Asherman syndrome--one century later.

OBJECTIVE: To provide an update on the current knowledge of Asherman syndrome.

DESIGN: Literature review.

SETTING: The worldwide reports of this disease.

PATIENT(S): Patients with Asherman syndrome who presented with amenorrhea or hypomenorrhea, infertility, or recurrent pregnancy loss.

INTERVENTION(S): Hysteroscopy and hysteroscopic surgery have been the gold standard of diagnosis and treatment respectively for this condition.

MAIN OUTCOME MEASURE(S): The etiology, pathology, symptomatology, diagnosis, treatment, and reproductive outcomes were analyzed.

RESULT(S): This syndrome occurs mainly as a result of trauma to the gravid uterine cavity, which leads to the formation of intrauterine and/or intracervical adhesions. Despite the advances in hysteroscopic surgery, the treatment of moderate to severe Asherman syndrome still presents a challenge. Furthermore, pregnancy after treatment remains high risk with complications including spontaneous abortion, preterm delivery, intrauterine growth restriction, placenta accrete or praevia, or even uterine rupture.

CONCLUSION(S): The management of moderate to severe disease still poses a challenge, and the prognosis of severe disease remains poor. Close antenatal surveillance and monitoring are necessary for women who conceive after treatment.