Detection of Asherman's syndrome after conservative management of placenta accreta: a case report

J Med Case Rep. 2018 Nov 20;12(1):344. doi: 10.1186/s13256-018-1869-7.

Abstract

Background: We present a case involving conservative treatment of placenta accreta, with a subsequent diagnosis of Asherman's syndrome.

Case presentation: A 41-year-old Japanese woman (G2P0A2) delivered a healthy male infant via cesarean section due to preeclampsia. The placenta did not spontaneously separate and was manually removed. Adhesion was tight and placenta accreta was diagnosed. During the procedure, no uterine inversion or perforation, and no uterine cavity adhesion, were observed. Four months postoperatively, hysteroscopy was performed. Adhesion was detected at the fundus of her uterus where the placenta had adhered to the uterus. Asherman's syndrome was diagnosed.

Conclusions: Asherman's syndrome might occur after conservative management of placenta accreta, which may be a direct cause of placenta accreta recurrence. When Asherman's syndrome is diagnosed, the site of the placenta and adhesion should be monitored during subsequent pregnancies.

Keywords: Asherman’s syndrome; Conservative management; Placenta accreta.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Conservative Treatment*
  • Female
  • Gynatresia / diagnosis*
  • Gynatresia / pathology
  • Gynatresia / therapy
  • Humans
  • Hysteroscopy
  • Placenta Accreta / diagnostic imaging
  • Placenta Accreta / pathology
  • Placenta Accreta / therapy*
  • Pregnancy
  • Prognosis
  • Tissue Adhesions / complications
  • Tissue Adhesions / diagnostic imaging
  • Tissue Adhesions / pathology*
  • Treatment Outcome
  • Uterus / pathology*