Prevalence of Asherman's syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion.
This prospective study assesses the prevalence of intrauterine adhesions among women undergoing secondary removal of placental remnants after delivery, or a repeat curettage for incomplete abortions, and evaluates risk factors associated with the presence of intrauterine adhesions. In 50 women, undergoing either a secondary removal of placental remnants more than 24 h after delivery, or a repeat curettage for incomplete abortions, ambulatory hysteroscopy was performed 3 months after the intervention. Intrauterine adhesions were found in 20 of the women (40%): five patients had Asherman's syndrome grade I, six had grade II, six had grade III and three had grade IV. In women with menstrual disorders a statistically significant 12-fold increased risk for Asherman's syndrome grade II-IV was found. Previous abortion as well as infection during surgery were associated with a mildly but non-significant increased risk. Based on our findings, hysteroscopy is recommended only in those patients who develop menstrual disorders, either after secondary intervention for placental remnants after delivery or after a repeat curettage.
Westendorp
I C
IC
Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Ankum
W M
WM
Mol
B W
BW
Vonk
J
J
D000027:Abortion, Incomplete / Q000150:complications* / Q000601:surgery; D000328:Adult; D005260:Female; D006175:Gynatresia / Q000209:etiology*; D006801:Humans; D008599:Menstruation Disturbances / Q000150:complications; D018457:Placenta, Retained / Q000150:complications* / Q000601:surgery; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk