Intrauterine adhesions (IUA)
Intrauterine adhesions (IUA), also known as Asheman's syndrome, is caused by a traumatic or non-pregnant uterus that causes damage to the lining of the endometrium and partially or completely occludes the uterine cavity, resulting in abnormal menstruation, infertility, or repeated abortion. Its essence is intimal fibrosis.
Endometrial damage is a necessary condition for intrauterine adhesions, which are caused by miscarriage and infection and iatrogenic damage.
1.1 【The uterus becomes weak during pregnancy, and the intima and the underlying layer are more susceptible to injury; the decline in estrogen levels after pregnancy surgery (including abortion, uterus, etc.) affects intimal hyperplasia. Pregnancy uterine damage (90%), including abortion (abortion, incomplete / missed abortion), postpartum hemorrhage, placental residue, cesarean section and gestational trophoblastic disease trauma.】
1.2 【Intrauterine adhesions can also occur in other non-pregnancy periods, such as diagnosis of curettage. Occurs in non-pregnancy: after diagnosis, uterine fibroids removal, cervical biopsy or polypectomy, radium exposure. Postoperative hysteroscopic surgery, such as mediastinal resection, submucosal myomectomy, bilateral uterine artery embolization, and postpartum hemorrhage uterine artery ligation.】
1.3 【Infection: Commonly endometrial tuberculosis. Chronic or subacute endometritis may also cause intrauterine adhesions.】
1.4 【Other: related to Mullerian tube dysplasia, especially the mediastinal uterus.】
1.5 【Genetic factors: The disease is associated with genetic factors.】
2. Clinical manifestation
There are no typical symptoms of intrauterine adhesions, mainly menstrual changes, less menstrual flow, and even menopause, dysmenorrhea and other symptoms. Some patients are also found because of infertility or repeated abortion patients due to visits. According to the degree of adhesion, intrauterine adhesions were divided into five degrees.
2.1 【I degree: There are multiple fiber-like adhesions in the uterine cavity, and the uterine horns and the fallopian tubes are normal on both sides.】
2.2 【I degree: There are multiple fiber-like adhesions in the uterine cavity, and the uterine horns and the fallopian tubes are normal on both sides.】
2.3 【III degree; fiber bundle adhesion caused partial uterine cavity and one side uterine angle atresia.】
2.4 【Va: Scarring of the adhesion zone causes extreme deformation and stenosis of the uterine cavity】
2.5 【Scarring of the adhesion zone causes the uterine cavity to completely disappear.】
【Adhesive classification: 1 according to the site: simple cervical adhesion; cervical and intrauterine adhesions; simple intrauterine adhesions; 2 according to adhesion location: central type; peripheral type; mixed type; 3 according to adhesion range: mild <1/4 Cavity; moderate > 1/4 uterine cavity, < 1/2 uterine cavity; severe > 1/2 uterine cavity.】