Asherman's syndrome

The Asherman's syndrome, also known as Fritsch syndrome, or Fritsch - Asherman's syndrome, called adhesions or adhesions ( synechiae ) of the uterus front and back wall, which is often caused by trauma, usually by curettage. Consequences may be amenorrhea Hypomenorrhoe, recurrent fetal loss and a secondary sterility. The clinical picture was after the Erstbeschreibern Joseph G. Asherman (1889-1968), a Czech- Israeli gynecologists and Heinrich Fritsch (1844-1915), a German gynecologist named. Single cases have been previously by Ernst Wertheim (1864-1920), Otto Ernst Küstner (1849-1931), Gustav Veit (1824-1903) and others described.

Causes

Adhesions and scar tissue can occur when the endometrium was injured during a surgical procedure in depth. Since during and after pregnancy, the uterine lining is particularly sensitive, there is an increased risk here.

Follow

The Asherman's syndrome is rare cause of infertility, however, often leads to amenorrhea, Hypomenorrhoe and habitual abortions. If the uterine wall was so badly injured that no mucosal remnants are left, often the adhesions occur after a new distance immediately. This is especially difficult those women where the Asherman's syndrome is caused by a curettage because of a miscarriage.

Diagnostics

The Asherman's syndrome is best diagnosed with a hysteroscopy. This can be as an outpatient procedure today - sometimes even under local anesthesia - happen. At times can be in the ultrasonic indications of the disease found. Previously, you could find such characters in a hysterosalpingogram.

Prophylaxis

In scrapings in or after pregnancy only blunt instruments ( curettes ) are used and it will only work with gentle pressure.

Therapy

The adhesions during a Hysteroscopy - removed with special instruments - thus under direct vision with the aid of an endoscope. In the best case is still healthy lining of the uterus present, then spread out and can prevent further adhesions. The patient then has another chance to get pregnant, although sequence pregnancies are considered high-risk pregnancies.