Wider Concerns About Asherman’s Syndrome

Wider Concerns About Asherman’s Syndrome

Wider Concerns About Asherman’s Syndrome should be communicated to women. Patient safety requires knowledge about conditions to be imparted.

The diagnosis and management of Asherman syndrome are often difficult. It requires a multi disciplinary team that includes an obstetrician, gynaecologist, and radiologist. Asherman’s syndrome should be treated by a surgeon experienced with hysteroscopy, sometimes with sonographic or laparoscopic guidance.

These patients should be closely followed by the nurse practitioner and primary caregiver as they may develop endometrial cancer before or after menopause.

While rare, biologically active endometrial tissue trapped within these intrauterine scars can undergo malignant changes post-menopause.

The hallmark sign of endometrial cancer after menopause is abnormal vaginal bleeding. However, because Asherman’s involves extensive scarring and sometimes cervical blockage, fluid and tissue may not be able to exit the uterus. This can obscure bleeding or delay the detection of a thickened endometrium.

Because standard “blind” biopsies can be difficult or inaccurate in a scarred uterus, hysteroscopy (a camera inserted into the uterus) combined with a targeted biopsy is essential for diagnosing synechiae and ruling out cancer. Because of the difficulty in detecting typical signs in a scarred uterus, experts often recommend that women with a history of Asherman’s syndrome receive routine pelvic sonograms as they navigate menopause to monitor for any abnormal endometrial changes