期刊
OBSTETRICS AND GYNECOLOGY
卷 142, 期 3, 页码 543-554出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AOG.0000000000005309
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Asherman syndrome is a condition characterized by pain, menstrual abnormalities, and infertility, resulting from intrauterine scar tissue after surgery. Hysteroscopy is the preferred method for diagnosis and treatment usually involves hysteroscopic-guided lysis of adhesions. Various methods are being explored to reduce the reformation of scar tissue after surgery, including the use of stem cells and platelet-rich plasma for regenerative therapy.
Asherman syndrome is characterized by a triad of symptoms including pain, menstrual abnormalities, and infertility and is a result of intrauterine scar tissue after instrumentation of a gravid uterus. Saline sonohysterogram is typically the most sensitive diagnostic tool; however, hysteroscopy is the criterion standard for diagnosis. Treatment includes hysteroscopic-guided lysis of adhesion, with restoration of the anatomy of the uterine cavity. Several modalities are used in an attempt to reduce the reformation of scar tissue after surgery; however, there is no consensus on the ideal method. Stem cells and platelet-rich plasma are being explored as means of regenerative therapy for the endometrium, but data remain limited. At present, most individuals can have restoration of menstrual function; however, lower pregnancy rates and obstetric complications are not uncommon. These complications are worse for patients with a higher grade of disease. Efforts are needed in standardizing classification, reducing uterine instrumentation of the gravid uterus, and referring patients to health care professionals with clinical expertise in this area.
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