Sadrzadeh S, Wamsteker K, Hummel P, Lambalk C B
Academisch Ziekenhuis Vrije Universiteit, afd. Verloskunde en Gynaecologie, Amsterdam.
Ned Tijdschr Geneeskd. 1998 Oct 24;142(43):2329-32.
Three women aged 35, 33 and 40 years had secondary amenorrhoea and monthly recurring abdominal pains after curettage for blood loss after a pregnancy. Hysteroscopy revealed intrauterine adhesions. The symptoms disappeared largely or completely after synechiolysis, introduction of an IUD and oestrogen treatment. Changes in the menstrual cycle, infertility or recurrent abortions starting after a puerperal or postabortum curettage should cause the physician to suspect intrauterine adhesions. For the diagnosis hysteroscopy is the method of choice and hysterography should be added for preoperative assessment and classification. Blind procedures for rupturing the adhesions should not be performed because of the risk of perforation and creating false routes.
三名年龄分别为35岁、33岁和40岁的女性,在因妊娠失血刮宫后出现继发性闭经,并每月反复出现腹痛。宫腔镜检查显示宫腔粘连。在粘连分解、放置宫内节育器和雌激素治疗后,症状大部分或完全消失。产后或流产后刮宫后开始出现的月经周期变化、不孕或反复流产应引起医生怀疑宫腔粘连。对于诊断,宫腔镜检查是首选方法,术前评估和分类应增加子宫输卵管造影。由于存在穿孔和形成假通道的风险,不应进行盲目分离粘连的操作。