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.
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.
Authors: Rebecca J Chason; Eric D Levens; Belinda J Yauger; Mark D Payson; Kenneth Cho; Frederick W Larsen Journal: Fertil Steril Date: 2008-09-14 Impact factor: 7.329