Intrauterine Adhesions and the Case of the Hidden Pregnancy скачать в хорошем качестве

Intrauterine Adhesions and the Case of the Hidden Pregnancy

This video reviews intrauterine adhesions (IUA) and a challenging case of pregnancy termination complicated by dense adhesions, detailing diagnostic and surgical management strategies. See full transcript here: www.cansagevideos.com/intrauterine-adhesions-hidden-pregnancy Presented By Dr. Chelsie Warshafsky Dr. Julie Thorne Dr. Mostafa Atri Dr. Heather Millar Affiliations Mount Sinai & Woman’s College Hospital; Department of Obstetrics and Gynecology University of Toronto, Department of Diagnostic Imaging University of Toronto Timestamps (00:06) Objective (00:17) Intrauterine Adhesions Definition (01:21) Table 1: Occurrence of Intrauterine Adhesions Following Surgery (01:51) Table 2: Classification of Intrauterine Adhesions (02:06) Diagnosis (02:29) Case Discussion (02:53) OR#1: Suction Dilation and Curettage (03:13) OR#2: Diagnostic Hysteroscopy, Suction D&C Under US Guidance (04:00) OR#3: Hysteroscopic Resection of Intrauterine Adhesions, Suction D&C, under US Guidance (05:37) Postoperative Care (05:52) Conclusions Intrauterine adhesions (IUA), or bands of scar tissue within the uterine cavity, can arise after intrauterine procedures, trauma, or infections and may lead to complications like menstrual irregularities, pain, infertility, and pregnancy loss. This video presents an in-depth overview of IUA and a complex case of “hidden pregnancy” obscured by adhesions. The case highlights a 29-year-old woman with a history of multiple uterine procedures and prior infections who presented for a pregnancy termination, complicated by IUA that concealed the pregnancy tissue. Initial attempts at a standard suction D&C failed, as no tissue was retrieved, leading to the use of diagnostic hysteroscopy with ultrasound guidance. The team encountered dense adhesions that had compartmentalized the pregnancy, requiring careful resection of the adhesions using a hysteroscope and micro-scissors to access and remove the pregnancy tissue successfully. Postoperatively, a pediatric Foley catheter was used to prevent reformation of adhesions, though the utility of this approach remains debated. This case underscores the importance of using hysteroscopy and concurrent ultrasound in patients with known risk factors for IUA, as it enables precise diagnosis and management of complex intrauterine conditions, reducing risks associated with incomplete procedures.