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Asherman's syndrome (AS) is an acquired uterine condition that occurs when scar tissue forms inside the uterus and/or the cervix. [1] It is characterized by variable scarring inside the uterine cavity, where in many cases the front and back walls of the uterus stick to one another.
The degree of menstrual deficiency is closely correlated to the extent of the adhesions. [ 2 ] Uterine: Scanty loss sometimes means that the bleeding surface is smaller than normal, and is occasionally seen when the endometrial cavity has been reduced in size during myomectomy or other plastic operation on the uterus .
Asherman's syndrome, also known as intrauterine adhesions, occurs when the basal layer of the endometrium is damaged by instrumentation (e.g., D&C) or infection (e.g., endometrial tuberculosis) resulting in endometrial scarring followed by adhesion formation that partially or completely obliterates the uterine cavity
Adhesions form as a natural part of the body's healing process after surgery in a similar way that a scar forms. The term "adhesion" is applied when the scar extends from within one tissue across to another, usually across a virtual space such as the peritoneal cavity. Adhesion formation post-surgery typically occurs when two injured surfaces ...
Intrauterine adhesions (IUA) present in Asherman's syndrome can cause ectopic cervical pregnancy or, if adhesions partially block access to the tubes via the ostia, ectopic tubal pregnancy. [ 26 ] [ 27 ] [ 28 ] Asherman's syndrome usually occurs from intrauterine surgery, most commonly after D&C . [ 26 ]
Signs and symptoms, when present, may include lower abdominal pain, vaginal discharge, fever, burning with urination, pain with sex, bleeding after sex, or irregular menstruation. [1] Untreated PID can result in long-term complications including infertility , ectopic pregnancy , chronic pelvic pain , and cancer .
During implantation, the embryo must cross the epithelial layer of the maternal endometrium before invading and implanting in the stroma layer. Maternal factors, including congenital uterine abnormalities, fibroids, endometrial polyps, intrauterine adhesions, adenomyosis, thrombophilia and endometriosis, can reduce the chances of implantation and result in RIF.
The Hippocratic Corpus outlines symptoms similar to endometriosis, including uterine ulcers, adhesions, and infertility. [187] Historically, women with these symptoms were treated with leeches , straitjackets , bloodletting , chemical douches , genital mutilation , pregnancy (as a form of treatment), hanging upside down, surgical intervention ...