Asherman syndrome: risk factors, clinical criteria and diagnosis in current literature

Authors

DOI:

https://doi.org/10.56294/saludcyt2024932

Keywords:

Asherman's Syndrome, Uterine Adhesions, Infertility, Diagnosis, Hysterosalpingography

Abstract

Asherman's syndrome is a condition characterized by the presence of uterine adhesions or uterine synechiae that are caused by unintentional trauma, severe infections or endometrial hypoxia in a pregnant uterus. The aim of the study was to identify the main risk factors and diagnostic alternatives for Asherman's syndrome through literature review. In an effort to better understand Asherman's syndrome, a descriptive documentary study reviewed articles published from 2019 to 2023 in high-impact journals, selecting 17 for analysis. These included case studies and theoretical sources, highlighting the still unknown pathophysiology of the syndrome. It was confirmed that diagnosis is mainly based on hysterosalpingography and hysteroscopy, although these methods do not guarantee complete endometrial recovery, leading to high recurrence rates and low conception success rates. This underscores the need for complementary therapies to restore the uterine cavity and prevent new adhesions. In addition to the medical challenges, the study highlights the significant emotional and psychological impact of the syndrome, underscoring the importance of emotional and psychological support for those affected, as well as the need to raise awareness and support research to improve their quality of life. In conclusion, partial or total obstruction of the uterine cavity by adhesions is noted as a risk, emphasizing the need for a multidisciplinary approach to treatment. The study highlights the absence of clinical guidelines and awareness in Ecuador, which hinders the management of this condition

References

1. López Quinga Nathaly, Bustillos Solorzano Marcos. El plasma rico en plaquetas como estrategia prometedora para el tratamiento del síndrome de Asheman. Revista científica Arbitrada Multidisciplinaria PENTACIENCIAS, 2023; 5(6): 384–399. Disponible en: El plasma rico en plaquetas como una estrategia prometedora para el tratamiento del síndrome de Asherman | Revista Científica Arbitrada Multidisciplinaria PENTACIENCIAS (editorialalema.org)

2. Dreisler, Eva, and Jens Joergen Kjer. Asherman's syndrome: current perspectives on diagnosis and management. International journal of women's health, 2019; 11: 191-198. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430995/

3. Naghshineh, E., Rouholamin, S., & Derakhshandeh, Z. Hormone Therapy with or without Platelet‑Rich Plasma (PRP) for Treatment Asherman Syndrome. ARandomized Clinical Trial. Advanced Biomedical Research, 2023; 13, 1–5. Disponible en: https://doi.org/10.4103/abr.abr_411_21

4. Cedars, M., y Adeleye, A. Adhesiones intrauterinas: tratamiento y prevención. UpToDate, 2021; 1–16.

5. Xavi Santamaria, Keith Isaacson, Carlos Simón. Asherman’s Syndrome: it may not be all our fault. OXFORD ACADEMIC human reproduction, 2018; 33: 1374–1380. Disponible en: https://academic.oup.com/humrep/article/33/8/1374/5061901?login=false

6. Calderón, G. R., & SOCIEM-UPSJB, D. C. Síndrome de Asherman. CPA SOCIEM-UPSJB, 2021; Disponible en: https://www.academia.edu/59049293/S%C3%ADndrome_de_Asherman

7. Lee, W.-L.; Liu, C.-H.; Cheng, M.; Chang, W.-H.; Liu, W.-M.; Wang, P.-H. Focus on the Primary Prevention of Intrauterine Adhesions. Current Concept and Vision. Int, 2021; 22, 5175. Disponible en: https://www.mdpi.com/1422-0067/22/10/5175

8. Zhu, R., Duan, H., Xu, W. et al. Decision tree model predicts live birth after surgery for moderate-to-severe intrauterine adhesions BMC Pregnancy Childbirth, 2022; 22, 78. Disponible en; https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-04375-x#citeas

9. Khan, Z., y Goldberg, J. M. Hysteroscopic Management of Asherman’s Syndrome. Journal of Minimally Invasive Gynecology, 2018; 25(2), 218–228. Disponible en: https://doi.org/10.2147/IJWH.S165474

10. Dreisler, E., y Kjer, J. J. Asherman’s syndrome: Current perspectives on diagnosis and management. International Journal of Women’s Health, 2019; 11, 191–198. Disponible en: https://doi.org/10.2147/IJWH.S165474

11. Hansen, B. B., y Nøhr, B. Surgical treatment of Asherman syndrome and reproductive outcome. Danish Medical Journal, 2022; 69(3), 1–7.

12. Cedars, M., y Adeleye, A. Adhesiones intrauterinas: manifestación clínica y diagnóstico. Up, 2021; 1–16.

13. Cedars, M., y Adeleye, A. Adhesiones intrauterinas: tratamiento y prevención. UpToDate, 2021; 1–16.

14. Torres, L. A., Campo, R., Devassy, R., Di Spiezio Sardo, A., Hooker, A., Koninckx, P., Urman, B., Wallwiener, M., y De Wilde, R. L. Adhesions and Anti-Adhesion Systems Highlights. Facts, Views y Vision in ObGyn, 2019; 11(2), 137–149.

15. Doroftei, B., Dabuleanu, A. M., Ilie, O. D., Maftei, R., Anton, E., Simionescu, G., Matei, T., y Armeanu, T. Mini-Review of the New Therapeutic Possibilities in Asherman Syndrome. Where Are We after One Hundred and Twenty-Six Years? Diagnostics, 2020; 10(9), 1–22. Disponible en: https://doi.org/10.3390/diagnostics10090706

16. Ma, J., Zhan, H., Li, W., Zhang, L., Yun, F., Wu, R., Lin, J., y Li, Y. Recent trends in therapeutic strategies for repairing endometrial tissue in intrauterine adhesión. Biomaterials Research, 2021; 25(1), 1–25. Disponible en: https://doi.org/10.1186/s40824-021-00242-6

17. Barros, G., Celedonio, M., Brandão, A. et al. Síndrome de Asherman: Análise da eficácia da terapia baseada em células-tronco. e-Acadêmica, 2022; 2675-8539. Disponible en: https://eacademica.org/eacademica/article/view/108

18. Ramos Argilagos M, Valencia Herrera Á, Vayas Valdiviezo W. Evaluación de estrategias de educación nutricional en escuelas del Ecuador utilizando TOPSIS neutrosófico. Rev Int Cienc Neutrosóficas. 2022;18(3):208-217.

19. Jaramillo MN, Chuga ZN, Hernández CP, Lits RT. Análisis multicriterio en el ámbito sanitario: selección del sistema de triaje más adecuado para las unidades de atención de urgencias en Ecuador. Rev Investig Oper. 2022;43(3):316-324.

20. Prado Quilambaqui J, Reyes Salgado L, Valencia Herrera A, Rodríguez Reyes E. Estudio del cuidado materno y conocimientos ancestrales en el Ecuador con ayuda de mapas cognitivos neutrosóficos. Revista Investigación Operacional. 2022;43(3):340-348. Disponible en: https://rev-inv-ope.pantheonsorbonne.fr/sites/default/files/inline-files/43322-06.pdf

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Published

2024-04-04

How to Cite

1.
Urbina Romo NY, Sánchez Álvarez DA, Solís Sánchez MI. Asherman syndrome: risk factors, clinical criteria and diagnosis in current literature. Salud, Ciencia y Tecnología [Internet]. 2024 Apr. 4 [cited 2024 Dec. 10];4:932. Available from: https://sct.ageditor.ar/index.php/sct/article/view/778