P-248: Uterine Synechiae on Hysterosalpingography (HSG)

Background: This study showed the patterns and grading of Asherman’s syndrome on hysterosalpingography(HSG). Asherman’s syndrome (AS)which is termed as uterine synechiae, and intrauterine adhesions (IUA),result in trauma to the basal layer of the endometrium with subsequent scarring. This may be from previous pregnancy, dilation and curettage, surgery, or infection such as genital tuberculosis.The radiographic appearance of intrauterine adhesions varies with the sites involved and the severity of scares. Intra-uterine adhesions are typically seen on hysterosalpingogram as multiple irregular linear filling defect (that may give an irregular, multiple angulated lacunar pattern) synechiae. Materials and Methods: The infertile women who visited Royan Institute and referred to HSG consecutively, prior to hysteroscopy, from 2011 to 2014 included in this cross-sectional study. Classification systems for Asherman’s syndrome (AS) were done according to the American Society of Reproductive Medicine (ASRM). The mild synechiae was suspected when up to of endometrial cavity involved and moderate (involvement of 1/2), and severe (involvement of 3/4 or more). Results: Uterine synechiae was found in 35 out of 3200 patients, 0.01 % of women undergoing hysterosalpingography HSG during a 3-year period. All cases of synechiae are confirmed by hystrocopy. 16 out of 35 patients (45%) had diagnosed with mild synechia.8/35 (22%)and 11/35 (31%) had diagnosed with moderate and severe synechiae,respectively. Conclusion: HSG is commonly used as a first-line tool in the diagnosis of intrauterine adhesions because it is simple, safe, cost effective, sensitive, and minimally invasive procedure, allowing the visualization of the uterine cavity, revealing the extent of the scar formation, while suggesting the presence of intrauterine adhesions.