a D&C leading to seconday amenorrhea is typical. Imaging by gynecologic ultrasonography or hysterosalpingography will reveal the extent of the scar formation. Hormone studies show normal levels consistent with reproductive function. A pregnant woman Human pregnancy refers to the process by which a human female carries a live offspring from implantation until childbirth. ... Gynecologic ultrasonography or Gyn sonography refers to the application of medical ultrasonography to the female pelvic organs, specifically the uterus, the ovaries, the Fallopian tubes, as well as the bladder, the culdesac, and any findings in the pelvis of relevance outsite of pregnancy. ...

Treatment

Operative hysteroscopy is used for visual inspection of the uterine cavity and dissection of scar tissue. Hysteroscopy is the inspection of the uterine cavity by endoscopy. ...

Prognosis

The extent of scar formation is critical. Small scars can usually be treated with success. Extensive obliteration of the uterine cavity may require several surgical interventions or even be uncorrectable. Patients who carry a pregnancy after correction of Asherman's syndrome may have an increased risk of having a placenta that invades the uterus more deeply, leading to complications in placental separation after delivery. A pregnant woman Human pregnancy refers to the process by which a human female carries a live offspring from implantation until childbirth. ... Human placenta shown a few minutes after birth. ... Female internal reproductive anatomy The uterus or womb is the major female reproductive organ of most mammals, including humans. ...

History

It is also known as Fritsch syndrome, or Fritsch-Asherman syndrome per the individuals who described it, Heinrich Fritsch and Joseph G. Asherman.

Links

http://www.ashermans.org/