Prevalence of Asherman's syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion

• Published in: Human reproduction (Oxford) Vol. 13; no. 12; pp. 3347 - 3350
• Main Authors: Westendorp, I C, Ankum, W M, Mol, B W, Vonk, J
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.1998
• Subjects: Abortion, Incomplete - complications; Abortion, Incomplete - surgery; Adult; Biological and medical sciences; Female; Female genital diseases; Gynatresia - etiology; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Menstruation Disturbances - complications; Non tumoral diseases; Placenta, Retained - complications; Placenta, Retained - surgery; Pregnancy; Prevalence; Prospective Studies; Risk; Curettage; Hysteroscopy; Menstruation disorders; Uterus; Female genital system; Risk factor; Female; Adhesion
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/13.12.3347

This prospective study assesses the prevalence of intrauterine adhesions among women undergoing secondary removal of placental remnants after delivery, or a repeat curettage for incomplete abortions, and evaluates risk factors associated with the presence of intrauterine adhesions. In 50 women, undergoing either a secondary removal of placental remnants more than 24 h after delivery, or a repeat curettage for incomplete abortions, ambulatory hysteroscopy was performed 3 months after the intervention. Intrauterine adhesions were found in 20 of the women (40%): five patients had Asherman's syndrome grade I, six had grade II, six had grade III and three had grade IV. In women with menstrual disorders a statistically significant 12-fold increased risk for Asherman's syndrome grade II-IV was found. Previous abortion as well as infection during surgery were associated with a mildly but non-significant increased risk. Based on our findings, hysteroscopy is recommended only in those patients who develop menstrual disorders, either after secondary intervention for placental remnants after delivery or after a repeat curettage.