A 26-year-old woman develops secondary amenorrhea with cyclic lower abdominal pain six months after a dilation and curettage done for a missed abortion. Hysteroscopy reveals bands of fibrous tissue obliterating the uterine cavity. What is the most likely diagnosis?
- A Sheehan syndrome
- B Cervical stenosis with hematometra
- C Asherman syndrome ✓
- D Chronic endometritis
Correct answer: C. Asherman syndrome
Explanation
Aggressive postpartum or post-abortal curettage can denude the basalis layer of endometrium, producing intrauterine synechiae known as Asherman syndrome. It classically presents with secondary amenorrhea or hypomenorrhea with cyclical pain after uterine surgery, and hysteroscopy is both diagnostic and therapeutic. Sheehan syndrome causes amenorrhea through pituitary necrosis after obstetric hemorrhage and lacks adhesions, while isolated cervical stenosis spares the cavity itself.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.