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Asherman Syndrome, Endometrial Synechiae
Christine O. Menias, MD; Ilse Castro-Aragon, MD; Sandra J. Allison, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Intrauterine adhesions (IUAs)
              • Uterine synechiae
            • Definitions

              • Permanent adherence of uterine walls, with partial or complete obliteration of uterine cavity and clinical symptoms including menstrual abnormalities, infertility, and recurrent pregnancy loss

            IMAGING

            • General Features

              • Hysterosalpingogram (HSG)

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Gizzo S et al: Secondary amenorrhea in severe Asherman's syndrome: step by step fertility retrieval by Bettocchi's hysteroscope: some considerations. Minim Invasive Ther Allied Technol. 23(2):115-9, 2014
                                          2. Sadow CA et al: Imaging female infertility. Abdom Imaging. 39(1):92-107, 2014
                                          3. Vancaillie TG et al: Asherman's syndrome. Aust Nurs J. 20(8):34-6, 2013
                                          4. Myers EM et al: Comprehensive management of severe Asherman syndrome and amenorrhea. Fertil Steril. 97(1):160-4, 2012
                                          5. Schankath AC et al: Hysterosalpingography in the workup of female infertility: indications, technique and diagnostic findings. Insights Imaging. 3(5):475-83, 2012
                                          6. Tuuli MG et al: Uterine synechiae and pregnancy complications. Obstet Gynecol. 119(4):810-4, 2012
                                          7. Acholonu UC et al: Hysterosalpingography versus sonohysterography for intrauterine abnormalities. JSLS. 15(4):471-4, 2011
                                          8. Marasinghe JP et al: Risk of synechiae following uterine compression sutures. BJOG. 118(8):1020-1; author reply 1021-2, 2011
                                          9. March CM: Asherman's syndrome. Semin Reprod Med. 29(2):83-94, 2011
                                          10. Poujade O et al: Risk of synechiae following uterine compression sutures in the management of major postpartum haemorrhage. BJOG. 118(4):433-9, 2011
                                          11. Dawood A et al: Predisposing factors and treatment outcome of different stages of intrauterine adhesions. J Obstet Gynaecol Can. 32(8):767-70, 2010
                                          12. Deans R et al: Review of intrauterine adhesions. J Minim Invasive Gynecol. 17(5):555-69, 2010
                                          13. Heinonen PK: [Intrauterine adhesions--Asherman's syndrome.] Duodecim. 126(21):2486-91, 2010
                                          14. Steinkeler JA et al: Female infertility: a systematic approach to radiologic imaging and diagnosis. Radiographics. 29(5):1353-70, 2009
                                          15. Al-Serehi A et al: Placenta accreta: an association with fibroids and Asherman syndrome. J Ultrasound Med. 27(11):1623-8, 2008
                                          16. Berman JM: Intrauterine adhesions. Semin Reprod Med. 26(4):349-55, 2008
                                          17. Lo ST et al: Endometrial thickness measured by ultrasound scan in women with uterine outlet obstruction due to intrauterine or upper cervical adhesions. Hum Reprod. 23(2):306-9, 2008
                                          18. Yu D et al: Asherman syndrome--one century later. Fertil Steril. 89(4):759-79, 2008
                                          19. Knopman J et al: Value of 3D ultrasound in the management of suspected Asherman's syndrome. J Reprod Med. 52(11):1016-22, 2007
                                          20. Imaoka I et al: MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics. 23(6):1401-21, 2003
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Intrauterine adhesions (IUAs)
                                                      • Uterine synechiae
                                                    • Definitions

                                                      • Permanent adherence of uterine walls, with partial or complete obliteration of uterine cavity and clinical symptoms including menstrual abnormalities, infertility, and recurrent pregnancy loss

                                                    IMAGING

                                                    • General Features

                                                      • Hysterosalpingogram (HSG)

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Gizzo S et al: Secondary amenorrhea in severe Asherman's syndrome: step by step fertility retrieval by Bettocchi's hysteroscope: some considerations. Minim Invasive Ther Allied Technol. 23(2):115-9, 2014
                                                                                  2. Sadow CA et al: Imaging female infertility. Abdom Imaging. 39(1):92-107, 2014
                                                                                  3. Vancaillie TG et al: Asherman's syndrome. Aust Nurs J. 20(8):34-6, 2013
                                                                                  4. Myers EM et al: Comprehensive management of severe Asherman syndrome and amenorrhea. Fertil Steril. 97(1):160-4, 2012
                                                                                  5. Schankath AC et al: Hysterosalpingography in the workup of female infertility: indications, technique and diagnostic findings. Insights Imaging. 3(5):475-83, 2012
                                                                                  6. Tuuli MG et al: Uterine synechiae and pregnancy complications. Obstet Gynecol. 119(4):810-4, 2012
                                                                                  7. Acholonu UC et al: Hysterosalpingography versus sonohysterography for intrauterine abnormalities. JSLS. 15(4):471-4, 2011
                                                                                  8. Marasinghe JP et al: Risk of synechiae following uterine compression sutures. BJOG. 118(8):1020-1; author reply 1021-2, 2011
                                                                                  9. March CM: Asherman's syndrome. Semin Reprod Med. 29(2):83-94, 2011
                                                                                  10. Poujade O et al: Risk of synechiae following uterine compression sutures in the management of major postpartum haemorrhage. BJOG. 118(4):433-9, 2011
                                                                                  11. Dawood A et al: Predisposing factors and treatment outcome of different stages of intrauterine adhesions. J Obstet Gynaecol Can. 32(8):767-70, 2010
                                                                                  12. Deans R et al: Review of intrauterine adhesions. J Minim Invasive Gynecol. 17(5):555-69, 2010
                                                                                  13. Heinonen PK: [Intrauterine adhesions--Asherman's syndrome.] Duodecim. 126(21):2486-91, 2010
                                                                                  14. Steinkeler JA et al: Female infertility: a systematic approach to radiologic imaging and diagnosis. Radiographics. 29(5):1353-70, 2009
                                                                                  15. Al-Serehi A et al: Placenta accreta: an association with fibroids and Asherman syndrome. J Ultrasound Med. 27(11):1623-8, 2008
                                                                                  16. Berman JM: Intrauterine adhesions. Semin Reprod Med. 26(4):349-55, 2008
                                                                                  17. Lo ST et al: Endometrial thickness measured by ultrasound scan in women with uterine outlet obstruction due to intrauterine or upper cervical adhesions. Hum Reprod. 23(2):306-9, 2008
                                                                                  18. Yu D et al: Asherman syndrome--one century later. Fertil Steril. 89(4):759-79, 2008
                                                                                  19. Knopman J et al: Value of 3D ultrasound in the management of suspected Asherman's syndrome. J Reprod Med. 52(11):1016-22, 2007
                                                                                  20. Imaoka I et al: MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics. 23(6):1401-21, 2003