February 2018 · Volume 7 · Issue 2 Page 375
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Opadiran RO et al. Int J Reprod Contracept Obstet Gynecol. 2018 Feb;7(2):375-379
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Outcome of intrauterine adhesion management at a Nigerian tertiary
hospital: a five-year review
R. O. Opadiran, A. D. Isah*, E. T. Agida, N. Adewole
INTRODUCTION
Intrauterine adhesion also known as “uterine synechiae”
or Asherman’s syndrome is a condition characterized by
the presence of adhesion or scar tissue within the uterine
cavity which prevents normal growth of the
endometrium.
1,2
It was first described in 1894 by
Heinrich Fritsch, it was only after 54years that a full
description of Asherman’s syndrome was carried out by
an Isreali Gynaecologist Joseph Asherman.
1
Its true incidence is unknown, but it was shown to occur
in about 20% of patients being treated for infertility and
1.73% of new patients seen in Gynaecology clinic.
3-6
An
ABSTRACT
Background: Intrauterine adhesion is a cause of menstrual abnormalities and infertility, which are leading complaints
in gynaecological practice in Nigeria. Determining the aetiology and management option would help reduce this
problem. The objective of this study was to determine the aetiology, mode of presentation, management option and
outcome of intrauterine adhesions
Methods: A retrospective analysis of intrauterine adhesions at the University of Abuja Teaching Hospital over a five-
year period from 2012 to 2016 was carried out. The case notes of the patients were retrieved from the records
department and information extracted from these case notes using a questionnaire included the age, level of education,
marital status, parity, complaints, predisposing factors, method of diagnosis, treatment method and outcome.
Additional information was obtained from the theatre registered. The least follow up period was one year.
Results: There were 82 patients diagnosed with Intrauterine Adhesion over the study period giving an incidence of
1.6%. Fifty-nine case notes were available for analysis. The case note retrieval rate was 72%. Majority of the patients
were between the age range of 30-34 years (21, 35.6%). Those with tertiary level of education constituted the majority
(34, 57%). Nullipara constituted 54.2% (32) of the total population. Menstrual abnormalities were the most common
complaint with 93.2% and this includes those with menstrual abnormalities and other complaints. The commonest
predisposing factor identified was a history of dilatation and curettage or uterine evacuation (28, 47.5%). Majority of
the patients had partial intrauterine adhesions (51, 86.4%). All patients were treated with adhesiolysis, Foleys catheter
insertion and hormonal therapy for 3 cycles. There was not statistical significance between those who had blind
adhesiolysis and hysteroscopic adhesiolysis in terms of outcome. Restoration of menstrual flow was in 25, (42.4%)
while 3, (5.1%) had miscarriges and an equal no of patients had term delivery.
Conclusions: Dilatation and curettage is still a major predisposing factor in the development of intrauterine
Adhesions. Blind adhesiolysis still has its place in the management of intrauterine adhesion in developing countries.
Keywords: Aetiology, Intrauterine adhesion, Management, Outcome
Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital Abuja, Nigeria
Received: 09 December 2017
Accepted: 08 January 2018
*Correspondence:
Dr. A. D. Isah,
E-mail: denisanthonyisah@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180151