Asherman‘s syndrome is a rare condition, where scar tissue forms in the uterine cavity. This condition usually occurs in women who have had uterine surgery. There are also severe pelvic infections that may lead to Asherman’s syndrome, even if not related to surgery. Infections with tuberculosis or schistosomiasis may also lead to intrauterine adhesions, although in rare cases.
Procedures that can lead to the condition (surgical):
- D&C (dilation and curettage) miscarriage, incomplete or missed
- D&C for retained placenta
- Suction method D&C
- Hysteroscopy myomectomy
- Cesarean section
- Uterine artery embolization
- Vacuum procedure performed for abortion
- IUD (intrauterine device birth control)
Non-surgical risk factor procedures:
- Uterine packing with gauze to prevent postpartum hemorrhage
- Douching with a caustic chemical to induce abortion
- Endometrial tuberculosis
- Pelvic irradiation for cancer treatment
Infections with tuberculosis or schistosomiasis may also lead to intrauterine adhesions, although in rare cases.
Symptoms of Asherman’s syndrome
Some of the symptoms of the adhesions include lack of menstrual periods, miscarriages, and infertility. These symptoms can occur due to different kinds of conditions but indicate Asherman’s syndrome when they occur suddenly after uterine surgery.
Women who have Asherman’s syndrome may notice menstrual periods being lighter than usual or having no periods at all. At the same time, there are women who have the condition and still have normal periods. Women may experience severe pain at the time of the menstrual period. This pain can be an indicator of adhesions near the cervix obstructing the normal menstrual flow.
Diagnosis
Different tests may be used to diagnose Asherman’s syndrome, such as hysteroscopy, hysterosonogram, transvaginal ultrasound examination, or blood tests to diagnose tuberculosis or schistosomiasis. A pelvic exam usually doesn’t reveal Asherman’s syndrome.