Severe obstetric complications after aggressive treatment of Asherman syndrome

Thirty-three cases of Asherman syndrome from Yale-New Haven Hospital are presented. Restoration of menses occurred in 91% of patients with pregnancy resulting in 79% of all treated patients. Spontaneous abortion occurred in only one patient (4%), whereas viable pregnancies resulted 96% of the time. Severe obstetric complications excluding premature labor occurred in three cases (12%) and included placenta increta, uterine sacculation, and a paper-thin uterine fundus (ie, uterine dehiscence). These cases are discussed to reinforce considering treated patients with Asherman syndrome to be a high-risk obstetric population, and to counsel and manage these patients accordingly.