Asherman syndrome--one century later

Fertil Steril. 2008 Apr;89(4):759-79. 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.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Abortion, Habitual / etiology
  • Communicable Diseases / complications
  • Diagnostic Imaging* / methods
  • Dilatation and Curettage
  • Endometrial Neoplasms / etiology
  • Endometrium / pathology
  • Female
  • Genetic Predisposition to Disease
  • Gynatresia* / complications
  • Gynatresia* / diagnosis
  • Gynatresia* / etiology
  • Gynatresia* / history
  • Gynatresia* / prevention & control
  • Gynatresia* / surgery
  • Gynecologic Surgical Procedures*
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Hysteroscopy
  • Hysterotomy
  • Infertility, Female / etiology
  • Menstruation Disturbances / etiology
  • Pregnancy
  • Prognosis
  • Radiography
  • Reoperation
  • Risk Factors
  • Secondary Prevention
  • Tissue Adhesions
  • Treatment Outcome
  • Uterus* / abnormalities
  • Uterus* / injuries
  • Uterus* / pathology
  • Uterus* / surgery