Asherman syndrome—one century later

ObjectiveTo provide an update on the current knowledge of Asherman syndrome.DesignLiterature review.SettingThe worldwide reports of this disease.Patient(s)Patients with Asherman syndrome who presented with amenorrhea or hypomenorrhea, infertility, or recurrent pregnancy loss.Intervention(s)Hysteroscopy and hysteroscopic surgery have been the gold standard of diagnosis and treatment respectively for this condition.Main Outcome Measure(s)The etiology, pathology, symptomatology, diagnosis, treatment, and reproductive outcomes were analyzed.Result(s)This syndrome occurs mainly as a result of trauma to the gravid uterine cavity, which leads to the formation of intrauterine and/or intracervical adhesions. Despite the advances in hysteroscopic surgery, the treatment of moderate to severe Asherman syndrome still presents a challenge. Furthermore, pregnancy after treatment remains high risk with complications including spontaneous abortion, preterm delivery, intrauterine growth restriction, placenta accrete or praevia, or even uterine rupture.Conclusion(s)The management of moderate to severe disease still poses a challenge, and the prognosis of severe disease remains poor. Close antenatal surveillance and monitoring are necessary for women who conceive after treatment.