ASHERMAN’S Syndrome Medical Notes & Mindmap

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Asherman’s syndrome is a rare condition that occurs when scar tissue forms in the uterus, often as a result of uterine surgery or injury. The scar tissue can cause the walls of the uterus to stick together, which can lead to problems with fertility, menstruation, and pregnancy.

Asherman's Syndrome [MEDNOTES+MINDMAP]

  • Definition:
    • Condition characterized by the development of scar tissue in the uterine cavity
    • Can lead to fertility problems and abnormal bleeding
  • Epidemiology:
    • Rare, affects only a small percentage of women
    • More commonly seen in women who have had previous uterine surgery, such as a cesarean section or abortion
  • Natural history:
    • Scar tissue can interfere with the implantation of a fertilized egg and the development of a pregnancy
    • If left untreated, can also cause abnormal bleeding and other menstrual problems
  • Classification/Types/Stages:
    • Based on severity:
      • Mild: minimal scarring
      • Severe: extensive scarring
    • Based on location:
      • Uterine cavity only
      • Cervix as well
    • Based on stage:
      • Stage 1: minimal scarring
      • Stage 2: moderate scarring
      • Stage 3: extensive scarring
      • Stage 4: inability to carry a pregnancy

  • Risk Factors

    • Previous uterine surgery (such as c-section or abortion)
    • Infection or inflammation in the uterus
    • Trauma to the uterus

  • Etiology/Causes

    • Scar tissue formation in the uterus
    • Adhesions (bands of scar tissue) form between the uterine walls and other organs

  • Signs

    • Amenorrhea (absence of menstrual periods)
    • Infertility
    • Abdominal pain
    • Abnormal bleeding

  • Symptoms

    • Irregular or absent menstrual periods
    • Pain during intercourse
    • Infertility
    • Abnormal bleeding
    • Pelvic pain or discomfort

  • Histology/Microscopic Changes
    • Scar tissue formation in the uterus
    • Adenomyosis (thickening of uterine muscle tissue)
    • Endometrial atrophy (thinning of uterine lining)
  • Pathology/Pathogenesis
    • Caused by trauma to the uterine lining, such as:
      • Surgical procedures (e.g. dilation and curettage, caesarean section)
      • Infections (e.g. sexually transmitted infections, uterine infections)
      • Inflammation (e.g. endometritis)
    • Scar tissue formation leads to blockage of the fallopian tubes and impaired menstrual flow
  • Diagnosis/Laboratory Diagnosis
    • Physical examination and medical history
    • Ultrasound or hysteroscopy to visualize uterine lining
    • Biopsy to confirm presence of scar tissue
    • Hormonal levels may be tested to determine menstrual function
  • Tests Required
    • Ultrasound or hysteroscopy
    • Biopsy
    • Hormonal testing (e.g. FSH, LH, estrogen, progesterone)

  • Contraindications
    • Previous uterine surgery or injury
    • Infections of the uterus
  • Associated with/Strongly Associated with
    • Dilation and curettage (D&C)
    • Abortion
    • Childbirth
    • Infections
    • Endometrial ablation
  • Similar syndromes
    • Adenomyosis
    • Endometriosis
  • Prevention
    • Avoiding unnecessary uterine surgery
    • Prompt treatment of infections
  • Treatment
    • Hormonal therapy to stimulate the growth of the endometrial lining
    • Surgery to remove scar tissue and repair damage to the uterus
    • Assisted reproductive techniques, such as in vitro fertilization, to help with fertility

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Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER working in govt.health department
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