Evaluation of Menstrual Pattern Before and After Treatment for Intrauterine Adhesion

Abstract

Objective: To determine the pattern of menstrual disorders and treatment outcome among women managed for intrauterine adhesion at a tertiary centre in Ilorin, Nigeria. Methodology: A descriptive study of women with intrauterine adhesion managed at the University of Ilorin Teaching Hospital over a three year period. Diagnosis was confirmed with hysterosalpingography; the case files were retrieved from the medical records department to review the management, extract relevant data and analyse the data using SPSS version 20.0 and p<0.05 was significant. Results: The incidence of intrauterine adhesion was 1.5% of all gynaecological clinic attendees; the modal age group was 25 to 29 years (36; 48.0%), 28(37.3%) were nulliparous, 47(62.7%) followed dilatation and curettage among which 34(45.3%) were performed for induced abortion. Menstrual disorder was reported in 73(97.3%) of participants; these were secondary amenorrhea (34; 45.3%), hypomenorrhea (29; 38.7%) and oligomenorrhea (10; 13.3%) while 2(2.7%) had normal menstruation. Treatment was by hysteroscopic 55(73.30%) or blind 20(26.70%) adhesiolysis. After treatment, normal menstruation resumed in 79.3% of those who presented with hypomenorrhea, 70% for oligomenorrhea and 66.7% for secondary amenorrhea. The treatment outcome was significantly improved following hysteroscopic compared to blind adhesiolysis (p 0.029). Conclusion: Complications from dilatation and curettage for induced abortion remains the commonest risk factor for intrauterine adhesion; safe abortion services and post abortion care may reduce the morbidity. Hysteroscopic adhesiolysis should be the preferred treatment modality for uterine synaechiae.