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

Hum Reprod. 1998 Dec;13(12):3347-50. doi: 10.1093/humrep/13.12.3347.

Abstract

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.

MeSH terms

  • Abortion, Incomplete / complications*
  • Abortion, Incomplete / surgery
  • Adult
  • Female
  • Gynatresia / etiology*
  • Humans
  • Menstruation Disturbances / complications
  • Placenta, Retained / complications*
  • Placenta, Retained / surgery
  • Pregnancy
  • Prevalence
  • Prospective Studies
  • Risk