From both a personal and scientific view point, prevention through the use of medical management and/or hysteroscopy is a better approach than relying solely on treatment. Live birth rates after treatment are only around 40% and with increased and potentially life-threatening obstetric complications. Unfortunately there is not enough support for prevention in the medical community which is often unaware of or unwilling to accept true incidence rates and causes. Also, as improvements were made in treatment, some saw this as a reason not to promote prevention. Others use the word 'prevention' when they really mean prevention of adhesions from recurring after corrective surgery which amounts to improvements in treatment, not prevention of adhesions from occurring in the first place. Although any uterine surgery can lead to AS, D&C is still overwhelmingly the number one cause due to its blind nature and widespread use. I focus on miscarriage management in particular because it is the only indication for which D&C is still considered 'standard care'. In Australia, medical management of first trimester miscarriage is not routinely offered. I have no links to any pharmaceuticals, and no financial interests in my support of misoprostol. I receive no financial gain from this blog. I believe that the only way to ensure rapid and unbiased medical progress is for medical professionals to abstain from religious agendas, financial interests and commercial ventures. I believe that the primary goal of medical research is to improve people's health.
About me
I hold a BSc and an MSc in Biology (Cytogenetics) from the University of Geneva in Switzerland, and a PhD in Molecular Microbiology from the University of New South Wales, Australia. I acquired Asherman's syndrome (AS) (intrauterine adhesions with or without fibrosis) after a D&C for a miscarriage at the age of 39. The most tragic part is that it is preventable but my ill-informed ObGyn refused to treat me with misoprostol (see My Story). I am a strong supporter of evidence-based medicine which is often lacking in studies (and attitudes) about Asherman's syndrome, the long term effects of D&C on fertility and related areas. I am currently studying Clinical Epidemiology and taking an elective course on Reproductive Medicine.
From both a personal and scientific view point, prevention through the use of medical management and/or hysteroscopy is a better approach than relying solely on treatment. Live birth rates after treatment are only around 40% and with increased and potentially life-threatening obstetric complications. Unfortunately there is not enough support for prevention in the medical community which is often unaware of or unwilling to accept true incidence rates and causes. Also, as improvements were made in treatment, some saw this as a reason not to promote prevention. Others use the word 'prevention' when they really mean prevention of adhesions from recurring after corrective surgery which amounts to improvements in treatment, not prevention of adhesions from occurring in the first place. Although any uterine surgery can lead to AS, D&C is still overwhelmingly the number one cause due to its blind nature and widespread use. I focus on miscarriage management in particular because it is the only indication for which D&C is still considered 'standard care'. In Australia, medical management of first trimester miscarriage is not routinely offered. I have no links to any pharmaceuticals, and no financial interests in my support of misoprostol. I receive no financial gain from this blog. I believe that the only way to ensure rapid and unbiased medical progress is for medical professionals to abstain from religious agendas, financial interests and commercial ventures. I believe that the primary goal of medical research is to improve people's health.
Dr
From both a personal and scientific view point, prevention through the use of medical management and/or hysteroscopy is a better approach than relying solely on treatment. Live birth rates after treatment are only around 40% and with increased and potentially life-threatening obstetric complications. Unfortunately there is not enough support for prevention in the medical community which is often unaware of or unwilling to accept true incidence rates and causes. Also, as improvements were made in treatment, some saw this as a reason not to promote prevention. Others use the word 'prevention' when they really mean prevention of adhesions from recurring after corrective surgery which amounts to improvements in treatment, not prevention of adhesions from occurring in the first place. Although any uterine surgery can lead to AS, D&C is still overwhelmingly the number one cause due to its blind nature and widespread use. I focus on miscarriage management in particular because it is the only indication for which D&C is still considered 'standard care'. In Australia, medical management of first trimester miscarriage is not routinely offered. I have no links to any pharmaceuticals, and no financial interests in my support of misoprostol. I receive no financial gain from this blog. I believe that the only way to ensure rapid and unbiased medical progress is for medical professionals to abstain from religious agendas, financial interests and commercial ventures. I believe that the primary goal of medical research is to improve people's health.
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