Asherman syndrome-one century later

作者：Yu Dan^*; Wong Yat May; Cheong Ying; Xia Enlan; Li Tin Chiu

来源：Fertility and Sterility, 2008, 89(4): 759-779.

DOI：10.1016/j.fertnstert.2008.02.096

• intrauterine adhesion
• Asherman syndrome
• hysteroscopic adhesiolysis
• infertility
• synechia
• hysteroscopy
• amenorrhea

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.

• 出版日期2008-4
• 单位首都医科大学