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
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
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?
Xiao Li happened "uterine adhesion"
What should I do if I want to get pregnant?
1. What is uterine cavity 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
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
If the uterine cavity adhesion occurs
Don’t taboo diseases and doctors
Must be actively treated
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