Adhesions and Abortion

Asherman syndrome is characterized by intrauterine adhesions in association with symptoms such as infertility and menstrual irregularities. The commonest cause of Asherman syndrome is curettage of a pregnant or recently pregnant uterus. Abortions, especially unsafe abortions, constitute a major cause of Asherman syndrome. The risk of Asherman syndrome increases with the number of abortion procedures performed. While medical and surgical methods of termination of pregnancy exist, Asherman syndrome is unlikely with the medical methods and significantly reduced following a vacuum aspiration. The role of infection in causing Asherman syndrome is unclear but it is logical to believe that post-inflammatory processes could worsen a traumatic endometrial damage. Diagnostic hysteroscopy constitutes the gold standard in the diagnosis of Asherman syndrome, while therapeutic hysteroscopy constitutes the method of choice in the treatment. Female health education, liberalizing abortion laws, and training of health personnel might help in reducing abortion complications, including Asherman syndrome.