Identifying the risk factors and incidence of Asherman Syndrome in women with post‐abortion uterine curettage

• Published in: The journal of obstetrics and gynaecology research 2021-04, Vol.47 (4), p.1549-1555
• Main Authors: Sevinç, Fahrünnisa, Oskovi‐Kaplan, Z. Asli, Çelen, Şevki, Ozturk Atan, Deniz, Topçu, Hasan Onur
• Format: Article
• Language: English
• Subjects: Abortion; Amenorrhea; Asherman Syndrome; Cervix; Curettage; dilatation and curettage; Growth rate; Infertility; intrauterine adhesion; miscarriage; Pregnancy; Premature birth; Risk factors; surgical abortion; Uterus
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.14667

Aim To evaluate the risk factors and incidence of Asherman Syndrome in women with post‐abortion uterine evacuation and curettage. Methods A total of 2546 patients who had surgical abortion (uterine evacuation and curettage) before the 20th gestational week with indications of missed abortion, anembryonic pregnancy, incomplete abortion, and elective curettage in a tertiary antenatal care center were recruited. The patients were called and surveyed for their symptoms; including infertility, oligo‐amenorrhea and recurrent pregnancy loss, preterm birth and intrauterine growth retardation and abnormal placentation as criteria of Asherman Syndrome. Diagnostic (office) hysteroscopy was performed for 177 who had one of those complaints. Results The incidence of Asherman Syndrome was 1.6% (n = 43/2546). History of ≥3 abortions was the main factor that increased the risk of Asherman Syndrome for by 4.6 times. Use of vacuum aspiration or sharp curettage, premedication for cervical priming, and having a pregnancy >10th gestational weeks were not risk factors for Asherman Syndrome. Conclusion When the diagnosis was based on presence of symptoms who underwent uterine instrumentation, the incidence of Asherman Syndrome was found to be 1.6%. Repeated abortions were the main risk factor for Asherman Syndrome and avoiding from repeated uterine instrumentations may have a role in prevention.