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Asherman Syndrome

Leah N. Delfinado, MD, FACOG, Yahaira Plata, MD, MPH and Katherine Tadros, DO Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Asherman syndrome (AS) is the term used to describe symptoms (i.e., amenorrhea or infertility) associated with intrauterine adhesions (IUAs) or development of scar tissue within the ...

DIAGNOSIS

HISTORY

  • History of uterine instrumentation

  • Infertility

  • Menstrual irregularities

  • Recurrent pregnancy loss

  • Cyclic pelvic pain

  • Rule out systemic endocrine disorders (eating disorders, excess exercisi...

TREATMENT

Operative hysteroscopy is the mainstay of treatment. 

GENERAL MEASURES

Expectant management is a reasonable option in women with asymptomatic and mild AS: 
  • 45.5% regain fertility in 1 to 7 year...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Uterine cavity should be reexamined before patient attempts conception.

  • HSG or SHG can be done 2 to 3 months after hysteroscopic adhesiolysis to assess if normal u...

REFERENCES

1
Salazar CA, Isaacson K, Morris S. A comprehensive review of Asherman’s syndrome: causes, symptoms and treatment options. Curr Opin Obstet Gynecol.  2017;29(4):249–256. [View Abstract ...

CODES

ICD10

N85.6 Intrauterine synechiae 

ICD9

621.5 Intrauterine synechiae 

SNOMED

  • 48236007 Asherman syndrome (disorder)

  • 361115000 Intrauterine adhesions (disorder)

CLINICAL PEARLS

  • 90% of AS cases are associated with curettage for pregnancy complications.

  • Highest risk for development is trauma to endometrium, occurring within first 4 weeks postpartum or postaborti...

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