March 06, 2024 | London,UK
Melkamu Siferih
Debremarkos University, Ethiopia
Dr. Melkamu Siferih is a committed Obstetrician and Gynecologist who is deeply passionate about women’s health, currently serving at Debremarkos University Hospital. Born and raised in Amhara region, East Gojjam, Bibugn district, Dr. Melkamu found his calling in medicine at a young age, driven by his commitment to empowering women through holistic healthcare practices. Following his successful completion of medicine at Adama University, School of Medicine, he took on the role of a lecturer at DebreMarkos University.
Background: Asherman syndrome is one of the endometrial factors that influence a woman’s reproductive capacity. However, in our context, comprehensive documentation is paramount. This study aimed to evaluate the clinical characteristics and hysteroscopic treatment outcomes of Asherman syndrome. Method: A retrospective follow-up study from January 1, 2019, to December 31, 2022, was conducted on cases of Asherman syndrome after hysteroscopic adhesiolysis at St.Paul’s Hospital in Addis Ababa, Ethiopia. Clinical data were collected via telephone survey and checklist. Epidata-4.2 and SPSS-26 were employed for data entry and analysis, respectively. Result: A total of 177 study participants were included in the final analysis. The mean patient age was 31 years (range: 21-39) at the initial presentation, and 32.3 years (range: 22-40) during the phone interview. The majority of the patients (97.7%) had infertility, followed by menstrual abnormalities (73.5%). Among them, nearly half (47.5%) had severe, 38.4% had moderate, and 14.1% had mild Asherman syndrome. The review identified no factor for 51.4% of the participants. Endometrial tuberculosis affected 42 patients (23.7%). It was also the most frequent factor in both moderate and severe cases of Asherman syndrome. Only 14.7% of patients reported menstrual correction. Overall, 11% of women conceived. Nine patients miscarried, three delivered viable babies, and six were still pregnant. The overall rate of adhesion reformation was 36.2%. Four individuals had complications (three uterine perforations and one fluid overload) making a complication rate of 2.3%. Conclusion: Our study found that severe Asherman syndrome, common in our setting, led to lower conception rates, irregular menstruation, and frequent adhesion recurrences. A heightened suspicion for Asherman syndrome, swift and accurate diagnostic techniques, and the creation of a specific algorithm for detecting endometrial tuberculosis are vital. Future studies should prioritize adhesion prevention techniques.
