Asherman's syndrome epidemiology and demographics
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Editor(s)-in-Chief: Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Canan S Fornusek, Ph.D.; Associate Editor-In-Chief: Saud Khan M.D.
Overview
Asherman's Syndrome may occur in up to 13% of women undergoing a termination of pregnancy during the first trimester, and 30% in women undergoing a dilation and curettage (D&C) after a late spontaneous abortion. Structural placental abnormalities and previous procedures done in the uterus increase the risk.
Epidemiology and Demographics
The true prevalence of Asherman’s syndrome is unclear. The condition is estimated to affect 1.5% of women undergoing HSG [1], between 5 and 39% of women with recurrent miscarriage [2][3][4] and up to 40% of patients who have undergone D&C for retained products of conception [5]. It may occur in up to 13% of women undergoing a termination of pregnancy during the first trimester, and 30% in women undergoing a dilation and curettage (D and C) after a late spontaneous abortion.
Women with placental abnormalities (e.g., placenta increta) may have a higher risk of developing Asherman syndrome as the placenta adheres to deeper layers within the uterus and becomes more difficult to remove. The incidence may be as high as 23.4% in patients undergoing procedures two to four weeks after the initial procedure for a vaginal delivery or missed abortion. The risk increases for patients undergoing repeated procedures for bleeding or repeated elective termination of pregnancies.
It is found in 1.5% of women evaluated with a hysterosalpingogram (HSG) for infertility, between 5 and 39% of women with recurrent miscarriage. Asherman’s Syndrome may occur in 31% of women after the initial hysteroscopic resection of leiomyoma, and up to 46% after the second hysteroscopic resection.[6][7]
References
- ↑ Dmowski WP, Greenblatt RB. (1969). "Asherman's syndrome and risk of placenta accreta". Obstet Gynecol. 34 (2): 288–299. PMID 5816312.
- ↑ Rabau E, David A. (1963). "Intrauterine adhesions:etiology, prevention, and treatment". Obstet Gynecol. 22: 626–629. PMID 14082285.
- ↑ Toaff R. (1966). "Some remarks on posttraumatic uterine adhesions.in French". Rev Fr Gynecol Obstet. 61 (7): 550–552. PMID 5940506.
- ↑ Ventolini G, Zhang M, Gruber J. (2004). "Hysteroscopy in the evaluation of patients with recurrent pregnancy loss: a cohort study in a primary care population". Surg Endosc. 18 (12): 1782–1784. doi:10.1007/s00464-003-8258-y. PMID 15809790.
- ↑ Westendorp ICD, Ankum WM, Mol BWJ, Vonk J. (1998). "Prevalence of Asherman's syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion". Hum Reprod. 13 (12): 3347–3350. doi:10.1093/humrep/13.12.3347. PMID 9886512.
- ↑ Chikazawa K, Imai K, Liangcheng W, Sasaki S, Horiuchi I, Kuwata T; et al. (2018). "Detection of Asherman's syndrome after conservative management of placenta accreta: a case report". J Med Case Rep. 12 (1): 344. doi:10.1186/s13256-018-1869-7. PMC 6245912. PMID 30454053.
- ↑ Tchente NC, Brichant G, Nisolle M (2018) [Asherman's syndrome : management after curettage following a postnatal placental retention and literature review.] Rev Med Liege 73 (10):508-512. PMID: 30335256