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Asherman Syndrome

Characterized by uterine synechiae, usually results from destruction of large areas of endometrium by overzealous curettage. The risk is maximum if curettage is done in the postpartum period.

If pregnancy follows, the amount of remaining endometrium may be insufficient to support the pregnancy, and abortion may ensue. A hysterosalpingogram that shows characteristic multiple filling defects may indicate Asherman syndrome, but hysteroscopy most accurately and directly identifies this condition. Recommended treatment consists of lysis or the adhesions via hysteroscopy and placement of an intra-uterine contraceptive device to prevent recurrence. Some practitioners also recommend continuous high-dose estrogen therapy for 60-90 days following adhesiolysis.

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