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Prospective incidence of intrauterine adhesions by pregnancy and procedure type

Prospective incidence of intrauterine adhesions by pregnancy and procedure type
Condition Procedure Incidence (%) Reference
Gravid
SAB Suction D&C 15 Gilman et al[1]
19 Hooker et al[2]
First trimester TOP Suction D&C 21 Hooker et al[3]
Retained POC* Hysteroscopic resection 6 Smorgick et al[4]
13 Hooker et al[5]
19 Barel et al[6]
Suction D&C 30 Hooker et al[5]
Gynecologic
Septum Hysteroscopic septum resection (bipolar) 24 Yu et al[7]
Fibroids Hysteroscopic myomectomy (bipolar) 8 Touboul et al[8]
Abdominal myomectomy 22 Bhandari et al[9]
SAB: spontaneous abortion; D&C: dilation and curettage; TOP: termination of pregnancy; POC: products of conception.
* Pregnancy types preceding retained POC for each study: Smorgick et al[5] includes data from surgical and medical TOP, SAB, and postpartum from vaginal and caesarean deliveries; Hooker et al[6] includes data from first- and second-trimester pregnancies, postpartum, and otherwise not reported; Barel et al[7] includes data from surgical and medical TOP, SAB, and postpartum from vaginal and caesarean deliveries.
References:
  1. Gilman AR, Dewar KM, Rhone SA, Fluker MR. Intrauterine adhesions following miscarriage: Look and learn. J Obstet Gynaecol Can 2016; 38:453.
  2. Hooker AB, Lemmers M, Thurkow AL, et al. Systematic review and meta-analysis of intrauterine adhesions after miscarriage: Prevalence, risk factors and long-term reproductive outcome. Hum Reprod Update 2014; 20:262.
  3. Hooker A, Fraenk D, Brölmann H, Huirne J. Prevalence of intrauterine adhesions after termination of pregnancy: A systematic review. Eur J Contracept Reprod Health Care 2016; 21:329.
  4. Smorgick N, Barel O, Fuchs N, et al. Hysteroscopic management of retained products of conception: Meta-analysis and literature review. Eur J Obstet Gynecol Reprod Biol 2014; 173:19.
  5. Hooker AB, Aydin H, Brölmann HA, Huirne JA. Long-term complications and reproductive outcome after the management of retained products of conception: aA systematic review. Fertil Steril 2016; 105:156.
  6. Barel O, Krakov A, Pansky M, et al. Intrauterine adhesions after hysteroscopic treatment for retained products of conception: What are the risk factors? Fertil Steril 2015; 103:775.
  7. Yu X, Yuhan L, Dongmei S, et al. The incidence of postoperative adhesion following transection of uterine septum: A cohort study comparing three different adjuvant therapies. Eur J Obstet Gynecol Reprod Biol 2016; 201:61.
  8. Touboul C, Fernandez H, Deffieux X, et al. Uterine synechiae after bipolar hysteroscopic resection of submucosal myomas in patients with infertility. Fertil Steril 2009; 92:1690.
  9. Bhandari S, Ganguly I, Agarwal P, et al. Effect of myomectomy on endometrial cavity: a prospective study of 51 cases. J Hum Reprod Sci 2016; 9:107.
From: Salazar CA, Isaacson K, Morris S. A comprehensive review of Asherman's syndrome: Causes, symptoms and treatment options. Curr Opin Obstet Gynecol 2017; 29:249. DOI: 10.1097/GCO.0000000000000378. Copyright © 2017. Reproduced with permission from Lippincott Williams & Wilkins. Unauthorized reproduction of this material is prohibited.
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