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Role of hysteroscopy in diagnosis of Asherman’s syndrome – A retrospective study

Author: 
Sravani Chithra, C. H., Rahul Manchanda, Nidhi Jain and Anshika Lekhi
Subject Area: 
Health Sciences
Abstract: 

Aim: To assess the significance of hysteroscopy in diagnosis of Asherman’s syndrome in patients presenting with infertility, hypomenorrhea, secondary amenorrhea and dysmenorrhea. Material and Method: This is a retrospective study conducted in the department of gynecological endoscopy at Manchanda’s Endoscopic Centre, PSRI, Delhi, from March 2014 to March 2016. 230 patients between 18 to 50 years age group, who presented with complaints of infertility, hypomenorrhea, amenorrhea and dysmenorrhea were selected. All patients underwent hysteroscopy post-menstrually whenever feasible except in patients with amenorrhea. Patients with Asherman’s syndrome were treated with adhesiolysis using scissors followed by insertion of intra uterine device in patients with moderate and severe Asherman’s syndrome. They were given conjugated estrogen for 21 days followed by medroxyprogesterone acetate for 7 days. Results: Total of 230 patients with above complaints were selected, of which 101 patients had Asherman’s syndrome and 129 patients had other pathologies. Of the 101 patients, 45.5% (46 cases) presented with primary infertility, 32.7% (33 cases) with secondary infertility, 8.9% (9 cases) with secondary amenorrhea, 8.9% (9 cases) with hypomenorrhea and 4% (4 cases) with dysmenorrhea. The role of hysteroscopy in asherman’s syndrome for patients presenting with infertility, amenorrhea and hypomenorrhea was found to be significant as proven by predictive value of less than 0.05. Conclusion: Hysteroscopy plays a vital role in accurately assessing and classifying the pathology and is the gold standard method for diagnosis and management of asherman’s syndrome.

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