1/4. Intrapartum spontaneous uterine rupture following uncomplicated resectoscopic treatment of Asherman's syndrome.Since Asherman first published his series of intrauterine synechiae in 1948, only a few physicians have described the obstetric complications of patients who conceived following surgical treatment of intrauterine synechiae. We present a woman with a history of resectoscopic resection of intrauterine adhesions with a term pregnancy and spontaneous uterine rupture that occurred during the intrapartum period. At emergent cesarean section, hemoperitoneum of approximately 1500 mL was noted and a 10-cm defect was present in the lateral uterine wall; the edges of the defect were bleeding actively. Because of the potential for a disastrous outcome in the rupture of the pregnant uterus, patients treated for Asherman's syndrome should be identified early and appropriate precautions should be taken in their obstetric management.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/4. Intrauterine adhesions after manual vacuum aspiration for early pregnancy failure.OBJECTIVE: To describe the occurrence of intrauterine adhesions after manual vacuum aspiration for early pregnancy failure. DESIGN: Case series. SETTING: Tertiary care center. PATIENT(S): Three women with intrauterine adhesions after manual vacuum aspiration for the treatment of early pregnancy failure. INTERVENTION(S): Chart review. MAIN OUTCOME MEASURE(S): Hysteroscopic diagnosis of intrauterine adhesions after manual vacuum aspiration. RESULT(S): Three cases of symptomatic intrauterine adhesions after manual vacuum aspiration. CONCLUSION(S): Intrauterine adhesion formation may follow manual vacuum aspiration for early pregnancy loss.- - - - - - - - - - ranking = 7keywords = pregnancy (Clic here for more details about this article) |
3/4. Successful use of vaginal sildenafil citrate in two infertility patients with Asherman's syndrome.Vaginal sildenafil citrate (Viagra, Pfizer, Inc., new york, NY) has been shown to be useful in increasing endometrial thickness and achieving pregnancy in women with varied uterine disorders. However, it failed to demonstrate favorable results in the setting of Asherman's syndrome, a condition characterized by the presence of uterine synechiae. We have successfully applied this treatment in two women noted to have inadequate endometrium after surgical resection of uterine synechiae. Both patients had a history of a postpartum uterine curettage with subsequent secondary infertility. Asherman's syndrome was surgically demonstrated and treated in both patients. Postoperatively, both patients were noted to have a thin endometrium and failed to conceive despite fertility treatment. Subsequently, these women achieved pregnancy in the first treatment cycle with vaginal sildenafil citrate. Using transvaginal ultrasound, endometrial thickness was noted to improve when sildenafil citrate was administered. It is suspected that this medication causes selective vasodilatation, resulting in improved endometrial development.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
4/4. Successful pregnancy outcome after hysteroscopic adhesiolysis in Asherman's syndrome.Asherman's syndrome is an uncommon finding at hysterosalpingography for infertility. Modern day management entails hysteroscopic confirmation and adhesiolysis. We present one such case of a young woman who had secondary infertility after dilatation and curettage, and who was diagnosed and treated with a successful outcome.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |