Asherman’s Syndrome
Asherman’s syndrome, also known as intrauterine adhesions, is a uterine condition in which there is a formation of bands/ scarring of the uterine cavity. This leads to limited space in the uterine cavity.
When such a condition becomes bothersome, treatment should be considered.
HOW DOES ASHERMAN’S SYNDROME CAUSE PROBLEMS?
Asherman’s syndrome can cause infertility (difficulty getting pregnant). Because of the bands, the embryo is unable to attach itself to the lining of the uterus, hence, patients experience infertility or miscarriages. It may even lead to irregular bleeding in some patients.
HOW DO WE DIAGNOSE THESE ADHESIONS?
Usually sonogram with saline (Saline Infusion Sonogram) or Hysteroscopy is used to diagnose this condition.
Patients who are trying to conceive or have had miscarriages usually go for this ultrasound as a part of their routine checkup. Band-like adhesions can be seen in the uterus in patients with intrauterine adhesions.
They may even be incidentally detected during an ultrasound examination for some other condition.
WHAT IS THE TREATMENT OF ASHERMAN’S SYNDROME?
The treatment for this condition entails completely removing these adhesions for the patient’s comfort. This treatment is especially helpful for women who are trying to conceive.
A hysteroscopy is performed to remove these adhesions. After the procedure, the success rate of pregnancy is high, depending on the extent of adhesions and the duration for which they’ve been present. Because there is a risk of uterine injury, these procedures are done under ultrasound guidance and should only be performed by experienced physicians who perform the procedure on a regular basis.
WHAT ARE THE CAUSES OF ASHERMAN’S SYNDROME?
These adhesions commonly occur in women after they undergo a procedure following pregnancy. A dilation and curettage performed because of a missed or incomplete miscarriage may cause these adhesions.
WHAT ARE THE POST-SURGERY EFFECTS?
To minimise uterine perforation, this procedure should be performed by a high-volume physician. It does not carry any risk of injury to the uterus.
Once these adhesions have been removed and the uterine cavity is normal, the chances of a successful pregnancy are much higher. Patients after the procedure have mild symptoms of bleeding and cramping. During the surgery, an intrauterine catheter may be placed, or the patient may be given hormonal therapy for some time to prevent adhesion formation, considering the extent of adhesions they may have.