Uterine adhesions are pregnancy-related in about 9l% of cases and are commonly seen after abortion or spontaneous abortion and curettage, and any factor that causes endometrial destruction can cause uterine cavity adhesions. As well as after postpartum bleeding scraping. Due to the soft wall of the pregnant uterus, it is not easy to control the depth when scraping the uterus, or excessive scratching of the uterine cavity, too much negative pressure during suction, and too long time. The endometrial basal layer is scraped off, producing postoperative uterine adhesions; suction head, scraper repeatedly in and out of the uterine orifice, irregular dilatation of the cervix, etc. can aggravate the injury, increasing the chance of postoperative uterine adhesions, non-pregnancy-induced uterine adhesions account for about 9%, such as endometrial tuberculosis, uterine fibroid excavation, diagnostic scraping, etc. Symptoms 1. Abdominal pain: If the patient’s condition keeps deteriorating, abdominal pain will appear, and some even have long nights, which brings great impact on women’s life and work. Generally, about a month after abortion or curettage, sudden spasmodic pain in the lower abdomen appears. Some patients have severe abdominal pain, restlessness, difficulty in movement, and even exhaustion and defecation are painful. 2. Pregnancy abnormalities: Patients are prone to pregnancy failure, including early and mid-pregnancy miscarriage, premature birth, ectopic pregnancy, premature abortion and fetal death in utero. Infertility is the main symptom of the disease. The disease often leads to blockage of the fallopian tubes of women, which leads to the inability of the fertilized egg to be laid normally and eventually leads to infertility, and even if pregnancy occurs, recurrent miscarriage and premature delivery will occur. 3. Menstrual abnormalities: In cases of complete cervical adhesions, amenorrhea may occur. In cases of partial cervical adhesions or partial destruction of the endometrium, menstruation may be scanty, but the menstrual cycle is normal. If it is caused by cervicitis or other inflammatory diseases, it will lead to amenorrhea, some patients have irregular menstruation, prolonged periods, dark menstrual blood and other abnormal phenomena. 4, press the lower abdominal pain: women who suffer from uterine adhesions, there will also be symptoms of severe abdominal pain, in the examination will also find that the size of the uterine body is generally normal, the texture is relatively soft, there are obvious symptoms of pressure pain. Etiology: 1. Pregnancy factor (25%): pregnancy-related uterine surgery such as early pregnancy negative pressure aspiration, middle pregnancy forceps scraping, middle pregnancy induction scraping, postpartum bleeding scraping and spontaneous abortion scraping. This may be due to the fact that the endometrial basal layer of the pregnant uterus is more easily damaged and the uterine walls stick to each other, resulting in permanent adhesions. 2. Non-pregnancy factors (30%): uterine fibroid enucleation (into the uterine cavity), submucosal fibroid removal via the uterine cavity, longitudinal hysterectomy, and double hysterectomy destroy the basal layer of the endometrium, exposing the myometrium to the uterine cavity and leading to anterior and posterior adhesions of the uterine wall. 3, surgical inflammatory factors (30%): intrauterine infection uterine tuberculosis, postmenopausal senile endometritis, secondary infection after operation of the uterine cavity, puerperal infection, secondary infection caused by the placement of intrauterine devices. 4, human factors (10%): artificially destroy the endometrial basal layer to make the uterine cavity adhesions. For example: after endometrial electrodesection, intrauterine microwave, freezing, chemotherapy and local radiation therapy. 5, other factors (5%): such as repeated scraping, which is very easy to damage the basal layer, caused by this cause of cavity adhesions called injury adhesions, the most common, so the obstetrician and gynecologist in the scraping depth to be moderate, women of childbearing age to implement good contraceptive measures to avoid abortion, especially the first abortion may cause cavity adhesions later secondary to infertility. The treatment of uterine adhesion needs to be based on the principle of identification, and different conditions to take different treatment methods, but the common treatment methods are mainly the following three: 1, drug treatment, using Chinese medicine ventral infusion therapy, for the pathogenesis of uterine adhesion characteristics, the use of high-tech, the use of traditional Chinese medicine dialectical treatment, with a unique Chinese medicine formula to promote the absorption of inflammation and subside. For example, Yang’s formula to dispel the adhesions, which is formulated with natural herbs such as myrrh, wulingheat, motherwort and Chuanxiong. 2, surgical treatment, the use of hysteroscopy technology, hysteroscopy in the clinical application, some of the more difficult to deal with gynecological diseases can be intuitive, simple and safe solution. Hysteroscopic treatment of uterine adhesions can determine not only the degree of adhesions, the type of adhesions, but also the adhesions
The hysteroscopy can determine not only the degree of adhesions, the type of adhesions, but also the toughness of adhesions. 3, physical therapy, relieve the patient’s mind concerns, enhance the confidence of treatment, increase nutrition, exercise, pay attention to the combination of work and rest, progress the body resistance. 4, hysteroscopy therapy: hysteroscopy in the clinical application, some of the more difficult to deal with gynecological diseases can be intuitive, simple and safe solution. Not only can you determine the degree of adhesions, the type of adhesions, and the toughness of the adhesions. For membranous adhesions and fibromuscular adhesions, they can be separated under hysteroscopy or surgically cut out; while for connective tissue-like dense adhesions, electrodesection is performed under ultrasound supervision, after which an intrauterine device is placed to prevent re-adhesions and estrogen and progesterone are administered to promote endometrial growth. The patient can resume menstruation and some patients can become pregnant again.