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Detection of Asherman's syndrome after conservative management of placenta accreta: a case report. 2018

Kenro Chikazawa, and Ken Imai, and Wang Liangcheng, and Shigetane Sasaki, and Isao Horiuchi, and Tomoyuki Kuwata, and Kenjiro Takagi
Perinatal Center, Division of Maternal Fetal Medicine, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan. kendokenro@hotmail.com.

BACKGROUND We present a case involving conservative treatment of placenta accreta, with a subsequent diagnosis of Asherman's syndrome. METHODS A 41-year-old Japanese woman (G2P0A2) delivered a healthy male infant via cesarean section due to preeclampsia. The placenta did not spontaneously separate and was manually removed. Adhesion was tight and placenta accreta was diagnosed. During the procedure, no uterine inversion or perforation, and no uterine cavity adhesion, were observed. Four months postoperatively, hysteroscopy was performed. Adhesion was detected at the fundus of her uterus where the placenta had adhered to the uterus. Asherman's syndrome was diagnosed. CONCLUSIONS Asherman's syndrome might occur after conservative management of placenta accreta, which may be a direct cause of placenta accreta recurrence. When Asherman's syndrome is diagnosed, the site of the placenta and adhesion should be monitored during subsequent pregnancies.

UI MeSH Term Description Entries
D010921 Placenta Accreta Abnormal placentation in which all or parts of the PLACENTA are attached directly to the MYOMETRIUM due to a complete or partial absence of DECIDUA. It is associated with POSTPARTUM HEMORRHAGE because of the failure of placental separation. Morbidly Adherent Placenta,Placenta Accreta Spectrum,Placenta Increta,Placenta Percreta,Accreta Spectrum, Placenta,Accreta, Placenta,Adherent Placenta, Morbidly,Increta, Placenta,Morbidly Adherent Placentas,Percreta, Placenta,Placenta, Morbidly Adherent
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D005260 Female Females
D006175 Gynatresia Absence of a normal opening in the lumen of the female genital tract, from the FALLOPIAN TUBES to the VAGINA. This anomaly may be congenital or acquired due to injuries, diseases, or TISSUE ADHESIONS. Asherman Syndrome,Asherman's Syndrome,Intrauterine Synechiae,Uterine Synechiae,Ashermans Syndrome,Gynatresias,Syndrome, Asherman,Syndrome, Asherman's,Synechiae, Intrauterine,Synechiae, Uterine
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072700 Conservative Treatment Therapeutic approaches that are limited, gradual, or well-established as opposed to radical methods. Conservative Management,Conservative Therapy,Conservative Managements,Conservative Therapies,Conservative Treatments,Management, Conservative,Managements, Conservative,Therapies, Conservative,Therapy, Conservative,Treatment, Conservative,Treatments, Conservative
D000267 Tissue Adhesions Pathological processes consisting of the union of the opposing surfaces of a wound. Adhesions, Tissue,Surgery-Induced Tissue Adhesions,Surgical Adhesions,Adhesion, Surgery-Induced Tissue,Adhesion, Surgical,Adhesion, Tissue,Adhesions, Surgery-Induced Tissue,Adhesions, Surgical,Surgery Induced Tissue Adhesions,Surgery-Induced Tissue Adhesion,Surgical Adhesion,Tissue Adhesion,Tissue Adhesion, Surgery-Induced,Tissue Adhesions, Surgery-Induced
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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