Epidemiological profile, etiological diagnosis and prognosis of uterine synechias: Report of 86 cases

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Published Apr 23, 2012
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Vol. 90 No. 4 (2012): Issue Apr 2012

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Daaloul Walid
Ouerdiane Nadia
Masmoudi Abdelwaheb
Ben Hamouda Sonia
Bouguerra Badreddine
Sfar Rachida

Abstract

Background: Uterine synechias may pose real problems for fertility prognosis. It depends mainly on its etiology.
Aim: To study the epidemiological profile of patients, describe the circumstances of discovery of uterine synechias, specify the diagnostic procedures for pelvic ultrasound, hysterography and hysteroscopy and estimate the benefits on fertility.
Methods: A retrospective study over a period of 10 years from 1 January 2000 to December 31, 2009 in the department of obstetrics gynecology B Charles Nicolle’s Hospital in Tunis.
Results: We collected 86 patients. The age average was 35.42 years, gestit average of 1.36 with 37.2% of nulligeste and an average parity of 0.67. The uterine revision was the main etiology (55.8%). The main circumstance of discovery was the exploration of infertility (60%). Hysterosalpingography showed a luminal filling defect in 79% of patients mostly fundic location (37.3%). Faced with data from the hysteroscopy sensitivity of HSG was 78% and positive predictive value was 100%. For the seat of the synechia its sensitivity is only 40%. The surgical procedure took place in one time in 74 cases. Our complication rate is 8.14%: 2 uterine perforations, 2 falseroads and 3 cases of hemorrhage stopping surgery.
Conclusion: The main etiology is a history of uterus revision. The main circumstance of discovery is the exploration of infertility. Anatomic results were generally good as testified hysteroscopy control.

Keywords:

Synechia - uterus - operative hyseroscopy - fertility

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