Story in the uterine cavity 2

Writer: Yan Weisheng, Gynecology, Fuxing Hospital Affiliated to Capital Medical University

Xiao Zhang (male) and Xiao Li (female) have been in love for a long time

Finally ended

The old people are waiting to hold their grandson

But 1 year has passed

Xiao Li’s belly has been quietly

I think menstruation is very regular

There are ovulation many times to measure

Why didn’t you get pregnant?

I went to the hospital and checked the man’s semen.

The woman’s hormone examination doctor said that it is normal

I have done a test of the tubal tube and said it is normal

Be a gynecological B ultrasound

Speaking of the endometrium is thin

This makes the couple very distressed

what happened?

After turning around many hospitals

Question in detail

When the two of them fell in love in 3 years

Because I don’t understand

No strict contraception

An accidental abortion was done by accidental pregnancy

The menstrual flow after abortion is much less than before

But it does not pay attention

Through such a question

Add B -ultrasound to indicate that the endometrium is thin

Infertility for more than a year

80 % of "uterine adhesion"?

So I did a hysteroscopy examination

Confirm this idea


What is uterine adhesion?

What caused?

Xiao Li happened "uterine adhesion"

What should I do if I want to get pregnant?

1. What is uterine cavity adhesion

Uterine adhesion

Also known as Asherman syndrome

Refers to the uterine cavity operation

After the infection of the uterine cavity

Caused endometrial repair damage

Instead, fibrosis occurs between the uterine muscle wall

Or muscle adhesion

Make the normal form and volume of the uterine cavity

Return and other changes


Infertility, fetal stopping and other conditions

In fact, the endometrium is like our soil

When the appropriate soil layer is destroyed

Then it may face "barren"

The seeds are not good to germinate

Oh, this time I understand Xiao Li’s "soil"

something is wrong

Although seeds (fertilized eggs) and transportation channels

(Donaltic) It’s okay

But "soil barren" is as bad as pregnant

2. Why does the uterine cavity adhesion occur?

There are many reasons

But it can basically be divided into the following points

1. After the operation of the uterine cavity: After the artificial abortion, the embryo stops the development of the Qing Dynasty, the curettage of the palace after the natural abortion, and the curettage of the uterine cavity after maternity during the middle of pregnancy, in general, the treatment of the uterine deformity — uterine deformities — uterine uterine uterineWound adhesion after section resection; wound adhesion after removing submucosal fibroids of the uterine.

2. Infection factors: For example, infection after abortion, infection of the upper ring and the ring infection, the endometritis that are prone to occur in the elderly, and the rare endometrial tuberculosis.

3. Other operations and treatment: For example, due to functional uterine bleeding, after removal of endometrium; after local radiation therapy; after the hemorrhage of the Department of Obstetrics and Gynecology, the uterine arterial embolism may cause uterine cavity adhesion.

3. How do I know that there is uterine cavity adhesion?

1. Memorial changes: The light adhesion may not be obviously abnormal, but the adhesion is slightly heavier, the amount of menstrual flow is reduced, and even menstruation, periodic abdominal pain, and so on.

2. Infertility: Mild adhesion, pregnancy does not necessarily affect it, but if the adhesion is heavier, there may be risks such as infertility, infertility, and placental adhesion leading to major bleeding.

4. If the uterine cavity is suspected, what do you need to do?

If there is the factors described above

Plus my own menstrual abnormalities

Not good for pregnancy

So it is best to go to a regular hospital for examination

1. Ordinary vaginal ultrasound can see the endometrium, and preliminary judgment is whether there is adhesion

2. Three -dimensional ultrasound and uterine fallopian tube angiography can evaluate whether there are abnormalities in the uterine cavity form

3. Hysteroscopic examination -found gold standards of uterine cavity adhesion

5. What to do after diagnosis of uterine cavity adhesion?

1. First of all, a specialist is required to evaluate it to determine the treatment plan -conservative OR surgery, emphasize individualized treatment, and cannot be generalized

2. If conservative treatment is conservative, you can test pregnancy first. If you are still difficult to get pregnant, you can consider drugs or surgery+drugs at the same time

3. Surgical treatment: The basic method is the endometrium adhesion of the uterine endometrium under the uterine lens. As shown in the figure below, the adhesive part is removed with an electric knife or scissors to restore the normal uterine cavity form. Generally, special uterine balls need to be usedThe sac is supported (equivalent to blocking the surgical wounds that are blocked before, left and right) to prevent re -adhesion; the particularly heavy uterine cavity adhesion, there may be two or even multiple surgery.

4. Drug treatment: The surgery is a separate adhesion band, but some of the endometrium must be treated at the same time to promote endometrial repair.Commonly used is large doses of estrogen hormone, which simulates the menstrual cycle; in addition, there are drugs that promote blood circulation such as aspirin (yes, that is what the elderly often eat), Wan Ai Ke (commonly known as Viagra, don’t be surprised!), Others; others;There are also irrigation cell stimulation factor in the uterine cavity, of course, it is still in the research stage.Also studying stem cell transplantation, oral mucosal cell planting, shenches transplantation, etc.

I understand now

The little Li mentioned by the beginning of the article

The "uterine cavity adhesion" caused by the flow of people

Fortunately, active treatment

Finally pregnant

Gave birth to a cute baby

Speaking of the previous flow of people

The two regret

Although there are currently effective means to treat uterine cavity adhesion

But there are still many people after treatment

Unable to get pregnant or be distressed by abnormal menstrual abnormalities


Prevent this situation is the key

Avoid unnecessary and inappropriate uterine cavity operations

Especially scientific contraception

Avoid abortion


If the uterine cavity adhesion occurs

Don’t taboo diseases and doctors

Must be actively treated

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