Prevalence of Asherman's syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion

This prospective study assesses the prevalence of intrauterine adhesionsamong women undergoing secondary removal of placental remnants afterdelivery, or a repeat curettage for incomplete abortions, and evaluatesrisk factors associated with the presence of intrauterine adhesions. In 50women, undergoing either a secondary removal of placental remnants morethan 24 h after delivery, or a repeat curettage for incomplete abortions,ambulatory hysteroscopy was performed 3 months after the intervention.Intrauterine adhesions were found in 20 of the women (40%): five patientshad Asherman's syndrome grade I, six had grade II, six had grade III andthree had grade IV. In women with menstrual disorders a statisticallysignificant 12-fold increased risk for Asherman's syndrome grade II-IV wasfound. Previous abortion as well as infection during surgery wereassociated with a mildly but non-significant increased risk. Based on ourfindings, hysteroscopy is recommended only in those patients who developmenstrual disorders, either after secondary intervention for placentalremnants after delivery or after a repeat curettage.