Asherman syndrome--one century later

Yu, Dan, Wong, Yat-May, Cheong, Ying, Xia, Enlan and Li, Tin-Chiu (2008) Asherman syndrome--one century later. Fertility and Sterility, 89 (4), 759-779. (doi:10.1016/j.fertnstert.2008.02.096).

Abstract

Objective: To provide an update on the current knowledge of Asherman syndrome.
Design:
Literature review.
Setting:
The worldwide reports of this disease.
Patient(s):
Patients with Asherman syndrome who presented with amenorrhea or hypomenorrhea, infertility, or recurrent pregnancy loss.
Intervention(s):
Hysteroscopy and hysteroscopic surgery have been the gold standard of diagnosis and treatment respectively for this condition.
Main outcome measure(s):
The etiology, pathology, symptomatology, diagnosis, treatment, and reproductive outcomes were analyzed.
Result(s):
This syndrome occurs mainly as a result of trauma to the gravid uterine cavity, which leads to the formation of intrauterine and/or intracervical adhesions. Despite the advances in hysteroscopic surgery, the treatment of moderate to severe Asherman syndrome still presents a challenge. Furthermore, pregnancy after treatment remains high risk with complications including spontaneous abortion, preterm delivery, intrauterine growth restriction, placenta accrete or praevia, or even uterine rupture.
Conclusion(s):
The management of moderate to severe disease still poses a challenge, and the prognosis of severe disease remains poor. Close antenatal surveillance and monitoring are necessary for women who conceive after treatment.

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Contributors

Author: Ying Cheong

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