Pregnancy with untreated Asherman's and the risks

For women who become pregnant BEFORE having had the chance to correct their Asherman’s

If a woman gets pregnant with adhesions still in her uterus, the risks are different. Getting pregnant with adhesions remaining in the uterus is not recommended because the chances of miscarriage, problems with fetal growth and/or other serious complications of pregnancy are high.  

If you become pregnant before your Asherman’s has been treated, it is imperative that you speak to your doctor right away and that you be closely monitored.  Even then, your risk of complications is significantly higher than if you wait and become pregnant after you are cleared by your doctor.

Material herein is provided for informational purposes only. It is general information that may not apply to you as an individual, and is not a substitute for your own doctor’s medical care or advice.  No warranties are given in relation to the medical information provided, and that no liability will accrue to the International Asherman's Association or any of its board members in the event that a user is damaged in any way as a result of reliance upon the information.


RECOMMENDED MONITORING FOR PREGNANCIES WITH ADHESIONS PRESENT IN UTERUS:

  • Weeks 4 to 7: regular HCG and progesterone blood tests

  • Weeks 6 to 10: regular ultrasounds, the first at approximately around 6 weeks.  This ultrasound will verify that the baby is in the right place (not in a fallopian tube) and is growing normally. Subsequent ultrasounds could be performed weekly in order to identify a normal heartbeat and to verify good interval growth of the baby and that all is going well. If a miscarriage happens, the doctor can get onto it straight away.  There should be no delay as this can cause further damage to your uterus.

  • Weeks 18 to 20: regular bi-weekly scans in order to evaluate for an incompetent cervix which is often a risk for those with post-AS pregnancies because of multiple prior cervical dilatations.  It involves performing ultrasounds in order to measure cervical length and to detect “funneling” of the fetal membranes.  These ultrasound examinations need to be performed by someone with the skill needed to detect these changes which are often subtle.    If placental abnormalities or inadequate fetal growth are not detected, the patient can be monitored by a routine schedule.  

  • Third trimester:  An evaluation, often by MRI, in order to detect placenta accreta, increta or percreta.  Continued assessment to identify IUGR (intrauterine growth restriction of the fetus) as well as placenta previa. If any of these complications are identified, you should be monitored more closely.
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