A syndrome of recurrent intrauterine adhesions

Traumatic intrauterine adhesions are known to be reversible. In some cases, following lysis of adhesions we find residual adhesions on hysterography. We have studied 11 cases in whom new adhesion formation, of different type and location have recurred following curettage for lysis of adhesions or in subsequent pregnancy. In each case there were between two and five different forms of intrauterine adhesions during the course of study. In all 11 cases hypomenorrhea was a prominent symptom. On premestrual curettage a scanty amount of endometrium was removed. Their obstetric history was characterized by sterility (four cases) and repeated early abortions, spontaneous or missed. Treatment consisted of repeated curettage and placement of an IUD. Four patients who subsequently become pregnant carried pregnancy to term or near term. Intrauterine adhesions may be considered as a localized manifestation of more generalized process of endometrial fibrosis. This may explain this syndrome of recurrent intrauterine adhesions and the paradoxical phenomenon of limited adhesions being associated with amenorrhea and hypomenorrhea.