Intrauterine Adhesions
Introduction
Intrauterine adhesions (IUAs) are the formation of scar tissues between the front and back inner walls of the uterus. The scar tissues forms after the stratum basalis get damaged.
Stratum basalis is one of the two endometrium layers that a uterus has. The other endometrium layer is the stratum functionalis.
| Stratum Basalis | Stratum Functionalis | |
| Position | Positioned at the innermost endometrium layer, it acts as a base. | Positioned above the stratum basalis layer. |
| Characteristic | A permanent layer that remains mostly unchanged throughout the lifetime. | A superficial layer that will thicken throughout the month and shed off during menstruation. |
What Causes Intrauterine Adhesions?
Intrauterine adhesions are trauma-induced.
The most common reason for intrauterine adhesion is due to dilation and curettage (D&C). D&C causes over 90 percent of intrauterine adhesions. The procedure involves scraping of the uterus lining, which has a high chance of injuring the uterus.
Other causes include:
- Surgical suturing to close a wound (e.g., during cesarean section)
- Endometriosis
Types of Intrauterine Adhesions
There are several types of intrauterine adhesions. They are mainly differentiated by the severity, location, and nature.
Severity of Intrauterine Adhesions:
- Mild intrauterine adhesions. The scar tissues are thin and do not cause serious obstructions in the uterine cavity.
- Severe intrauterine adhesions. The scar tissues are thick and might cause a partial or complete obstruction in the uterine cavity.
Location of intrauterine adhesions:
- Cervical adhesions. The scar tissues are located at the neck of the womb.
- Uterine horn adhesions. The scar tissues are located at the connecting point of the uterus and the fallopian tube.
Nature of the intrauterine adhesions:
- Endometrial adhesions. The nature of this adhesion is milder, where the front and back of the stratum basalis are stuck together.
- Muscular adhesions. The nature of this adhesion is serious. The uterus’ front and back muscles underneath the stratum basalis layer are stuck together. This happens when the stratum basalis is damaged to the point where it has eroded, leaving the muscles exposed to adhesion.
Symptoms of Intrauterine Adhesions
Despite the variety of intrauterine adhesions, their symptoms are mostly similar.
The main symptoms include:
- Light, infrequent, or no menstruation
- Painful period cramps
- Miscarriages
- Infertility
Why Does Intrauterine Adhesions Cause Miscarriage?
Intrauterine adhesions cause miscarriage mainly due to poor blood circulation resulting from obstruction of scar tissues. With poor blood circulation, the baby cannot receive adequate oxygen and nutrients essential to sustain life and development.
Diagnosis of Intrauterine Adhesions
Due to the uncommon nature of intrauterine adhesions, this condition is usually diagnosed incidentally. However, if you are suffering from recurrent miscarriage or infertility and have undergone scar-inducing surgeries before, it is recommended that you check for intrauterine adhesions.
Following are the checks you can go for:
- B-Scan: B-Scan can check for endometrial thickness. The endometrium is the thickest on the 22nd day of your menstrual cycle. If you do a B-Scan on the 22nd day and it is not more than 0.8 cm/8mm, then you are considered to have a thin endometrium. B-Scan can also check for uneven endometrial thickness.
- Hysterosalpingogram (HSG). HSG can check for uneven endometrial thickness as well. It is a conventional diagnosis method for intrauterine adhesions but has slowly been replaced by hysteroscopy.
- Hysteroscopy. Hysteroscopy is now the best method to diagnose intrauterine adhesions. The scar tissues and uneven colors can be seen directly.
Treatment of Intrauterine Adhesions
To treat intrauterine adhesions, patients have to undergo an operative hysteroscopy and insert an intrauterine balloon stent.
Operative hysteroscopy:
- The adhesions are removed during operative hysteroscopy.
Intrauterine balloon stent:
- After removing the adhesions, an intrauterine balloon stent is inserted into the uterus to prevent re-adhesion.
- After the wounds are healed, the stent is removed from the uterus, and the patient can have normal pregnancies.
Importance of Intrauterine Balloon Stent
The intrauterine balloon stent is essential for the prevention of re-adhesion. Unfortunately, the intrauterine balloon stent is not widely used by doctors because it is still considered a “novel device” in the market. Hence, many patients suffer from re-adhesion after the operation.
Antai hospital is a pioneer in using the intrauterine balloon stent to prevent re-adhesion. Antai hospital has been incorporating the use of the stent to treat intrauterine adhesions for almost 20 years. Over the years, our surgeons have trained to become highly-skilled in treating intrauterine adhesions and experienced in placing the intrauterine balloon stent.
We have a proven track record of treating intrauterine adhesions with no relapse. Get in touch with us today!
Antai Hospital’s Commitment
Antai Hospital’s full refund policy for the miscarriage prevention treatments we provide should already be the best guarantee for a healthy pregnancy. Patients should rest assured, can and should go about their everyday life, focusing their diet on vegetables, beans, celery, and other fiber-rich foods. Besides that, an active lifestyle of yoga and swimming should also be incorporated to help relieve stress and increase blood circulation, which is beneficial for the fetus’s development and the mother’s health. With our assurance, a healthy lifestyle, and peace of mind, you can go through a healthy pregnancy with no complications.
Recurrent miscarriages are no doubt a heavy blow to the patient’s physical and mental health. All we can do is to help ease the burden and decrease your trauma, to slowly help you overcome the anxiety with the love and care that we provide at Antai Hospital.
Trust in Antai Hospital and trust in yourself, your pregnancy is our priority.