Intrauterine adhesion syndrome

Intrauterine adhesion syndrome refers to intrauterine adhesions, which lead to all or part of the uterine cavity being blocked, causing a series of symptoms. Patients with intrauterine adhesion syndrome generally have a history of uterine operation, such as artificial abortion, curettage, myomectomy, and even full-term delivery or mid-term induced labor. It is more common after abortion and repeated curettage.

Due to excessive trauma to the uterine wall and myometrium, especially in the case of combined infection, adhesions may occur in the uterine body or cervical canal. Depending on the location, level and area of ​​adhesions, the clinical symptoms vary, such as amenorrhea, oligomenorrhea, dysmenorrhea, recurrent miscarriage and infertility. The diagnosis is based on medical history, pelvic examination, hysteroscopy, hysteroscopy, etc.

Causes of Intrauterine Adhesion Syndrome

Under normal physiological conditions, the anterior and posterior walls of the uterine cavity are in contact with each other, and adhesions are not likely to occur even when the uterine wall is exfoliated during menstruation. This is because the consistency and function of the dermis of the uterine wall are normal. If the uterine wall is damaged by physical factors such as surgery or inflammation, resulting in the destruction of the endometrial dermis and disrupting the regular growth and shedding of the uterine wall during the normal physiological cycle, it can cause fibrinogen extravasation and accumulation in the uterine interstitial space, leading to adhesions of the anterior and posterior walls of the uterine cavity.

The main causes of intrauterine adhesions are:

1. History of intrauterine operation

(1) Pregnancy factors: intrauterine surgical treatments related to pregnancy, such as vacuum aspiration in early pregnancy, forceps curettage in mid-pregnancy, curettage for induction of labor in mid-pregnancy, curettage for postpartum hemorrhage, and curettage for spontaneous abortion. This may be because the endometrial dermis of the pregnant uterus is more easily damaged, causing the endometrium to adhere to each other and form permanent adhesions.

(2) Non-pregnancy factors: Myomectomy (entering the uterine cavity), intrauterine resection of submucosal uterine fibroids, uterine septum removal, double hysteroplasty, etc. destroy the dermis of the endometrium, exposing the myometrium to the uterine cavity, resulting in anterior, posterior, and posterior adhesions of the uterine wall. ,

(3) Human error: The dermis of the uterine wall is destroyed due to human factors, resulting in the formation of intrauterine adhesions. Such as adhesions caused by electrosurgical ablation of the uterine wall, microwave heating and refrigeration of the uterine cavity, and treatment with organic drugs.

2. Surgery to treat inflammatory factors

Intrauterine infection includes uterine tuberculosis, postmenopausal endometritis, secondary infection after intrauterine operation, postpartum infection, secondary infection after IUD insertion, etc.

3. Human Error

Some women develop adhesions in their uterine cavity, which is caused by sensory factors. Artificial factors destroy the dermis of the uterine wall, causing intrauterine adhesions. Such as microwave heating of the uterine cavity, electrical removal of the uterine wall, refrigeration, chemotherapy, and after radiotherapy for some tumors.

4. Endometrial damage during curettage due to various reasons

If the curettage is repeated several times, it is very easy to damage the dermis. The intrauterine adhesion caused by this reason is called damaging adhesion, which is the most common. Therefore, obstetricians and gynecologists should use appropriate intensity during curettage, and pregnant women should implement contraceptive methods and avoid abortion. In particular, abortion for the first child may cause secondary infertility after intrauterine adhesion.