Paper Title: Clinical presentation and treatment outcome of Asherman syndrome in a Nigerian Teaching Hospital

Authors: Bassey G, Isaac A.

Abstract/Summary:

Background:
Asherman’s 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’s 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’s syndrome was 6.62%. The age range of patients was 20-42
years. Most of the risk factors for Asherman’s 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’s syndrome amongst the studied population. There is
need to build capacity for the use of hysteroscopically directed adhesiolysis as this may yield
better results.

Publication Date:
2019-06-30

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