Re: Grades of Ashermans??

[Guest guest]

Dear W,

AS grades are from European Society fro Hysteroscopy and settled in 1989:

I - Thin or filmy adhesions easly ruptured by histeroscope sheath alone, cornual areas normal;

II - Singular firm adhesions connecting separate parts of the uterine cavity, visualization of both tubal ostia possible, cannot be ruptured by histeroscope sheath alone;

IIa - Occludina adhesions only in the region of the internal cervical OS. Upper uterine cavity normal;

III - Multiple firm adhesions connecting separate parts of the uterine cavity, unilateral obliteration of ostial areas of the tubes;

IIIa - Extensive scarring of the uterine cavity wall with amenorrhea or hypomenorrhea;

IIIb - Combination of III and IIIa;

IV - Extensive firm adhesions with agglutination of the uterine walls. Both tubal ostial areas occluded

Following Valle and Sciarra's table of 1988 classification is as follows:

Mild- Filmy adhesions composed of basal endometrium producing partial or complete uterine cavity occlusion;

Moderate - Fibromuscolar adhesions that are characteristically thick, still covered by endometrium that may bleed on division, partially or totally occluding the uterine cavity;

Severe - Composed of connective tissue with no endometrial lining and likely to bleed upon division, partally or totally occludin the uterine cavity.

Following Donnez and Nisolle (1994) classification as follows:

I - Central adhesions a) thin filmy adhesions (endometrial adhesions) myofibrous (connective adhesions)

II - Marginal adhesions (always myofibrous or connective) a) wedge like projection obliteration of one horn;

III - Uterine cavity absent on HSG a) occlusion of the internal os (upper cavity normal) extensive coaptation of uterine walls (absence of uterine cavity - true AS)

Hope this can helps

Ciao Ivana

[Guest guest]

Hi Lesia & Corinna,

yes I found AS grades informations basically on Internet, but that article (from Al Inany) is not "visible" on the web, so I asked a MD I know, actually the one who first diagnosed me with AS!, to get it for me, they have special subscriptions and separate enters to special parts of web sites. I will write down them better and post for our group as soon as I can

Love Ivana

[Guest guest]

Poly,

Will do new page but as that involves taking my web off line it will not be

for a few days in the mean time do we have a link that I could put it up

under?

Lesia

[Guest guest]

Dear Poly, dear Lesia,

the very interesting article where I found AS grades is:

key words: intrauterine adhesions, reproductive problems, uterine trauma

Acta Obstet Gynecol Scand 2001; 80:986-993.

Submitted 18 Dec. 2000 Accepted 6 June 2001

"Intrauterine Adhesions An update - Hesham Al-Inany"

This is what it is written, as I told you I wasn't able to open it on Internet and I got it via traditional mail. It is very interesting, if you want and you have a fax number I can fax it to you.

Love - Ivana

[Guest guest]

Hi Ivana,

No, have you got the first email that you sent us showing the different

grades.

Many Thanks

Lesia

[Guest guest]

Hi,

OOOOOpps got it.

Thanks

Lesia

[Guest guest]

Lesia. I hope this is what you asked me!

Ciao Ivana

Dear Poly, dear Lesia,

the very interesting article where I found AS grades is:

key words: intrauterine adhesions, reproductive problems, uterine

trauma

Acta Obstet Gynecol Scand 2001; 80:986-993.

Submitted 18 Dec. 2000 Accepted 6 June 2001

" Intrauterine Adhesions An update - Hesham Al-Inany "

This is what it is written, as I told you I wasn't able to open it on

Internet and I got it via traditional mail. It is very interesting,

if you want and you have a fax number I can fax it to you.

Love - Ivana

---------------------------------

[Guest guest]

Poly, I hope this is the message you mentioned.... sorry I hadn't had

the time to write it down properly yet.

Ciao Ivana

Dear W,

AS grades are from European Society fro Hysteroscopy and settled in

1989:

I - Thin or filmy adhesions easly ruptured by histeroscope sheath

alone, cornual areas normal;

II - Singular firm adhesions connecting separate parts of the

uterine cavity, visualization of both tubal ostia possible, cannot be

ruptured by histeroscope sheath alone;

IIa - Occludina adhesions only in the region of the internal

cervical OS. Upper uterine cavity normal;

III - Multiple firm adhesions connecting separate parts of the

uterine cavity, unilateral obliteration of ostial areas of the tubes;

IIIa - Extensive scarring of the uterine cavity wall with amenorrhea

or hypomenorrhea;

IIIb - Combination of III and IIIa;

IV - Extensive firm adhesions with agglutination of the uterine

walls. Both tubal ostial areas occluded

Following Valle and Sciarra's table of 1988 classification is as

follows:

Mild- Filmy adhesions composed of basal endometrium producing

partial or complete uterine cavity occlusion;

Moderate - Fibromuscolar adhesions that are characteristically

thick, still covered by endometrium that may bleed on division,

partially or totally occluding the uterine cavity;

Severe - Composed of connective tissue with no endometrial lining and

likely to bleed upon division, partally or totally occludin the

uterine cavity.

Following Donnez and Nisolle (1994) classification as follows:

I - Central adhesions a) thin filmy adhesions (endometrial adhesions)

myofibrous (connective adhesions)

II - Marginal adhesions (always myofibrous or connective) a) wedge

like projection obliteration of one horn;

III - Uterine cavity absent on HSG a) occlusion of the internal os

(upper cavity normal) extensive coaptation of uterine walls

(absence of uterine cavity - true AS)

Hope this can helps

Ciao Ivana

---------------------------------

[Guest guest]

Lesia and Ivana,

It was the grades that I was looking for. If you can forward them to me, I can add them to the questionnaire.

Thanks

Poly