Lesson 5 (Part 4) Flashcards
What is the sonographic appearance and ashermans syndrome? (2)
- Hyperechoic uterine lining
- scar tissue in uterine cavity - Hyperechoic bands traversing through the endometrial cavity
What are 6 differential diagnosis for ashermans syndrome?
- Normal intra-uterine longitudinal folds in a non distended uterus
- Amenorrhea
- PCOD
- Hypomenorrhea
- Infertility
- Postdilatation and Postcurettage
How can ashermans syndrome be cured?
In most women its with surgery
- although sometimes more than one procedure will be necessary
What happens to women who are infertile because of Asherman syndrome after treatment?
May have a successful pregnancy
What can help in the diagnosis of ashermans syndrome?
Sonohysterography
- further evaluate the endometrium and better management of the problem
What can a sonohysterography do with ashermans syndrome?
Distinguish focal from diffuse abnormalities
What do focal abnormalities of ashermans syndrome require?
A hysteroscopy with directed biopsy
What do diffuse abnormalities of ashermans syndrome require?
Nondirected biopsy
How do you perform a sonohysterography? (8)
- Insert sterile saline into the endometrial cavity under ultrasound guidance
- Distends the endometrial cavity
- separating the walls - Sterile speculum is then inserted into the vagina
- A catheter is inserted into the uterine cavity
- Speculum is removed and the transvaginal probe is inserted
- The catheter position is identified and repositioned if necessary
- Saline is injected slowly
- Uterus is scanned in sagittal and transverse planes and imaged
When is a SHG usually performed?
Days 4-7 of the cycle
When is a SHG usually performed in postmenopausal womne?
Any time
What are contraindications of SHG?
- If patient could be pregnant
- Acute Pelvic inflammatory disease
- PID
What are treatments for symptomatic patients? (2)
- Endometrial Ablation
- IUCD
- intra uterine contraceptive device
Endometrial Ablation
Treatment for irregular bleeding in perimenopausal women
- day surgery lasers off the endometrium
What are complications of an endometrial ablation? (4)
- Residual non ablated endometrial left and adjacent scarring
- Result in Cornual hematometra or central hematometra
- Can cause pain
- Postablation tubal sterilization syndrome
- pain from hematosalpinx and cornual hematometra
