Paper Title: Clinical presentation and treatment outcome of Asherman syndrome in a Nigerian Teaching Hospital
Authors: Bassey G., Isaac A.
ABSTRACT Background: Asherman syndrome is an important gynaecological condition due to its association with secondary amenorrhoea and infertility. Objective: This study was to evaluate the clinical presentation, risk factors, mode of presentation, treatment modality and outcome at the University of Port Harcourt Teaching Hospital (UPTH). Methodology: This was 5-year review of case files of patients with Asherman syndrome managed at the UPTH. Relevant information was extracted from the case files and analysed with SPSS version 22 software package. Treatment outcome between modes of treatment were compared using Chi square test and P value < 0.05 was regarded as significant. Results: The prevalence of Asherman syndrome was 6.62%. The age range of patients was 20-42 years. Most of the risk factors for Asherman syndrome were pregnancy related in 66.1% of cases with unsafe abortion accounting for 41.9%. Infertility and hypomenorrhoea were the commonest modes of presentation. Blind adhesiolysis and insertion of Foley catheter was the most frequent mode of treatment and there was no documented treatment with hysteroscopically directed adhesiolysis. Correction of menses was achieved in 45.2% while the overall pregnancy rate following treatment was 33.1%. Treatment outcome was significantly better with Foley catheter than Intrauterine device (P=0.0000) Conclusion: Discouraging the practice of preventing unwanted pregnancies through unsafe abortion may reduce the prevalence of Asherman syndrome amongst the studied population. There is need to build capacity for the use of hysteroscopically directed adhesiolysis as this may yield better results.