Asherman’s Syndrome

Question 1

Asherman’s syndrome

Answer 1

Symptomatic adhesions form within the uterus , following uterine damage

Question 2

When does Asherman’s syndrome normally occur?

Answer 2

After a pregnancy-related dilatation and curettage procedure
- Tx of retained products of conception

After uterine surgery

Several pelvic infection

Question 3

Presentation of Asherman’s syndrome

Answer 3

Secondary amenorrhoea

Significantly lighter periods

Dysmenorrhoea

Question 4

Complications of Asherman’s syndrome

Answer 4

Infertility

Recurrent miscarriages

Menstrual abnormalities

Question 5

Investigations for Asherman’s syndrome

Answer 5

Hysteroscopy - gold standard

Hysterosalpingography

Sonohysterography

MRI scan

Question 6

Hysteroscopy

Answer 6

Gold standard investigation for Asherman’s syndrome and can dissect and treat adhesions at the same time

Question 7

Hysterosalpingography

Answer 7

Contrast is injected into the uterus and imaged with xrays

Question 8

Sonohysterography

Answer 8

Uterus is filled with fluid and a pelvic ultrasound is performed

Question 9

Management of Asherman’s syndrome

Answer 9

Dissecting the adhesions during hysteroscopy

Question 10

Complications of hysteroscopy and dissection

Answer 10

Reoccurrence of the adhesions after treatment is common