If the Mullerian ducts fail to fuse, or, if the wall which is the result of fusion is not adequately resorbed, the result is a spectrum of uterine abnormalities called Mullerian fusion and absorption defects. The impact of these abnormalities on fertility is a subject for debate, but at least a subset seems to have a negative impact on reproductive performance manifesting in recurrent abortion and/or premature labor. Previous surgical interventions required laparotomy, but, with careful application of imaging techniques, a group of patients can be identified with a uterine septum amenable to removal under hysteroscopic direction with little morbidity. Intrauterine adhesions or synechiae are usually secondary to curettage in the context of missed abortion or pregnancy-related hemorrhage. These lesions cover a spectrum that ranges from minor and insignificant to severe cohesive adhesions that affect menstrual function and fertility. Surgical repair of the endometrial cavity affected with such adhesions presents a challenge to the hysteroscopic surgeon. Appropriate management is controversial but may include second loop hysteroscopy and the use of postoperative adjuvants such as systemic estrogens and intrauterine devices or systems designed to impede the development of adhesions.

Septums and synechiae: Approaches to surgical correction [Recensione] / L. Fedele, S. Bianchi, G. Frontino. - In: CLINICAL OBSTETRICS AND GYNECOLOGY. - ISSN 0009-9201. - 49:4(2006 Dec), pp. 767-788.

Septums and synechiae: Approaches to surgical correction

L. Fedele
Primo
;
S. Bianchi
Secondo
;
2006

Abstract

If the Mullerian ducts fail to fuse, or, if the wall which is the result of fusion is not adequately resorbed, the result is a spectrum of uterine abnormalities called Mullerian fusion and absorption defects. The impact of these abnormalities on fertility is a subject for debate, but at least a subset seems to have a negative impact on reproductive performance manifesting in recurrent abortion and/or premature labor. Previous surgical interventions required laparotomy, but, with careful application of imaging techniques, a group of patients can be identified with a uterine septum amenable to removal under hysteroscopic direction with little morbidity. Intrauterine adhesions or synechiae are usually secondary to curettage in the context of missed abortion or pregnancy-related hemorrhage. These lesions cover a spectrum that ranges from minor and insignificant to severe cohesive adhesions that affect menstrual function and fertility. Surgical repair of the endometrial cavity affected with such adhesions presents a challenge to the hysteroscopic surgeon. Appropriate management is controversial but may include second loop hysteroscopy and the use of postoperative adjuvants such as systemic estrogens and intrauterine devices or systems designed to impede the development of adhesions.
Mullerian fusion defects ; septate uterus ; uterine septum ; Asherman syndrome ; uterine adhesions ; uterine synechiae ; intrauterine adhesions ; metroplasty
Settore MED/40 - Ginecologia e Ostetricia
dic-2006
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/46744
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