Placenta acreta following hysteroscopic treatment of Asherman syndrome after one uncomplicated cesarean section: a case report

Document Type : Case report

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Asherman syndrome (uterine adhesion) occurs due to injuries to the basal layer of endometrium that is usually caused following surgeries of uterine such as curettage and myomectomy. In the next pregnancy, obstetrical complications such as abortion, placenta pravia and acreta may be increased.
Case presentation: In this study, a case of amenorrhea after one uncomplicated caesarean section is reported. She had spontaneous pregnancy after treatment with three times histroscopy. In the next pregnancy, she developed severe adhesion to the myometrium, resulting in severe hemorrhage and hysterectomy. 
Conclusion: Ashman syndrome may be caused following an uncomplicated cesarean section and may increase the chance of obstetrical complications in next pregnancy.

Keywords


  1. Fritsch H. Ein Fall von volligen Schwund der Gebärmutterhohle nach Auskratzung. Zentralbl Gynaekol 1894; 18:1337-42.
  2. Chen L, Zhang H, Wang Q, Xie F, Gao S, Song Y, et al. Reproductive Outcomes in Patients With Intrauterine Adhesions Following Hysteroscopic Adhesiolysis: Experience From the Largest Women's Hospital in China. J Minim Invasive Gynecol 2017; 24(2):299-304.
  3. Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta 2008; 29(7):639-45.
  4. Kodaman PH, Arici A. Intra-uterine adhesions and fertility outcome: how to optimize success? Curr Opin Obstet Gynecol 2007;19(3):207-14.
  5. March CM. Management of Asherman’s syndrome. Reprod Biomed Online 2011;23(1):63–76.
  6. Belfort MA. Placenta accreta. Am J Obstet Gynecol 2010; 203(5):430-439.
  7. Schenker JG, Margalioth EJ. Intrauterine adhesions: an updated appraisal. Fertil Steril 1982; 37(5):593-610.
  8. Engelbrechtsen L, Langhoff-Roos J, Kjer JJ, Istre O. Placenta accreta: adherent placenta due to Asherman syndrome. Clin Case Rep 2015; 3(3): 175-178.
  9. Cenksoy PO, Ficicioglu C, Yesiladali M, Kizilkale O. T The Diagnosis and Management of Asherman's Syndrome Developed after Cesarean Section and Reproductive Outcome. Case Rep Obstet Gynecol 2013;2013:450658.
  10. Sonan Y, Aoki S, Enomoto K, Seki K, Miyagi E. Placenta Accreta following Hysteroscopic Lysis of Adhesions Caused by Asherman’s Syndrome: A Case Report and Literature Review. Case Rep Obstet Gynecol 2018; 2018:6968382.
  11. Surgery AEG. AAGL practice report: practice guidelines on intrauterine adhesions developed in collaboration with the European Society of Gynaecological Endoscopy (ESGE). J Minim Invasive Gynecol 2017; 24(5):695-705.