Causes of Adhesions in Uterus

Causes of Adhesions in Uterus

 

Causes of Adhesions in Uterus usually involves a D&C. There is a significantly higher rate of adhesions after D&C if the miscarriage was a missed abortion (30.9%) versus an early miscarriage (6.4%) (Adoni et al., 1982). There is a higher rate with spontaneous abortion (60%) versus induced abortion (17.8%) (Lancet and Kessler, 1988).

Moreover, uterine anomalies and especially partial uterine septum have been reported in up to 25% of patients diagnosed of missed abortion. However, early evacuation of the uterus in missed abortions within the first 4 days of diagnosis does not seem to increase the incidence of adhesion(Friedler et al., 1993).

In patients diagnosed with adhesions after post-partum curettage, the curettage was performed during the second, third or fourth week post-partum. Immediate post-partum curettage does not seem to cause traumatic adhesions. Therefore the endometrium seems very susceptible to denudation during this critical period as observed by the amount of basalis and myometrium observed in the specimens removed in the curettage (Jensen and Stromme, 1972).