Evacuation of embryo in the presence of intrauterine adhesions

Abstract

Asherman syndrome is a controversial topic in gynecology without a clear consensus for treatment. This pathology is characterized by adhesions in the uterine cavity. The main cause of this disorder is injuries to the gravid uterus especially in abortion, during postnatal period or after missed miscarriage. Menstrual disorders and infertility are characteristic clinical features of Asherman syndrome. Pregnancy may be complicated with premature labor, placenta previa and placenta accreta. Introduction of hysteroscopy has changed diagnosis and management of intrauterine synechiae and it is therefore considered the most valuable tool nowadays. Preferred treatment method is hysteroscopic lysis of adhesions combined with estrogens. A clinical case of asymptomatic Asherman syndrome in a 29 year old female is presented in the article. Bipolar hysteroscopic resection of synechiae in combination with curettage was proved to be an effective and safe method of treatment.