What are the sequelae of intrauterine adhesions after cesarean section?

Intrauterine adhesions after cesarean section may lead to abnormal menstruation, infertility or recurrent miscarriage. In severe cases, medical treatment should be sought promptly. The occurrence of intrauterine adhesions is related to surgical trauma, infection, endometrial damage and other factors. Treatment methods include drug therapy, hysteroscopic surgery and assisted reproductive technology.

1. Abnormal menstruation is a common manifestation of intrauterine adhesions. Adhesions may cause the endometrium to fail to grow and shed normally, which can manifest as decreased menstrual volume, irregular cycles, or even amenorrhea. Mild adhesions can be treated by oral estrogen to promote endometrial repair, such as estradiol valerate tablets. Moderate to severe adhesions require hysteroscopic surgery to separate adhesion tissue and place an intrauterine contraceptive device to prevent recurrence.

2. Infertility is a serious sequela of intrauterine adhesions. Adhesions may hinder the passage of sperm or affect embryo implantation, leading to difficulty in conception. For mild adhesions, natural conception can be attempted, while Chinese medicine conditioning can be combined with blood circulation and stasis-removing drugs such as angelica and Chuanxiong. For moderate adhesions, artificial insemination is recommended after hysteroscopy. For severe adhesions or multiple surgeries that have failed, IVF technology can be considered.

3. Recurrent miscarriage is closely related to intrauterine adhesions. Adhesions may lead to abnormal uterine cavity morphology or decreased endometrial receptivity, increasing the risk of miscarriage. Preventive measures include regular postoperative follow-up to promptly detect and treat recurrent adhesions. Treatment can be achieved by hysteroscopic adhesion separation, followed by sequential treatment with estrogen and progesterone to promote endometrial repair. For those with multiple miscarriages, a comprehensive reproductive system evaluation is recommended to exclude other potential factors.

4. Prevention of intrauterine adhesions is crucial. After cesarean section, you should avoid infection, pay attention to personal hygiene, and use antibiotics as prescribed by the doctor. Get out of bed and move around early after surgery to promote uterine contraction and lochia discharge. Eat more foods rich in protein and vitamins, such as eggs, lean meat, fresh fruits and vegetables, to promote wound healing. Avoid strenuous exercise or heavy physical labor too early to reduce the risk of uterine damage.

The sequelae of intrauterine adhesions after cesarean section need to be taken seriously, and early detection and treatment are the key. Those with abnormal menstruation, infertility or recurrent miscarriage should seek medical attention in time and solve the problem through drug treatment, hysteroscopic surgery or assisted reproductive technology. Postoperative preventive measures should not be ignored, including personal hygiene, diet conditioning and appropriate activities. Regular review can help to timely detect and treat recurrent adhesions and reduce the risk of sequelae. For women with fertility needs, it is recommended to develop a personalized treatment plan under the guidance of a doctor to improve the success rate of pregnancy.