Prevalence of Asherman's syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion

This prospective study assesses the prevalence of intrauterine adhesions am ong women undergoing secondary removal of placental remnants after delivery , car a repeat curettage for incomplete abortions, and evaluates risk facto rs associated with the presence of intrauterine adhesions, in 50 women, und ergoing either a secondary removal of placental remnants more than 24 h aft er delivery, or a repeat curettage for incomplete abortions, ambulatory hys teroscopy was performed 3 months after the intervention, Intrauterine adhes ions were found in 20 of the women (40%): five patients had Asherman's synd rome grade I, six had grade II, six had grade III and three had grade IV. I n women with menstrual disorders a statistically significant 12-fold increa sed risk for Asherman's syndrome grade II-IV was found. Previous abortion a s well as infection during surgery were associated with a mildly but non-si gnificant increased risk. Based on our findings, hysteroscopy is recommende d only in those patients who develop menstrual disorders, either after seco ndary intervention for placental remnants after delivery or after a repeat curettage.