scholarly journals Mini-Review of the New Therapeutic Possibilities in Asherman Syndrome—Where Are We after One Hundred and Twenty-Six Years?

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 706 ◽  
Author(s):  
Bogdan Doroftei ◽  
Ana-Maria Dabuleanu ◽  
Ovidiu-Dumitru Ilie ◽  
Radu Maftei ◽  
Emil Anton ◽  
...  
Keyword(s):  
Adhesion Formation ◽  
Uterine Cavity ◽  
Complete Removal ◽  
Cervical Canal ◽  
Reproductive Outcomes ◽  
Efficient Tool ◽  
Non Invasive ◽  
Intrauterine Adhesion ◽  
New Directions ◽  
Therapeutic Possibilities

Asherman syndrome is a multifaceted condition describing the partial or complete removal of the uterine cavity and/or cervical canal. It is a highly debatable topic because of its pronounced influence on both reproductive outcomes and gynaecologic symptoms. The latest reports demonstrated that trauma to the endometrium is the main cause of intrauterine adhesion formation. Left untreated, such adhesions gradually lead to a range of repercussions ranging from mild to severe. Considering the lack of non-invasive approaches, the advent of hysteroscopy has revolutionized the entire field, being otherwise considered the most efficient tool offering new directions and amplifying the chances of treating the Asherman syndrome.

scholarly journals Diagnosis and treatment of intrauterine adhesions

1970 ◽  
Vol 10 (2) ◽  
pp. 72-82 ◽  
Author(s):  
U Salma ◽  
D Xu ◽  
MSA Sheikh
Keyword(s):  
Operative Procedure ◽  
Medical Science ◽  
Adhesion Formation ◽  
Surgical Techniques ◽  
Uterine Cavity ◽  
Abdominal Adhesions ◽  
Intrauterine Adhesions ◽  
Intrauterine Adhesion ◽  
The Impact ◽  
Single Modality

Intrauterine adhesions develop as a result of intrauterine trauma. The degree of adhesion formation and the impact of the adhesions on the contour of uterine cavity vary greatly. It has been reported that intra abdominal adhesions occur in 60–90% of women who have undergone major gynecological procedures. Hysteroscopy is the gold standard for the diagnosis of severe intrauterine adhesions. Effective methods for preventing adhesions, a variety of surgical techniques and agents have been advocated for the prevention of intrauterine adhesion formation. The present review indicates that there is still no single modality proven to be unequivocally effective in preventing post-operative adhesion formation either for laparoscopic or for hysteroscopic use. Hopefully, the increasing understanding of the future emphasis will probably be on a multimodality therapy, including the use of pharmacologic adjutants in conjunction with a barrier material tailored to the specific operative procedure and a precise surgical technique. Key words: Intrauterine adhesion; hysteroscopy; Pharmacologic adjutants. DOI: http://dx.doi.org/10.3329/bjms.v10i2.7801 Bangladesh Journal of Medical Science Vol.10 No.2 Apr’11 pp.72-82

scholarly journals Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility

2017 ◽  
Vol 13 (4) ◽  
pp. 281-285 ◽  
Author(s):  
A. Nigam ◽  
P. Saxena ◽  
A. Mishra
Keyword(s):  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Diagnostic Modality ◽  
Infertile Patient ◽  
Infertile Women ◽  
Intrauterine Abnormalities

Background Hysterosalpingography (HSG) is a useful screening test for the evaluation of female infertility. Laparoscopy has proven role in routine infertility work up but role of hysteroscopy in an infertile patient with normal HSG for additional information is a subject of debate. Hysteroscopy permits direct visualization of the cervical canal and the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion.Objective To detect uterine abnormalities in infertile women by various approaches i.e. HSG and hysteroscopy and evaluating the role of combining hysteroscopy with laparoscopy for the evaluation of tubo-uterine factor for primary infertility.Method One twenty eight infertile women were evaluated and HSG was performed as a basic test for evaluation of tubes and uterine cavity. Women were subjected to combined laparoscopic and hysteroscopic examination on evidence of HSG abnormalities. In absence of any HSG abnormality, women were subjected to ovulation induction for three to six months and if they did not conceive during this period they were undertaken for combined laparo-hysteroscopic evaluation.Result The positive predictive value of HSG for detecting the intrauterine abnormalities was 70% among 126 patients where the hysteroscopy could be performed successfully. The diagnostic accuracy of HSG for intrauterine abnormalities revealed false negative rate of 12.96%. The most frequent pathologies encountered by laparoscopy were tubal and/or peritoneal and were found in 68% (87/128) of women. Total 64.06% infertile women had some abnormality on laparoscopy. This detection rate has been increased from 64.06% to 71.86% on including the concomitant hysteroscopy.Conclusion HSG is a good diagnostic modality to detect uterine as well as tubal abnormalities in infertile patient. HSG and hysteroscopy are complementary to each other and whenever the patient is undertaken for diagnostic laparoscopy for the infertility, hysteroscopy should be combined to improve the detection rate of abnormalities especially in communities where there is enormous risk of pelvic infection.

scholarly journals A Rare Case of Intrauterine Adhesion Caused by Intrauterine Fallopian Tube Incarceration

2021 ◽  
pp. 64-67
Author(s):  
Yiran Liu ◽  
Yugang Chi
Keyword(s):  
Fallopian Tube ◽  
Rare Case ◽  
Early Recognition ◽  
Uterine Cavity ◽  
Uterine Perforation ◽  
Secondary Infertility ◽  
False Passage ◽  
Intrauterine Adhesion ◽  
Tubal Lumen ◽  
The Right

Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion. Such technique, however, sometimes has limitations and even second damages. We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration. A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage. First hysteroscopy created a false passage through the previous uterine perforation, entered into the cavity of incarcerated fallopian tube, and led to iatrogenic hydrosalpinx. Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage, released the adhesion, and reconstructed the uterine cavity. Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.

Determining of biomarkers in menstrual blood as possibility of non-invasive diagnostics of inflammatory process in uterine cavity

2016 ◽  
pp. 88-91
Author(s):  
T.M. Motovilova ◽  
T.S. Kachalina ◽  
G.O. Grechkanev ◽  
L.V. Borovkova ◽  
A.N. Zinoviev ◽  
...  
Keyword(s):  
Inflammatory Process ◽  
Uterine Cavity ◽  
Menstrual Blood ◽  
Non Invasive ◽  
Invasive Diagnostics

A 12-month comparative clinical investigation of a levonorgestrel-releasing intracervical device situated in the uterine cavity or cervical canal

Contraception ◽  
1996 ◽  
Vol 54 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Päivi Pakarinen ◽  
Tapani Luukkainen ◽  
Kaisa Elomaa ◽  
Kari Ratsula ◽  
Pekka Venesmaa ◽  
...  
Keyword(s):  
Clinical Investigation ◽  
Uterine Cavity ◽  
Cervical Canal

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

scholarly journals Cervical gene delivery of the antimicrobial peptide, Human β-defensin (HBD)-3, in a mouse model of ascending infection-related preterm birth

2019 ◽  
Author(s):  
Natalie Suff ◽  
Rajvinder Karda ◽  
Juan Antinao Diaz ◽  
Joanne Ng ◽  
Julien Baruteau ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Uterine Cavity ◽  
Preterm Births ◽  
Premature Delivery ◽  
Cervical Canal ◽  
Adeno Associated Virus ◽  
Cellular Events ◽  
Microbial Invasion ◽  
Ascending Infection ◽  
Pregnant Mice

AbstractApproximately 40% of preterm births are preceded by microbial invasion of the intrauterine space: ascent from the vagina is the most common pathway. Within the cervical canal, antimicrobial peptides and proteins (AMPs) help to constitute a barrier which prevents ascending infection. We investigated whether expression of the AMP, human β-defensin-3 (HBD3), in the cervical mucosa prevented bacterial ascent from the vagina into the uterine cavity of pregnant mice. An adeno-associated virus vector containing both the HBD3 gene and GFP transgene (AAV8 HBD3.GFP) or control (AAV8 GFP), was administered intravaginally into E13.5 pregnant mice. Ascending infection was induced at E16.5 using bioluminescent E.coli (E.coli K1 A192PP-lux2). Bioluminescence imaging showed bacterial ascent into the uterine cavity, cellular events that led to premature delivery and a reduction in pups born alive, compared with uninfected controls. In addition, a significant reduction in uterine bioluminescence in the AAV8 HBD3.GFP-treated mice was observed 24 hours post-E.coli infection, compared to AAV8 GFP treated mice, signifying reduced bacterial ascent in AAV8 HBD3.GFP-treated mice. There was also an increase in the number of living pups in AAV HBD3.GFP-treated mice. We propose that HBD3 may be considered a possible candidate for augmenting cervical innate immunity to prevent ascending infection-related preterm birth.

scholarly journals Hysteroscopy to identify retained placental tissue and excision in secondary post-partum haemorrhage

2020 ◽  
Vol 9 (5) ◽  
pp. 1847
Author(s):  
Pratibha Devabhaktuni ◽  
Padmaja Allani
Keyword(s):  
Caesarean Delivery ◽  
Postpartum Haemorrhage ◽  
Post Partum ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Placental Tissue ◽  
Complete Removal ◽  
Time Treatment ◽  
Products Of Conception ◽  
Retained Placental Tissue

Background: Most cases of secondary postpartum haemorrhage (PPH) are due to retained placental products (RPP). This study had a crop of five cases of secondary PPH, referral cases, during a period of six months during 2006. Four cases were following a caesarean delivery and in one, sub mucous and intra mural, uterine fibroids, caused retained placental tissue by distortion of the uterine cavity. Objectives of this study were to evaluate the feasibility of hysteroscopy to identify the retained placental products in cases of secondary postpartum haemorrhage. Verification of complete removal of RPP by reinsertion of hysteroscope, after removal of RPP by using a sponge holder, or curette.Methods: Trans vaginal ultrasonography (TVS) identified echogenic retained products of conception in all cases. Surgical profile investigations were done as per protocol. Transfusion of blood products was needed in some. Bettocchi 5 mm continuous flow hysteroscope (Karl Storz) was used. Storz endomat hysteroflator was used for irrigation and aspiration.Results: Hysteroscopic guided excision of the placental tissue was one-time treatment in four of study cases, and one needed a second hysteroscopic excision. Secondary PPH occurred at varying periods after the caesarean delivery, one week in one, two weeks in one case, three weeks in two cases and one woman was admitted with retained placenta, primary PPH continuing to secondary PPH. Hysteroscopy done during the puerperal period, in cases of secondary PPH, had certain challenges to cope with.Conclusions: Hysteroscopic guided excision of the retained placental tissue was successful in all the five cases with secondary postpartum haemorrhage. Hysteroscopy is an excellent procedure in cases of secondary PPH. We request guidelines committees to consider including hysteroscopic guided removal of retained placental products, in the algorithm of management of secondary PPH.

VIII.—Transuterine (“Internal”) Migration of Fertilised Ova in the Albino Rat

1953 ◽  
Vol 65 (1) ◽  
pp. 106-116
Author(s):  
A. Young ◽  
George M. Wyburn
Keyword(s):  
Experimental Investigation ◽  
Internal Migration ◽  
Genital Tract ◽  
Uterine Cavity ◽  
Uterine Horn ◽  
The Other ◽  
Cervical Canal ◽  
Vascular Pattern ◽  
Albino Rat ◽  
In Pregnancy

SynopsisThe passage of ova down the Fallopian tube and uterine horn of one side into the horn of the other side is generally referred to as transuterine migration. There is evidence that such transmigration can occur in a wide variety of animals—Ungulata, Carnivora, Cheiroptera, Insectivora and Primates (Boyd, Hamilton and Hammond, 1944; Marshall'sPhysiology of Reproduction, 1952). In all these forms the genital tract has a single supravaginal segment varying from a common cervical canal to the single uterine cavity of the primate uterus simplex. The uterus of the albino rat is generally described as “uterus duplex”, with separate cervical canals opening independently into the vagina, and it has been stated by Hanson and Boone (1925, 1926) and by Slonaker (1927) that there is no evidence that transuterine migration occurs in the albino rat. In the course of an experimental investigation of the vascular pattern in pregnancy in the rat, some results were obtained which indicate that transuterine migration can occur in the albino rat.

Sign in / Sign up

Export Citation Format

Share Document