Aetiology, clinical features and treatment outcome of intrauterine adhesion in Ilorin, Central Nigeria

Abstract

Background: Intrauterine adhesion is a cause of menstrual disorder and reproductive failure. It could be a long term sequelae of unsafe abortion which is a common reproductive health problem in developing countries. Objective: To determine the predisposing factors, mode of presentation and outcome of management of intrauterine adhesion in University of Ilorin Teaching Hospital. Methods: The record of patients with intrauterine adhesion newly diagnosed and managed in the Hospital over a five-year period was analyzed for their age, parity, predisposing factors, clinical presentation, methods of diagnosis and treatment outcome. Results: A total of 136 patients were newly diagnosed and managed for intrauterine adhesion during the period under review. This constituted 1.3 % of new gynaecological patients and 4.0% of consultations for infertility. Endometrial curettage on account of pregnancy complications accounted for 92 (67.6%) patients, and this was mostly for induced abortion. Hypomenorrhoea and secondary amenorrhoea were the commonest presenting menstrual abnormalities occurring in 48 (35.3%) and 53 (39.0%) patients respectively. Normal menstruation resumed in 99 (72.8%) patients following treatment. Conclusion: The incidence of intrauterine adhesion among gynaecological patients in this study is lower than those from previous reviews elsewhere in the country. However, dilatation and curettage for induced abortion still remains the commonest cause in our center. Measures to prevent unwanted pregnancy are needed and there should be increased advocacy for the use of manual vacuum aspiration for uterine evacuation procedures.