Chapter 108 Asherman’s Syndrome (Uterine Synechia)
INTRODUCTION
Description: Asherman’s syndrome is characterized by scarring or occlusion of the uterine cavity after curettage, especially when performed after septic abortion or in the immediate postpartum period. (Although the same changes occur following therapeutic endometrial ablation, the term is generally not applied in that setting.)
ETIOLOGY AND PATHOGENESIS
Causes: Endometrial damage (excessive curettage, curettage when infection is present or in the immediate postpartum period—some intrauterine adhesions form in 30% of patients treated by curettage for missed abortion), endometrial infection (tuberculosis or schistosomiasis), scarring after myomectomy or metroplasty. A severe pelvic infection unrelated to surgery may also lead to Asherman’s syndrome.
