TRAUMATIC INTRAUTERINE ADHESIONS. (THE FRITSCH-ASHERMAN SYNDROME)

In contrast to the foreign literature, there are no large North American studies on the sequelae to trauma and infection in the recently pregnant uterus. For this reason, the present status of these sequelae was reviewed and re-evaluated. They constitute a long-recognized, well-established clinical syndrome comprising: (1) past history of puerperal or postabortal infection and/or curettage, followed by (2) amenorrhea or hypomenorrhea, (3) dysmenorrhea, (4) habitual abortion, and (5) sterility. Knowledge of the existence of the entity is of great importance for its prevention and treatment. Strict maintenance of aseptic technique during curettage, use of a dull or serrated curette, and proper use of antibiotics are essential preventive measures. Treatment measures for this condition are solely surgical and consist of (1) dilatation and curettage, (2) hysterotomy, (3) transplantation of living tissues, and finally (4) hysterectomy.