Ashermann's Syndrome - Hysteroscopy

Symptoms

A 39 year old woman presented with secondary infertility. She had 2 children delivered by Caesarean Section. The second delivery was complicated by endometritis (infection of the lining of the uterus). She had been trying to conceive a third pregnancy for 6 months. She had noted her periods had become significantly lighter and were painful.

Diagnosis

Hysteroscopy revealed Ashermann's Syndrome. The walls of the uterus had become adherent because of adhesions.

Procedure

The adhesions were divided. She took a course of high dose oestrogen post-operatively.

Outcome

She subsequently had a miscarriage. This was followed by a term delivery.

The view of the cavity of the uterus showing adhesions
 

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The cavity is gradually opened as the adhesions are divided

The adhesions are carefully divided using operating scissors.

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The normal cavity at the end of the procedure. All adhesions have been divided.